A patient presents with a complaint of diplopia. “I’ve been seeing double since last night. It started after I woke up from a nap”
Patients who present with diplopia following trauma require straightforward imaging. There is usually damage to one of the cranial nerves, either CN IV or VI.
What if there is no trauma? I have a 5 step method I use to diagnose patients with diplopia.
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The steps are:
Is it Monocular or Binocular Diplopia?
Is there any other Neurology?
If Binocular and no other neurology test CN III, IV and VI.
Look for papilloedema
Check what medications the patient is on