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Intermittent Diplopia 

Intermittent Diplopia
Intermittent Diplopia

Matthew J. Thurtell

, and Robert L. Tomsak

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date: 25 January 2021

Intermittent diplopia is a common complaint that has a broad differential diagnosis. In this chapter, we begin by discussing the crucial role of the history in the evaluation of intermittent diplopia. We next review the differential diagnosis for intermittent diplopia, which includes conditions involving the eye, extraocular muscle, neuromuscular junction, cranial nerve, brainstem, and cerebellum. We emphasize the importance of distinguishing monocular diplopia from binocular diplopia when determining the appropriate diagnostic approach. We then review the symptoms, signs, pathogenesis, and diagnostic evaluation of superior oblique myokymia. We discuss practical strategies for detecting the ocular oscillations of superior oblique myokymia. Lastly, we review the medical and surgical management options for superior oblique myokymia.

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