Double Vision, Diplopia: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate diplopia (double vision):

  • Perceiving two images next to or on top of each other.

Warning signs (Red flags)

  • Anamnestic information:
    • Intoxications (poisonings), resulting in head injury → neurological monitoring required.
  • Acute diplopia → usually serious illness (e.g., warning signs of apoplexy/stroke).
  • Headache – think of: transient ischemic attack (TIA; sudden circulatory disturbance of the brain, which leads to neurological disorders that regress within 24 hours), apoplexy (stroke), brain tumor.
  • Intermittent diplopia (paroxysmal diplopia) → think of: Myopathy (muscle disease; e.g., myasthenia gravis (synonyms: myasthenia gravis pseudoparalytica; MG); rare neurological autoimmune disease, with characteristic symptoms such as abnormal load-dependent and painless muscle weakness, , typical eyelid elevator weakness, asymmetry, in addition to local also temporal variability (fluctuation) in the course of hours, days, resp. Weeks, an improvement after recovery or rest periods; clinically can be differentiated a purely ocular (“the eye concerning”), a faciopharyngeal (“the face (Facies) and the throat (pharynx) concerning”) emphasized and a generalized myasthenia; about 10% of cases already show a manifestation in childhood) or multiple sclerosis (MS).
  • Double vision occurring when looking down and in → think of: Paralysis of the trochlear nerve (IV cranial nerve).