Diplopia or ophthalmoplegia

DDx

  • Microvascular infarction, eg, diabetes, hypertension
  • Wernicke’s encephalopathy
  • Multiple sclerosis
  • Myasthenia gravis
  • Graves’ ophthalmopathy
  • Botulism
  • Internal carotid aneurysm or dissection
  • Posterior inferior cerebellar artery (PICA) aneurysm
  • Other mass compressing nerves to extraocular muscles
  • Brainstem infarct
  • Neurosyphilis
  • Systemic lupus erythematosus
  • Sarcoidosis
  • Pseudotumor cerebri
  • Muscle entrapment from orbital blowout fracture
  • Orbital cellulitis
  • Sphenoid sinusitis
  • Cavernous sinus thrombosis
  • Ophthalmoplegic migraine
  • Temporal (giant cell) arteritis
  • Tuberculous meningitis
  • Diphtheria
  • Progressive supranuclear palsy
  • Progressive external ophthalmoplegia (mitochondrial myopathy)
  • Other causes of cranial nerve palsy
Monocular diplopia (with one eye closed)
  • Refractive error
  • Early cataract
  • Lens dislocation, eg, Marfan syndrome, homocystinuria
  • Corneal opacity, eg, scar, pterygium

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Last updated: December 1, 2014