Rucker Janet C, Tomsak Robert L
Department of Neurology and Ophthalmology, Case Western Reserve School of Medicine, Cleveland, Ohio 44106, USA.
Neurologist. 2005 Mar;11(2):98-110. doi: 10.1097/01.nrl.0000156318.80903.b1.
Diplopia is a common complaint in both inpatient and outpatient neurologic practice. Its causes are many, and special historical and examination features are important to localization and accurate diagnosis.
This review is divided into 2 sections: the first related to diagnosis and the second to treatment of binocular diplopia. In the diagnostic section, emphasis is placed on identification of historical and examination features that can help to differentiate diplopia caused by dysfunction of cranial nerves versus neuromuscular junction, or orbital extraocular muscle. Techniques available to the neurologist for examining ocular motility and ocular misalignment and focused laboratory testing to evaluate diplopia are discussed in detail. The final section covers the various treatments for binocular diplopia, with recommendations regarding the utility of each treatment for different types of diplopia.
A logical step-by-step approach applied to each patient with diplopia will help prevent misdiagnosis and improve patient care.
复视是住院和门诊神经科常见的主诉。其病因众多，特殊的病史和检查特征对定位及准确诊断很重要。
本综述分为两个部分：第一部分与双眼复视的诊断相关，第二部分与治疗相关。在诊断部分，重点在于识别有助于区分由颅神经功能障碍、神经肌肉接头或眼眶眼外肌功能障碍引起的复视的病史和检查特征。详细讨论了神经科医生用于检查眼球运动和眼球偏斜的可用技术以及评估复视的针对性实验室检查。最后一部分涵盖了双眼复视的各种治疗方法，并针对每种治疗方法对不同类型复视的效用提出了建议。
对每位复视患者采用合乎逻辑的逐步方法将有助于防止误诊并改善患者护理。
