What is it about?

This article serves as a reference for non-ophthalmological clinicians, to assist with the diagnosis of the causes of this particular visual disturbance, also known as diplopia or double vision. The article focuses on the symptoms presenting only when both eyes are open.

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Why is it important?

It is important to be able to ascertain the reason behind this type of visual disturbance, as there are many sight and life threatening causes. As such, prompt diagnosis and treatment is required. We hope that this article enables readers to systematically work through a plan of history and examination of a patient that presents with double vision, and helps them develop a management plan so the correct investigations and referral to correct treatment team are instigated.


As a junior doctor, managing patients who are presenting with diplopia in an acute setting can seem a daunting prospect. This article provides a simple and systematic guide for practitioners to confidently assess patients. Through illustrated images, the specific examinations are explained with the relevant anatomy and clearly clarify why a sign might be elicited. The most likely causes of diplopia are also addressed and how each cause might present with other specific signs. Causes that need immediate escalation and further investigations are highlighted in the explanations.

Faaizah Chishty
Sherwood Forest Hospitals NHS Foundation Trust

Read the Original

This page is a summary of: What you need to know about assessing a patient with diplopia, British Journal of Hospital Medicine, March 2023, Mark Allen Group, DOI: 10.12968/hmed.2022.0055.
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