Wydanie 1/2011
str. 29

Podwójne widzenie w przebiegu zaburzeń równowagi mięśniowej – przyczyny i diagnostyka

Diplopia in the Course of Muscle Imbalance – Aetiology and Diagnosis

Anna Zamłyńska, Lidia Ludwisiak-Kocerba, Agnieszka Samsel, Dariusz Kęcik

Katedra i Klinika Okulistyki I Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego
Kierownik: dr hab. n. med., prof. ndzw. Dariusz Kęcik

Summary: Binocular vision results from precisely aligning both eyes on an object of regard; the images fall on the fovea of both eyes and image orientation on corresponding retinal areas causes cortical processing which results in fusion of two images. Double vision is a result of separate images from each eye, as when the visual axes are not aligned. The patient with diplopia will fixate on an object with one fovea, and see a diplopic image of that object that comes from the perifoveal retina of the deviated eye. Diagnosis should reveal the reason for diplopia and assess the amount of disturbances. It is crucial to exclude physiological diplopia and other causes of false diplopia. Ophthalmological examination should assess: visual acuity, pupils, anterior and posterior segment of the eye, eyes position, versions and force ductions, examination with streak of light, binocular vision examination, Hess-Lees chart, abnormal head posture. EMG, ultrasonography, MRI and CT of the orbit and central nervous system may be very helpful. Investigations for neurological disorders (especially vascular or neoplastic), vascular and metabolic conditions, endocrine problems, orbit disorders, trauma, complications after ocular and orbit surgery are guided by clinical findings. Diplopia work up is an interdisciplinary problem and the aim of the ophthalmology examination is to determine direct mechanism leading to muscle balance disturbances.

Słowa kluczowe: podwójne widzenie, etiologia, badanie okulistyczne, trudności diagnostyczne.

Keywords: diplopia, aetiology, ophthalmological examination, diagnostic difficulties.


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