[Clinical picture and treatment of diplopia].

A total of 203 patients with stable binocular diplopia were observed. Examinations included coordimetry, analysis of double images, and investigation of the doubling field in the gaze field. All examinations were performed using an original method with a serial computer. The treatment included therapy of the underlying disease, choice of correcting prisms, exercises aimed at extension of separate vision field, and operation on the oculomotor muscles. Three main forms of diplopia were distinguished: 1) muscular; 2) sensory; and 3) mixed. The first form includes diplopias in paresis of n.III and n.IV, n.VI, late development of convergent squint, orbital injuries, endocrine ophthalmopathy, and myasthenia. The second form includes diplopias developing after delayed operations for convergent squint, and the third form are diplopias after operations for detachment of the retina and implantation of intraocular lenses. The treatment led to complete neutralization of doubling in 18.7% cases, neutralization in the main part of the gaze field in 53.7%, the same with prism correction in 12.8% cases; in 14.8% patients adaptation to diplopia was attained after suppression of the second image. Diplopia in late squint is prognostically the most favorable, and the following conditions are listed in the order of more or less good prognosis: paresis of n.VI, n.IV, orbital injuries, endocrine ophthalmopathy, and artiphakia. The least favorable prognoses are for patients after delayed operation for squint and detachment of the retina. A new operation, plastic repair of the external m. rectus, was used in 96 patients with pareses of n.VI; no compensation was attained in only 2 patients.