93. Acute-Onset Double Vision

  1. Christopher P. Holstege MD2,3,4,
  2. Alexander B. Baer MD2,5,
  3. Jesse M. Pines MD, MBA, MSCE6,7 and
  4. William J. Brady MD8,9,10
  1. Chris S. Bergstrom MD, OD1 and
  2. Alexander B. Baer MD2,5

Published Online: 3 AUG 2011

DOI: 10.1002/9781444397994.ch93

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

How to Cite

Bergstrom, C. S. and Baer, A. B. (2011) Acute-Onset Double Vision, in Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition (eds C. P. Holstege, A. B. Baer, J. M. Pines and W. J. Brady), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444397994.ch93

Editor Information

  1. 2

    Division of Medical Toxicology, University of Virginia School of Medicine, Charlottesville, VA, USA

  2. 3

    Blue Ridge Poison Center, University of Virginia School of Medicine, Charlottesville, VA, USA

  3. 4

    Departments of Emergency Medicine & Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

  4. 5

    Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA

  5. 6

    Center for Health Care Quality, George Washington University, Washington, DC, USA

  6. 7

    Departments of Emergency Medicine and Health Policy, George Washington University, Washington, DC, USA

  7. 8

    Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA

  8. 9

    Center for Emergency Management, University of Virginia Health System, Charlottesville, VA, USA

  9. 10

    Charlottesville-Albemarle Rescue Squad & Albemarle County, Fire Rescue, Charlottesville, VA, USA

Author Information

  1. 1

    Department of Ophthalmology, Emory University, Atlanta, GA, USA

  2. 2

    Division of Medical Toxicology, University of Virginia School of Medicine, Charlottesville, VA, USA

  3. 5

    Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA

Publication History

  1. Published Online: 3 AUG 2011
  2. Published Print: 12 AUG 2011

ISBN Information

Print ISBN: 9781444333473

Online ISBN: 9781444397994

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Keywords:

  • Case 93, acute-onset double vision;
  • 47-year-old female, with complaints - of acute retrobulbar pain, and left lid droop;
  • patient, reporting - that when she holds her eyelid open, of having a double vision;
  • past medical and ocular history - negative for hypertension and diabetes;
  • no medications taken;
  • physical examination, revealing - complete ptosis of left upper lid;
  • manually, lifting eyelid - left eye, with an outward deviation;
  • extraocular muscles, marked reduction - in adduction and elevation, left globe depression;
  • pupillary testing, and marked anisocoria - right pupil 3 mm and left pupil 8 mm;
  • most likely cause of patient's physical examination findings