Violation of the visual work of diplopia. Syndromes in ophthalmology: diplopia. Double vision in both eyes. binocular diplopia

Diplopia is an ophthalmic pathology associated with double vision. Objects entering the field of view of a person appear double as a result of the deviation of the axis of one of the eyes. Such disorders can cause a number of causes of ophthalmological, neurological or infectious nature.

Causes of diplopia

The development of diplopia can provoke a shift in the orbit eyeball. It often leads to eye injuries, for example, infringement eye muscles caused by fracture of the wall of the orbit. The abnormal position of the eyeball is also caused by hematomas of the eye tissues.

Other possible reason diplopia - damage to the oculomotor nerve. It can be caused by an aneurysm carotid artery, intracranial tumors or meningitis of tuberculous etiology.

The causes of diplopia are also infectious processes that affect the brain stem with rubella, mumps, diphtheria or tetanus. Severe alcohol or drug intoxication can also cause diplopia.

Double vision or diplopia is often observed against the background of botulism, thyrotoxicosis, multiple sclerosis, or hysterical seizures. The cause of diplopia, as one of the types postoperative complications, can serve as manipulations on the eyes with surgical treatment retinal detachment, strabismus or cataract.

Symptoms of diplopia

The main complaint of patients with diplopia is double vision. In most cases, doubling of objects of the surrounding reality occurs when seeing with two eyes. This is how binocular diplopia manifests itself. Double vision can be partial and appear only in a certain area of ​​the visual field or complete. The manifestation of diplopia is also individual, depending on the distance of the objects in question. In some cases, doubling occurs only when looking at closely spaced or, conversely, exclusively at distant objects.

Two images of the same object that occur with diplopia have different brightness and contrast. One of them is usually slightly offset vertically as well as horizontally and is located at a certain angle to the second image.

Due to progressive diplopia, the patient loses work skills. It can be difficult for him to do housework, drive, and sometimes just get around. To restore the clarity of the image, a person with binocular diplopia has to close one of the eyes. For patients with another type of disease, monocular diplopia, this measure does not help.

Types of diplopia

Binocular diplopia is the most common form of double vision. With binocular diplopia visual picture both eyes is not projected in the corresponding points of the retina. The visual axis shifts, and a patient with binocular diplopia sees a double image of objects. binocular diplopia may be motor, sensory or mixed, permanent or temporary, neuroparalytic, orbital, trauma-induced, strabismus strabogenic, etc.

Monocular diplopia is a more rare pathology of double vision. Image violations in this case occur even with vision in one eye. Monocular diplopia results from the projection of the image simultaneously on two different points of the retina of one eye. Monocular diplopia is most often caused by subluxation or partial clouding of the lens. The cause of monocular diplopia may also be iridodialysis (tearing off the iris from the ciliary body as a result of eye injury) or polycoria ( congenital pathology structure of the iris with several holes).

Diagnosis of diplopia

The primary diagnosis of diplopia is established on the basis of the patient's complaints about double images. Further diagnosis of the disease continues with the help of test control over the vision of a person whose gaze is directed to a moving light source.

By mapping the coordinates of the resulting images, the doctor can diagnose which of the eye muscles is affected. More modern method determination of the damaged extraocular muscle of the eye - coordimetry using an OK ophthalmocoordimeter.

Diagnosis of diplopia also involves a mandatory assessment of the state of the position and mobility of the eyelids using a cover test. Additionally, the conjunctiva of the eyeballs is examined, visual acuity, refraction and color perception are checked.

Treatment of diplopia

Treatment of diplopia of a secondary type of neurological, infectious or ophthalmic etiology involves the treatment of the underlying disease.

Treatment of diplopia as the underlying disease is the responsibility of a neurologist or neurosurgeon. In the treatment of diplopia of a traumatic nature, an ophthalmologist surgeon performs resection or plastic surgery of the eye muscles. At the same time, surgery on the eye muscles is allowed, as a rule, only 6 months after the injury.

Optical correction of diplopia is carried out using prismatic glasses. They can significantly improve the clarity of the patient's vision. The optimal correction in the treatment of diplopia is 6 prism diopters for each eye.

AT rare cases glasses with higher prismatic compensation are allowed. Fresnel prisms can have a strength of up to 20 pr. diopters, however, even with compensation of 15 pr. diopters, they affect visual acuity and create an iris effect around visible objects.

Functional treatment of diplopia is to perform special exercises according to Kashchenko to restore abilities binocular vision and expanding the field of view, as well as exercises to merge objects using red glass, etc.

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The information is generalized and is provided for informational purposes only. Seek medical attention at the first sign of illness. Self-medication is dangerous to health!

Comments on the material (56):

1 2 3

Quoting Peter:

Good afternoon. After kidney surgery and bladder I took ciprofloxacin and levofloxacin, now I see a double image of objects. How to treat?

Quoting victoria:

Hello everyone, here are the facts: I had a sports injury 20 days ago. Immediately I saw double images. After hospitalization and CT, I was diagnosed with an orbital floor fracture that should be treated surgically using film. According to the doctor, the operation went well, nothing was pinched (nothing is visible), and the chances of recovery were pretty good. Now, fourteen days later, the diplopia is still there, right after I sleep, it takes me about an hour until I can "fix" my gaze. During the day, the effect of double vision is weakened, in the evening it increases again. In an open space outdoors, this double vision is especially annoying. Diplopia before the operation was noticeably less.
now my questions are:
- What is the probability of disappearance of diplopia?
- how long should I wait?
- Can you somehow counteract this?
- Is it possible that the tumor is still present inside after fourteen days and is causing diplopia?

Quoting Alex:

Hello. A week ago, I hit my eye and started seeing double. I went to the ophthalmologist, he said that the contusion of the eye. The question is whether diplopia will go away with concussion, and if so, after how long and whether it should be treated. (The doctor did not say how to treat exactly diplopia, he only said to drip drops).

1 2 3

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Diplopia is an ophthalmic pathology, manifested by dysfunction oculomotor muscles and bifurcation of the object at which the patient is looking. Translated from the Greek, “diploos” is double, and “opos” is an eye, i.e. this deviation implies a doubling of the image received by the eye.

In normal vision, an object is visualized clearly with both eyes. This image is obtained due to the formation in the brain general view one subject or another. With diplopia, the outlines of the object under consideration are bifurcated, and at the same time, the displacement of the visual axis of the eye can be vertical, horizontal or diagonal. The reason for such a bifurcation lies in the deviation of the eyeball and because of this, the visualization is not projected onto the central eye fossa, as is normal, but onto another area of ​​the retina.

Usually diplopia is not independent disease but a concomitant manifestation of some other disease. In some cases, this pathology is congenital. Why does diplopia develop? What are the varieties of this pathology? How is it manifested, diagnosed and treated? You will receive answers to these questions in this article.

The main reason for the development of diplopia is the displacement of the eyeball in the orbit. This condition of the organs of vision can be provoked by the following factors or diseases:

All of the above factors can lead to:

Forms of diplopia

If diplopia occurs, the doctor conducts a series of diagnostic measures and determines the form of visual deviation. Depending on the characteristics and causes that cause the pathology considered within the framework of this article, experts distinguish the following types of diplopia:

1. Binocular diplopia. This variety is most often detected by ophthalmologists. With it, the visual axes are not parallel, and the brain forms two pictures that seem to overlap each other. As a result, the object appears bifurcated. If the patient closes one eye, then the picture is visualized as single and clear.

Usually, such a pathology is detected when the position of the eyeballs is deviated from the norm. They are able to move up and down, get divorced to the sides, come down inward. With such violations of the normal position of the eyes, vision is not able to remain normal and the resulting image of the object begins to double.

It is characteristic that with strabismus in children, such a deviation from the norm does not occur, since baby brain can “remove” the image from the affected eye. This means that vision is actually carried out by one healthy eye. As a result, the child's binocular vision is impaired, but he is able to see relatively normally. In adults, strabismus almost always leads to diplopia and is characteristic of childhood adaptation is very rare. Binocular diplopia is also subdivided into strabogenic, motor, sensory orbital and mixed.

2. Monocular diplopia. Found infrequently. With this visual impairment, viewing an object leads to the fact that the image received by the brain is displayed immediately in two different parts of the retina. If the patient closes the other eye, then doubling does not disappear.

This form of diplopia can be caused congenital anomalies structure of the eye or traumatic lesions(for example, keratoconus, subluxation of the lens, etc.). Specialists distinguish between such varieties of monocular diplopia: retinal, aberrational, refractive, pupillary.

Doctors warn! Monocular diplopia is a sign of a serious disease and always needs a comprehensive diagnosis to identify the root cause of this visual impairment. This measure will allow you not to miss the time and start timely treatment dangerous illness.

Do not self-medicate, use our form to find a doctor:

Depending on how the bifurcation of visualization occurs, the following forms of diplopia are distinguished:

Diplopia may be temporary. Such a deviation of vision may be the result of a severe traumatic brain injury or concussion, taking toxic drugs, or alcohol intoxication. In a number clinical cases temporary diplopia is provoked by excessive fatigue of the oculomotor muscles. If after a certain period of time it does not resolve itself and causes sensations of pain and eye fatigue (for example, in case of injury spinal column or skull), then the patient needs to consult a doctor and undergo a comprehensive diagnosis, which allows to identify the cause and assess the condition of the organs of vision.

Sometimes referred to as diplopia strong-willed. This variety does not apply to pathological conditions, since the person independently controls the movements of the eyes (reduces them inward, turns them to the sides, etc.). Volitional diplopia is individual physiological feature and does not cause any inconvenience. This condition does not need treatment.

Symptoms

Usually, patients with diplopia during a visit to an ophthalmologist complain about the occurrence of doubling of the image of objects. Such a symptom is observed when a person looks at a particular object with both eyes. Thus, it “declares” its presence monocular diplopia. Double vision can be partial, complete, or double vision occurs only in a certain area of ​​the visual field.

The severity of diplopia is individual and depends on the distance at which the object in question is located. In a number of clinical cases, double vision occurs when looking at distant objects, and sometimes when looking at closely spaced things.

Pictures of the same object that appear during diplopia have varying degrees contrast and brightness. One of the images is usually shifted horizontally and vertically and is located at one angle or another to the other picture.

With the aggravation of the pathology, the patient loses his labor skills, it is difficult for him to perform some household work, manage vehicles and even move around. With binocular diplopia, the patient tries to close the eye in order to see the necessary object normally.

In addition to visual impairment, patients with diplopia complain of the occurrence of frequent episodes of dizziness. In some cases, this symptom disappears or weakens when one eye is closed or in a stationary position. Sometimes severe dizziness is complemented by a feeling of nausea.

In some cases, patients with diplopia cannot adequately control their movements when trying to put an object in the right place. They do not see the edges of the necessary object (for example, a table, cabinet, etc.), they can miss and drop the thing on the floor.

Other manifestations of diplopia are usually associated with the underlying cause of this vision pathology. These may be symptoms of meningitis, vascular pathologies, infections, injuries, oncological diseases etc.

Methods for the diagnosis and treatment of diplopia

Diplopia is diagnosed on the basis of the patient's complaints of double vision and analysis of data from a number of studies that confirm the dysfunction of one of the oculomotor muscles. To do this, the following procedures are performed:

If diplopia is accompanied by strabismus, then such diagnostic tests as diplopic projection and coordimetry.

Examination of the patient can be supplemented by ultrasound, CT and MRI. If necessary, the ophthalmologist appoints consultations with specialized specialists: a neurologist, rheumatologist, endocrinologist, oncologist, dermatologist, psychiatrist, neuro-ophthalmologist.

The method of treatment of diplopia is determined by the underlying disease that caused such visual impairment. If the cause of double vision lies in ophthalmic, neurological or infectious causes, then the patient is first offered therapy for the underlying ailment. Depending on the underlying cause of visual impairment, the patient may be recommended to remove the neoplasm (with a tumor process), remove (puncture) a hematoma, treat a stroke or underlying inflammatory, infectious, endocrinological or neurological disease.

Diplopia itself can be treated using the following techniques.

Diplopia is a visual impairment in which the image visible object doubled as a result of deviation of the visual axis of the eye. The cause of double vision is the deviation of the eyeball, as a result of which the image is projected not on the central eye fossa, but on another point of the retina.

Causes

Most often, diplopia occurs with paralysis or paresis of one of the oculomotor muscles.

Conditions that can lead to the development of diplopia:

• disorders that occur in the work of the central link of the visual analyzer - diseases affecting the cerebral cortex, pathways optic nerve;
• violations of muscle tone, which ensure the friendly work of the eyeballs, which leads to a displacement of one eye to the side or to a change in its mobility;
• pathological processes in the orbit, which lead to a change in the normal position of the eyeball;
• traumatic eye injury.

Symptoms of diplopia

The main signs of diplopia are as follows:

• double vision;
• difficulty in determining the location of objects;
• frequent dizziness.

The manifestations of the disease depend on the localization of the pathological process. With the defeat of the oblique muscles, doubling places the image of objects one above the other. If the rectus muscles are affected, parallel doubling appears.

Often, in order to get rid of double vision, the patient turns or tilts his head in the direction of the lesion.

The two images of an object that occur in diplopia usually differ in contrast and brightness. One of them is somewhat shifted vertically and horizontally, located at an angle to the second.

Diagnostics

Diagnosis of diplopia is based on the patient's complaints of double vision. During the examination, the doctor conducts a test control of the patient's vision with his directed gaze at a moving light source, maps the coordinates of the resulting images. This method allows you to determine the affected eye muscle.

AT modern medicine to establish the damaged eye muscle, coordimetry is used, which is carried out using an ophthalmocoordimeter.

Also, in the diagnosis of diplopia, a special cover test is used. It makes it possible to assess the position and state of mobility of the eyelids.

Additionally, the conjunctiva, refraction (refractive power of the eye), color perception, visual acuity are examined.

Types of disease

Diplopia is divided into binocular and monocular. The most common is binocular diplopia. Binocular diplopia can be of different forms:

• sensory;
• motor;
• mixed.

In rare cases, monocular diplopia develops. There are the following forms of monocular diplopia:

• refractive;
• aberrational;
• pupillary;
• retinal.

Patient's actions

Double vision may indicate serious illness therefore, when this symptom appears, it is necessary to consult a doctor (ophthalmologist, neuropathologist).

Treatment of diplopia

Treatment of secondary diplopia of infectious, ophthalmic or neurological etiology involves the treatment of the underlying disease. Treatment of diplopia as the underlying disease is carried out by a neuropathologist or neurosurgeon. In the treatment of diplopia of traumatic origin, an ophthalmologist surgeon takes part, who performs plastic surgery or resection of the eye muscles. Surgery on the eye muscles, as a rule, can be performed only six months after the injury.

If necessary, optical correction of diplopia is carried out using prismatic glasses, which can significantly improve visual clarity. Correction, which is 6 prismatic diopters for each eye, is considered to be optimal in the treatment of diplopia. In some cases, it is allowed to wear glasses with even more prismatic compensation.

Functional therapy of diplopia consists in performing a special set of exercises according to Kashchenko in order to restore the abilities of binocular vision, expand the field of view. Also recommended are exercises to merge objects with red glass and the like.

Complications

Diplopia can occur without other common or specific symptoms. Sometimes this disorder accompanied by pain in the eyes, increased fatigue eyes, headache, blurred vision. The appearance of these symptoms may indicate the development of a more serious disorder.

Prevention of diplopia

Prevention of diplopia involves the following activities:

• timely treatment inflammatory diseases nervous system;
• prevention of vascular accidents (level control blood pressure, blood sugar concentration, etc.);
• monitoring hormone levels thyroid gland in blood.

Diplopia is a disorder visual system, at which doubling occurs.

Pathology may be associated with deviation of the eyeball, as a result of which the image falls on the main part of the retina, and not on the fovea.

Diplopia always covers binocular vision, that is, if you close one eye, the doubling of the image will disappear. Depending on the type of disease, monocular diplopia occurs, but this a rare event, which is caused by trauma to the iris. The peculiarity of such an ailment is that when the second eye is closed, the doubling of the image does not disappear.

Is diplopia curable? What can be done to remove double vision?

A disease such as diplopia brings many inconveniences.

Many patients resort to folk methods, but this does not always positive result, because the disease is sometimes called various diseases and not just mechanical damage.

Diplopia is completely curable, but can cause various complications in the presence of chronic diseases that disrupt the visual system. Doctors advise at the first symptoms of pathology contact the clinic.

Feature of the treatment of the disease- combination efficiency folk methods and home gymnastics for the eyes on a par with surgical intervention. Each procedure is selected individually, depending on the cause of doubling.

Diagnostic methods

• Examination of the organs of vision patient after complaining of ghosting.
• Required blood analysis, which will point to possible diseases such as diabetes or myasthenia gravis.
• Prozerin test is a diagnostic method in which a special drug is administered ( Prozerin) to reduce the severity of diplopia and alleviate the patient's condition. Medicine fills the cells and creates a supportive effect in which the eye responds better to focusing.

• CT ( CT scan) and head MRI. Magnetic resonance imaging allows you to see the structure of the brain, identify possible violations(tumors, injuries or hemorrhages).
• In addition to consultation with an ophthalmologist and a neuropathologist, you will need an additional examination by a neurosurgeon.

The whole diagnosis of diplopia is to recognize the reasons that led the patient to this condition. It is necessary to take into account all the previous symptoms and pay attention to even minor details.

Important! Diplopia should be diagnosed only after complete examination of the patient and ancillary analyses.

How to get rid of the disease?

Diseases of various etiologies suggest therapy for the primary disease. This should be done by a neurosurgeon or a neuropathologist. If diplopia has arisen as a result of an injury, an additional consultation with an ophthalmologist will be required. The doctor determines the need for a plastic procedure for the eye muscles.

Surgical intervention allowed only after injury. During surgery, the muscle is shortened or moved back to compensate for the work of another muscle.

Applies and optical correction - improving the clarity of the patient's vision with the help of prismatic glasses ( up to 6 diopters. for each eye).

Most effective method therapy is considered set of exercises which aims to restore binocular vision. This exercise is easy to do at home.

Its essence is to draw a line on a piece of paper and attach the picture to the wall. The patient must keep the image in the field of view, while turning his head to the left and right. Focusing attention, the patient will adjust the work of muscles and learn to concentrate on one subject.

This exercise should be done daily. 2 to 6 times per different time days(Change in illumination also has a good effect on visual function). Such physical education is done with varying degrees diseases, and preventive purposes to improve visual acuity. Distance from leaf from 50 cm, gradually increase it.

Kashchenko exercises: what is it

There is a set of exercises developed by T. P. Kashchenko, the essence of which is to work with prisms. It includes three main steps:

• excitation of diplopia;
• the formation of bifixation - a reflex that provides an opportunity to connect bifurcated images;
• consolidation of this reaction.

For each of these stages, there are separate exercises that must be carried out in medical institution under the supervision of an ophthalmologist.

T. P. Kashchenko developed a method mergers images using binocular images.

This method is in the connection of successive figures, which contain the same elements and belong to both the right and left eyes. The author of the method is confident that the merging of images that appear in sequence can form a single image.

For prevention diplopia necessary:

• treat everything inflammatory processes that are associated with the nervous system;
• timely take a blood test and keep sugar levels under control;
• to not allow sharp increase blood pressure;
• keep a close eye on hormonal system and hormone levels.

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Binocular and monocular diplopia. How to treat these forms of the disease?

binocular diplopia- the most common type of disease that requires treating the cause of the disorder. The therapy is aimed at developing a reflex of connecting images when doubling the image.

Monocular diplopia occurs in rare cases. Reasons for the appearance of the disease - cataract, glaucoma or astigmatism. Treatment is aimed at eliminating the primary disease. Often the symptoms are removed only partially.

If astigmatism is thought to be the cause of monocular diplopia, the patient may be advised to corrective lenses.

Photo 1. This is what an eye with monocular diplopia looks like. The cornea is irregularly shaped, resulting in an incorrect focus on the retina.

If the problem is due to a cataract, you will need surgical intervention to eliminate pathology.

How to cure a disease in children

Diplopia occurs in babies due to poor mobility of the eyeballs, there are cases of temporary malaise after viewing movies in 3D. Symptoms are difficult to recognize, parents should pay attention to how the child behaves and ask him about how he sees various objects.

Attention! Very often, children do not feel changes and may neglect the symptoms of diplopia. If the child often squints, his eyes look at the object from different angles, parents should consult a specialist.

Defects and disorders of nerve fibers can be eliminated as far as possible. To do this, the neurologist must establish connection between visual function and brain work. Usually such treatment and additional exercises can completely eliminate the disease in a child. If a teenager develops monocular diplopia, this often means early stage cataracts. In such cases, treatment is carried out with the help of surgery.

In fact, diplopia occurs when the focus of the image of the object in question is not on the central fovea of ​​the retina of the affected eye, but on any other part of it.

Classification

Depending on whether this disorder is caused by a lesion of only one eyeball or becomes a vision disorder with two eyes, there are:

• monocular diplopia is a rare variant of the disorder that develops against the background of an eye injury with detachment of the iris, the formation of two false pupils, or subluxation of the lens. With such diplopia, even when closing the unaffected eye, doubling of objects does not disappear
• binocular diplopia is a common variant of the disorder that occurs against the background of damage to the oculomotor muscles, pathology of the tissues surrounding the eyes (hematomas, suppuration of the retrobulbar tissue), diseases of the nervous system

In this case, diplopia disappears as soon as one eye is turned on from the act of vision (closed by hand or closed)

Causes

All conditions that can potentially lead to the development of diplopia are divided by ophthalmologists and neuropathologists into:

• disorders that occur in the work of the central link of the visual analyzer - pathological processes affecting the cerebral cortex and the pathways of the optic nerve
• violations of the tone of the muscles that ensure the friendly work of the eyeballs - these conditions can lead to a displacement of one eye away from the central axis or to a change in its mobility
• pathological processes that occur in the orbit - they lead to a change in the normal position of the eyeball
• eye injury.

Among all these causes, most often diplopia is provoked by neurogenic and muscular diseases, leading to the development of paresis or paralysis of the oculomotor nerves - in this case, friendly and coordinated eye movement is disturbed.

These diseases include myasthenia gravis (severe muscle weakness) or multiple sclerosis(a pathology in which the destruction normal structure nerve fiber disrupts normal transmission nerve impulse along nerve fibers).

Much less often, diplopia can develop against the background of:

• injuries facial skull accompanied by a fracture bottom wall eye sockets and concomitant infringement of the oculomotor muscles
• tumor processes localized in the region of the facial skull and accompanied by germination of the walls of the orbit, limitation of mobility, and then complete fixation of the eye on the side of the lesion
• head injuries complicated by damage to the oculomotor nerve
• violations of the structure and pathology of blood vessels (aneurysms of the internal carotid artery), leading to infringement of the oculomotor nerve
• diseases of the soft tissues of the orbit - hematomas, suppuration

In addition, it must be remembered that the appearance of signs of diplopia may indicate damage to the structures of the brain stem - the departments in which the nuclei of the cranial nerves responsible for eye movements are located.

In this case, it is necessary to comprehensive examination, which will allow you to confirm or refute the presence of infections in the patient that affects the central nervous system (rubella, mumps, diphtheria, tetanus, botulism), brain stem tumors, various intoxications (including drug and alcohol).

Possible development of diplopia (double vision) against the background of a severe course endocrine diseases thyrotoxicosis and diabetes mellitus.

Transient diplopia can be one of the symptoms of hysteria, hysterical psychosis and other mental illnesses.

Symptoms of the disease

The most frequent complaints that make the patient seek qualified medical care, become:

• double vision - persistent, not going away for a significant period of time
• development of severe and prolonged dizziness
• violation of normal orientation in space, due to the inability to correctly assess the location of objects

Depending on how binocular vision is impaired, the doctor can make an assumption about which of the groups of oculomotor muscles is affected in the patient:

• with damage to the rectus muscles, objects are located parallel
• with damage to the oblique muscles, objects are located one above the other

In the process of examining the patient, a deviation of the eye towards healthy, normally functioning muscles (away from the affected) is always found. There is also a pronounced limitation or complete absence movement of the eyeball in the direction of damage, as well as forced position the head or its rotation in the direction of the lesion, helping to get rid of double vision or reduce it.

Diseases in which damage to the central nervous system is possible can also be accompanied by diplopia, but in this case, impaired binocular vision clearly fits into clinical picture diseases - with botulism, this symptom occurs as one of the first manifestations of infection, while in patients suffering from rubella, diphtheria and mumps - only with severe course and in the midst of illness.

Treatment of diplopia

Modern options for the treatment of diplopia depend on the timely recognition of this condition and effective therapy diseases of which it has become a symptom.

When infections of the central nervous system (botulism, tetanus, diphtheria, meningitis) are detected, the development of diplopia is warning sign and the patient should be immediately hospitalized in the infectious disease department to clarify the diagnosis and prescribe the necessary treatment.

In case of head injuries (directly to the facial skull), the patient needs to be hospitalized in the department maxillofacial surgery or neurosurgery multidisciplinary hospital, while if a fracture of the base of the skull is suspected - in the traumatological or neurosurgical department.

In cases where diplopia develops after an eye injury or when accurate diagnosis damage to the oculomotor muscles, the question of the place and possibilities of treatment should be decided by an oculist or neuropathologist - hospitalization in an ophthalmological or neurological department may be required, or ambulatory treatment doctors of the specified specialties.

Every person who has developed diplopia, and his relatives, need to remember that this seemingly harmless symptom can be the first sign serious illness or bodily injury.

Therefore, the patient needs an immediate consultation with a qualified doctor and a complex additional research, which will help clarify the nature of diplopia and the reasons for its development - only after that it is possible to prescribe treatment.