MedicosNotes.com

A site for medical students - Practical,Theory,Osce Notes

How to know which muscle is affected in Diplopia?

Diplopia is worse in the direction of action of the weak eye muscle.

Lateral rectus muscle weakness causes diplopia worse on looking to the side of the weak muscle and is worse at distance.

Medial rectus muscle weakness causes diplopia that is worse for near than for distance vision and is worse to the contralateral side.

Superior oblique weakness causes diplopia that is worse on looking downward to the side opposite the weak muscle and causes difficulty with tasks such as reading, watching television in bed, descending a staircase, and walking on uneven ground.

Yolk muscles work in unison, so that the images fall on corresponding parts of the retina. Diplopia indicates weakness of one of the yolk muscles.

For example : For looking to right side, the yolk muscles acting are right lateral rectus and the left medial rectus. On looking up and out to the right side, they are the right SR and left 10.

For Horizontal diplopia:
Find out whether diplopia is maximum to the right or left.
For example : if diplopia is maximum on looking to the left, it can be either left lateral rectus or right medial rectus (yolk muscles).
If the diplopia is worse on looking at far objects, it likely to left lateral rectus. If diplopia is more while reading (convergence), it is more likely to be right medial rectus.

For Vertical diplopia
Problems comes mainly with vertical diplopia. Vertical diplopia is caused by weakness of a depressor or elevator. If diplopia is worse in downgaze, the weak muscle is a depressor.
Either inferior rectus or superior oblique, if the diplopia is worse in upgaze, it is an elevator.
Either superior rectus or inferior oblique, If one image is tilted, then the weak muscle is more likely an oblique than a vertically acting rectus.

Related articles

  1. What are the History you should ask in Diplopia?
  2. What is Concomitant and Incomitant deviations in squint ?
  3. What are the causes of Horizontal and Vertical Diplopia
  4. Differential Diagnosis of Monocular Diplopia
  5. What are Beilchowski’s three step test ?
  6. How to find out which eye is producing the peripheral image in Diplopia?
  7. How to know which muscle is affected in Diplopia?
  8. What are the clinical approach that need to take care on diplopia History taking?
  9. What causes the Pathophysiology of misalignment?
  10. What causes binocular diplopia?
  11. What are the symptom of diplopia and how to diagnose diplopia ?
  12. Clinical approach to DIPLOPIA (Binocular and Uniocular)
Labels: , ,
: Posted at :

Labels

abdomen adrenal gland Anatomy anemia Anesthesia Anesthesiology angina antiplatelets AntiSeizureDrugs Aortic regurgitation Aortic stenosis apexbeat arrhthmia arthritis ascites Ataxia atrial septal defect Audio autoimmune disease Autoimmune_Encephalitis AutoimmuneEncephalitis Biochemistry blood supply of brain blood_supply built Capsular_Warning_Syndrome cardiac auscultation cardiac tamponade Cardiology Carotid_Artery_Disease Carotid_Stenosis CerebellarAtaxia cerebellum cerebral circulation cerebro vascular accident cerebrospinal cerebrovascular accident clinical sign clinical_examination ClinicalDecisionMaking ClinicalDiagnosis ClinicalMedicine ClinicalNeurology ClinicalTrials clubbing ClusterHeadache coarctation of aorta Cognitive_Decline collagen vascular disease congenital heart disease COPD coronary circulation coronaryheartdisease cranial nerve CranialNerves critical care CSF CSFLeak CTMyelography cvj Cyanotic heart disease dementia Dementia_Mimics dermatology diabetes DiagnosticAlgorithm dialysis Differential_Diagnosis DifferentialDiagnosi DifferentialDiagnosis diplopia drugs dwarfism Dyslipidemia ECG edema EEG electrolyte disturbance electrophysiology embryology EmergencyMedicine EMG endocrinology Epilepsy EpisodicAtaxia fever gastroenterology general examination Genetics graves disease hair examination headache HeadacheClassification heart heart failure heart murmurs heartmurmurs heartsounds height hematology hemo hemochromatosis hemolysis hemophilia hepatic encephalopathy hepatology higher mentalfunction history taking hyperkalemia hypertension HypertensionManagement hyperthyroidism hypokalemia ICHD3 iih infectious disease infective endocarditis insulin internal capsule Internal_Capsule Internal_Medicine InternalMedicine Intracerebral Hemorrhage involuntary movement iron defiency Ischemic_Stroke jaundice JME JVP kidney labour Lacunar_Stroke Laptop Lecture Notes LGI1_Antibodies Limbic_Encephalitis Limbic_System liver function test long qt lumbar puncture LumbarPuncture marfans syndrome MBBS MCA_Stroke MedicalEducation MedicalErrors MedicalHistory MedicalResearch MedicalStudentGuide medicine MedicosNotes Memory_Impairment Migraine MigraineCriteria MigraineMechanisms MigraineVsTTH mitral regurgitation mitral stenosis motor neuron disease MovementDisorders mrcp MRI musculoskeletal system myocardial infarction myotonia nail NASH Nausea nephrology Neurobiology neurocutaneous markers Neurogenetics Neuroimaging Neuroimmunology Neurological_Disorders neurology Neurology_Review NeurologyFlowchart NeurologyGuidelines NeurologyNotes neuroophthalmology NICE Guidelines note notes notes. nuerology nutrition Nystagmus obesity obstestrics ocularmovements oedema oncology opening snap oral cavity osce osteoarthirtis p parasternal heave parathyroid gland patent ductus arteriosus Pathophysiology PatientSafety PDA PDF PediatricNeurology percussion Pharmacology Pharmacotherapy physiology PKD ClinicalCases plague posterior circulation stroke PPT practical note practical notes practicalnotes Preventive_Cardiology primaryheadache PrimaryHeadaches protein pulmonary medicine pulmonology pulse radiofemoraldelay Radiology rare manifestations reflex respiratory system rheumatic fever rheumatology seizure sepsis short stature Silent_Brain_Infarction skin spinal cord SpontaneousCSFLeak Squint strabismus stroke Stroke Management Stroke_Medicine Stroke_Risk Stroke_Subtyping StrokeCare symptomatology Synovial joint tallstature temperature Therapeutics thrill thrombolysis thyroid thyrotoxicosis TIA TrigeminalSystem tuberculosis.infection urinary bladder usmle Valvular heart disease Video vitals monitoring vitals monitoring. VSD