Assessment of diplopia in adults
### What you need to know Double vision, or diplopia, may be the first sign of sight or life threatening pathology. A thorough, accurate first assessment is important for determining the clinical urgency of related pathology and ensuring timely management. Whether diplopia is monocular or binocular will help identify aetiology and determine the urgency of management. Ensure double vision is distinguished from blurred vision (when a patient sees a single image that appears unclear), which has many other distinct causes. In diplopia, the second image may appear fainter as a “ghost” image. Monocular diplopia refers to double vision originating solely from one eye. This will persist when the patient is asked to cover the other, unaffected eye and suggests an intraocular pathology. Differentials for monocular diplopia include refractive error, dry eye syndrome, corneal pathology, cataract, and non-urgent retinal pathology. In such cases, a routine optometrist or ophthalmology referral is ap