Diplopia is a disease of the visual system, which is characterized by impaired functioning of the oculomotor muscles, leading to a bifurcation of the visible image. In this case, the image shift can be vertical, horizontal and even diagonal.
Some information
A person with normal vision sees an object clearly with both eyes. This mechanism works well by creating a common image in the brain. And diplopia is a phenomenon in which the patient sees two pictures of one whole. Usually this pathology does not exist independently, but accompanies any disease. In addition, cases of congenital diplopia are known.
Disease types
There are several varieties of this pathology:
- Binocular diplopia is characterized by the lack of quality images on the retina. This is due to the displacement of the visual axis of one of the eyes. This variety is subdivided into sensory, strabogenic, motor, orbital, mixed disease. With this type of pathology, when one eye is closed, the image stops double.
- Monocular diplopia, which is characterized by the display of the image seen by one eye, simultaneously in two places of the retina. Usually this phenomenon occurs due to the inflammatory process in the iris or fogging of the lens. If you close the other eye, double vision with this type of diplopia will not disappear.
- Paralytic pathology develops due to paralysis of one or more eye muscles.
- Cross view, in which the image is projected crosswise. In other words, the picture that belongs to the right eye is visible to the left, and vice versa. Such a pathology causes maximum discomfort in a sick person.
Types of the most common disease
Regarding varieties of binocular diplopia:
- strabogenic pathology develops in patients with different forms of strabismus;
- orbital may appear after surgery on the visual organs;
- restrictive occurs against the background of eye injury along with stiffness of the motor muscles or a change in the normal location of the apple.
Clinical picture
First of all, diplopia is a consequence of myasthenia gravis. It arises due to various failures of the main parts of the visual system and disorders of muscle balance of various nature. This pathological condition leads to a decrease in the mobility of the organ or to a lateral movement of the eye. In addition, diplopia can be caused by pathological changes occurring in the orbit, causes of a neurogenic nature.
The disease develops with myasthenia gravis or paralysis of the eye muscles responsible for the movement of the visual organ. In this case, the consistency of the eyeballs is lost. In addition, in some cases, diplopia is a sign of injury to the nerves that are responsible for the functioning of the muscles.
Risk groups
Among other things, there are several more common causes of diplopia:
- various hematomas and tumors that interfere with eye mobility or lead to complete paralysis;
- cornea inflammation - an untimely cured disease can lead to complications such as damage to muscles and nerves;
- diabetic neuropathy is one of the complications of diabetes that can occur in patients who are ill for a long period;
- disorders of the thyroid gland and the endocrine system as a whole;
- displacement of the orbit due to destructive processes inside;
- Increasing the dosage of cosmetic Botox can lead to neuromuscular conduction;
- trauma to the orbit, which often occurs after damage to the lower border of the eye or pinched muscles;
- dilation of the carotid artery, which as a result pinches the nerve;
- vegetovascular dystonia can lead to an idiopathic form of diplopia, in which case the disease lies in psychological problems;
- trauma to the skull that destroys the oculomotor nerve.
Comorbidities
In addition, diplopia can be the result of other serious pathologies:
- Neoplasms inside the skull, tuberculous meningitis, stroke, multiple sclerosis and other neurological diseases.
- Severe intoxication due to the use of alcohol or medicines.
- Botulism, which is caused by damage to the nervous system to cause symptoms similar to weakening of the eye muscles.
- Diphtheria, rubella, tetanus, mumps are pathologies that injure the brain stem and affect the central nervous system.
- Thyrotoxicosis, due to which the muscles of the eye swell and movement becomes difficult.
- Diabetes mellitus, in which the disease is secondary and resolves on its own with a risk of relapse.
- Surgical intervention in the brain, which was performed to eliminate cataracts, strabismus, retinal detachment.
- Psychic neuroses and tantrums.
Sometimes even perfectly he althy people have double vision when looking at objects due to lack of sleep, too hard physical or intellectual work, temporary intoxication of the body.
Symptoms
The signs of the disease appearing depend on where exactly the failure occurred. For example, if the oblique muscles are injured, then bifurcation occurs as the placement of one object on top of another.
In case of damage to the rectus muscles, diplopia will take on a parallel character. In general, this pathology is characterized by various stages of deviation of the eyes inthe side opposite the injured tissue.
As a result, there is a restriction of movement or even its complete absence. Often, patients are forced to tilt or turn their head in order to somehow deal with discomfort.
Among the most common symptoms of diplopia are:
- actual split image;
- difficulties in locating objects;
- regular dizziness.
Features
Two identical pictures can differ significantly in saturation and contrast. One image can move vertically or horizontally and be placed at a certain angle relative to the second.
With meningitis, skull injuries, infectious diseases, tumors, pathologies of the vascular system, the symptoms of diplopia will be combined with the signs characteristic of these diseases. In the case of diphtheria, bifurcation can occur at the peak of the disease. If we are talking about botulism, then diplopia will be one of the initial symptoms.
Diagnosis
Any patient can be diagnosed with double vision only in a specialized ophthalmological center. Diagnostics is necessary to determine the localization of the failure, detect the causes of the pathological condition and further prognosis. This disease has a strong effect on:
- the eye itself;
- nerve;
- auxiliary eye apparatus;
- brain.
Diagnosisinvolves the implementation of classical manipulations in the form of visiometry and ophthalmoscopy. In addition, a thorough examination of the conjunctiva, contrast perception, analysis of the refraction of light rays and visual acuity is performed. After all these manipulations, the specialist listens to the complaints of the patient himself.
Auxiliary examinations are performed using MRI, CT and ultrasound. If necessary, the doctor can give the patient a referral for a consultation with other specialists: an oncologist, a rheumatologist, a dermatovenereologist, a neuro-ophthalmologist, a psychiatrist, an endocrinologist, a neurologist.
If the patient has strabismus, diplopia of the eye is diagnosed by provocation and coordimetry. These techniques involve testing the visual acuity and quality of vision. The patient must look at the moving light source for some time. The resulting image is transferred to a special map of coordinates. In this way, the specialist gets the opportunity to determine the lesion of a particular muscle.
How and where to treat diplopia
A patient who has been diagnosed with this should understand that such symptoms can immediately lead to serious illnesses and complications. And in order to avoid possible problems, it is urgent to seek help from a specialist.
Therapy for such a disease is aimed at eliminating the cause of its occurrence. The treatment itself is performed on an outpatient basis, under the supervision of a qualified ophthalmologist in a specialized ophthalmological center. There are several effective therapies:
- Elimination of volumetric pathologies in the orbit - for example, puncture of a hematoma, as well as removal of neoplasms.
- Treatment of stroke, as well as all sorts of neuropathic and neurological failures.
- Treatment of inflammatory and infectious pathologies with diuretics, anti-inflammatory drugs and antibiotics.
- Treatment of the underlying disease - correction to restore the full functioning of the optic nerve.
- If the cause of the disease lies in intoxication, the first step is to cleanse the entire body.
- The occlusion technique is used when several nerves are affected simultaneously. This method involves the failure of one eye. The specialist offers the patient special contact lenses or sticking a special tape on glasses.
- Prismatic therapy to reduce the manifestations of pathology. In this case, the specialist prescribes the use of special glasses made to order, which have a lens shifted in the middle. In addition, 6 prism diopters are often used for each eye.
- Surgery. Such an operation involves shifting the damaged muscle a little back, and the crossed tendon is sutured to the sclera. In some cases, the tissue is shortened slightly to compensate for the functioning of other organs.
Therapeutic gymnastics
Exercises for the eyes with diplopia. This is a special gymnasticsaimed at increasing the field of view and its stabilization. Effective exercises can be done at home.
To do this, you need to fix a piece of paper on the wall, after drawing a strip on it. Then you should fix your eyes on this line, while turning your head in opposite directions.
The purpose of such gymnastics is to keep the picture intact. This exercise is effective only with incomplete manifestation of pathology. If the patient is diagnosed with "sensory diplopia", he needs to combine the two strips into one picture.
Traditional medicine
Treatment of diplopia may involve more than traditional methods. Folk recipes in the fight against manifestations of pathology turned out to be no less effective:
- Tincture based on white wine, dry valerian and lavender leaves. These ingredients must be mixed and infused for at least three days. Dishes with liquid should be shaken periodically. After the product is ready, it remains only to strain. The tincture should be consumed about half an hour before meals, one spoon daily.
- Flower pollen is also famous for its healing properties. For a month, you should take a teaspoon of this substance in the morning and evening.
- Vitamin fees. Such a medicine must be taken constantly. Tincture can be made from rose hips and viburnum, for example. The components in equal quantities must be poured with water and boiled for 15 minutes over low heat. After cooling, the liquid must be filtered. Use the product should be 100 ml twice a day.
Prevention of diplopia
This disease has an unpredictable prognosis, so preventive measures in this case can only be of a general strengthening nature. You can minimize the risk of diplopia if:
- get rid of all kinds of bad habits, such as smoking tobacco or drinking alcohol;
- lead an active lifestyle - walk, workout, exercise every day;
- observe the correct mode - sleep should last at least eight hours;
- systematically undergo all necessary examinations;
- constantly monitor blood pressure;
If you experience the slightest symptoms, you should immediately contact a specialist.
