Diplopia ddx

BINOCULAR DIPLOPIA

VASCULAR

  • Microvascular infarction (diabetes, HTN)
  • Internal carotid aneurysm or dissection
  • PICA aneurysm
  • Cavernous sinus thrombosis
  • Brainstem infarct

INFECTIOUS/AUTOIMMUNE

  • Multiple sclerosis
  • Myasthenia gravis
  • Graves' ophthalmolpathy
  • Botulism
  • Neurosyphilis
  • Systemic lupus erythematosus
  • Sarcoidosis
  • Orbital cellulitis
  • Sphenoid sinusitis
  • Temporal arteritis
  • Tuberculous meningitis
  • Diphtheria
NEUROLOGIC
  • Wernicke's encephalopathy
  • Mass compressing nerves to extraocular muscles
  • Pseudotumor cerebri
  • Ophthalmocataract
  • Ophthalmoplegic migraine
  • Progressive supranuclear palsy
MUSCULOSKELETAL
  • strabismus
  • muscle entrapment (orbital blowout fracture)

MONOCULAR DIPLOPIA
  • Refractive error
  • Early cataract
  • Lens dislocation 
  • Corneal opacity (scar, pterygium)