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Diplopia charting
Strabismus
Key Points
- •Diplopia charting using the red glass test and Hess screen systematically identifies the paretic muscle - the false image is always the more peripheral image from the deviating eye
- •Parks 3-step test is the gold standard for localizing a paretic cyclovertical muscle - it narrows 8 possible muscles to 1 in 3 logical steps
- •Uncrossed (homonymous) diplopia indicates esotropia; crossed (heteronymous) diplopia indicates exotropia
- •Secondary deviation exceeds primary deviation in paralytic squint due to Hering's law - this is a key exam differentiator from restrictive strabismus
- •Microvascular CN palsies recover spontaneously in ~90% within 3–6 months; pupil-involving CN III palsy requires urgent neuroimaging
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations