NEW
Font size
WorksheetsApproach To Diplopia
Total questions: 20
Worksheet time: 7mins
What is the definition of diplopia?
Painful eye movements
Rapid eye movement dysfunction
Blurred vision in both eyes
Perception of two images of a single object
Which of the following is the most common cause of monocular diplopia?
Cranial nerve palsy
Refractive error
Myasthenia gravis
Brainstem stroke
Binocular diplopia resolves when:
Looking at a near object
Either eye is closed
Both eyes are closed
Both eyes are opened
Which cranial nerve palsy is most likely in horizontal diplopia during abduction?
CN III
CN V
CN IV
CN VI
Vertical diplopia that worsens when reading or going downstairs suggests involvement of:
Superior rectus
Lateral rectus
Superior oblique
Inferior rectus
Which condition is suggested by variable diplopia and ptosis that worsens at the end of the day?
Myasthenia gravis
Diabetes
Thyroid eye disease
Brainstem stroke
Which investigation is commonly used to diagnose Myasthenia Gravis?
Tensilon test
Ice pack test
Schirmer's test
A 68-year-old man presents with vertical and horizontal diplopia, worse in left and downward gaze. He also has mild dysarthria and ataxia. Examination reveals left hypertropia and right internuclear ophthalmoplegia.
What is the most likely underlying diagnosis?
Orbital apex syndrome
Myasthenia gravis
CN IV palsy
Brainstem stroke
Park-Bielschowsky 3-step test is useful in
Diagnosing refractive error
Identifying weak extraocular muscle in horizontal diplopia
Evaluating monocular diplopia
Identifying weak extraocular muscle in vertical diplopia
Which of the following suggests restrictive eye movement disorder rather than paresis?
Reduced saccadic velocity
Fatigability
RAPD
Normal saccadic velocity
Oblique diplopia usually indicates:
Single muscle involvement
Multiple muscle/nerve involvement
Isolated CN IV palsy
Retinal disease
Which test uses alternating cover to detect latent deviations?
Visual acuity test
Pinhole test
Alternate cover test
Maddox rod
What does the Maddox rod test evaluate?
Visual acuity
Ocular deviation
Pupillary reflex
Tear production
Which of the following treatments provides immediate symptom relief for diplopia?
Ground-In Prism
Botulinum injection
Fresnel prism
Radiation therapy
A 70-year-old man complains of binocular diplopia. He recently experienced a mild head trauma. Examination shows hypertropia of the left eye that worsens with right gaze and right head tilt. Which is the muscle most likely involved?
Left superior rectus
Right superior oblique
Left superior oblique
Right superior rectus
A 28-year-old woman complains of blurred vision in the left eye only. Pinhole improves the vision. She has a history of high astigmatism. What type of diplopia does she have?
Binocular
Monocular
A patient reports diplopia only when looking far to the left. There is underaction of the left lateral rectus. Saccadic velocity is reduced. What is the likely cause?
Myasthenia gravis
CN VI palsy
Thyroid eye disease
Orbital mass
A 52-year-old patient with longstanding esotropia now complains of eye strain and diplopia. Cover-uncover test shows a manifest deviation.
This patient has developed:
Nystagmus
Tropia
Internuclear ophthalmoplegia
Phoria
A 35-year-old female with fatigue, ptosis, and diplopia has a positive anti-AChR antibody test.
What is the first-line treatment for symptom control?
Intravenous steroids
Plasmapheresis
Radiotherapy
Pyridostigmine
A 40-year-old male post-orbital trauma develops diplopia and cannot look up with the right eye. Saccadic velocity is normal. Forced duction test is positive.
What is the most likely mechanism?
Myasthenia gravis
CN III palsy
Mechanical restriction
CN IV palsy
