Acierno M D
Department of Ophthalmology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Semin Neurol. 2000;20(1):21-30. doi: 10.1055/s-2000-6830.
The diagnosis of an acquired vertical strabismus is not always straightforward. There is no one specific test that will diagnose a vertical deviation. The clinical presentation, signs, and symptoms are the driving forces that will help lead to the correct diagnosis. Patients with binocular vertical diplopia may have symptoms of recent onset or that have been long-standing. Others may not even be completely aware that their ocular symptoms are attributable to a doubled vertical image. The differential diagnosis for vertical diplopia includes oculomotor nerve palsy, superior oblique palsy, restrictive ophthalmopathies, myasthenia gravis, and skew deviation. This differential diagnosis is best used to sort out signs and symptoms in a patient with a vertical misalignment and diplopia. Because most clinicians feel more comfortable addressing the patient with complaints of horizontal diplopia, this paper will discuss the causes of vertical diplopia so that recognition will be easier, thus leading to more accurate diagnoses.
后天性垂直斜视的诊断并非总是一目了然。没有一种特定的检查能诊断垂直偏斜。临床表现、体征和症状是有助于得出正确诊断的关键因素。双眼垂直复视的患者可能有近期发作的症状，也可能是长期存在的症状。其他人甚至可能根本没有完全意识到他们的眼部症状是由垂直图像重影引起的。垂直复视的鉴别诊断包括动眼神经麻痹、上斜肌麻痹、限制性眼病、重症肌无力和斜视偏差。这种鉴别诊断最适合用于梳理有垂直斜视和复视患者的体征和症状。由于大多数临床医生更擅长处理有水平复视主诉的患者，本文将讨论垂直复视的病因，以便更容易识别，从而得出更准确的诊断。
