University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Semin Neurol. 2010 Feb;30(1):54-65. doi: 10.1055/s-0029-1244995. Epub 2010 Feb 1.
Double vision may arise from ocular, neurologic, or extraocular muscle disorders. The approach to patients with diplopia requires a systematic approach to the history and the physical examination. There are many challenges in the evaluation of diplopia, ranging from the patient's mental status to the fine points of the examination. This article provides a process for interviewing and examining these patients, explaining the rationale and differential diagnosis of various clinical presentations. Common causes of monocular and binocular diplopia are addressed by the pattern of diplopia described by the patient. The examination and the interpretation of examination findings are presented by incorporating the "upside-down-and-backwards" concept. This review offers some Pearls-perhaps even diamonds-on evaluating patients who complain of diplopia, as well as those who have eye movement abnormalities but can't articulate their symptoms.
复视可能由眼部、神经科或眼外肌疾病引起。对复视患者的处理需要采用系统的方法来了解病史和进行体格检查。在评估复视时存在很多挑战，包括患者的精神状态和检查的细微之处。本文提供了一个访谈和检查这些患者的流程，解释了各种临床表现的基本原理和鉴别诊断。通过患者描述的复视模式来解决单眼和双眼复视的常见原因。通过整合“上下颠倒向后”的概念来呈现检查和解释检查结果。本文综述了评估抱怨复视的患者以及有眼球运动异常但无法表达其症状的患者的一些要点，也许甚至是钻石级的要点。
