Nonsurgical management of binocular diplopia induced by macular pathology

Mark Silverberg, Eileen Schuler, Suzanne Veronneau-Troutman, Kenneth Wald, Abraham Schlossman, Norman Medow

Research output: Contribution to journalArticle

32 Scopus citations


Objective: To treat binocular diplopia secondary to macular pathology. Methods: Seven patients underwent evaluation and treatment. All had constant vertical diplopia caused by various maculopathies, including subretinal neovascularization, epiretinal membrane, and central serous retinopathy. Visual acuity ranged from 20/20 to 20/30 in the affected eye. All except 1 patient had a small-angle, comitant hyperdeviation with no muscle paresis. Sensory evaluation demonstrated peripheral fusion and reduced stereoacuity. Neither prism correction nor manipulation of the refractive errors corrected the diplopia. A partially occlusive foil (Bangerter) of density ranging from 0.4 to 1.0 was placed in front of the affected eye to restore stable, single vision. Results: The Bangerter foil eliminated the diplopia in all patients. Two patients elected not to wear the foil; 1 patient was afraid of becoming dependent, and the other was bothered by the visual blur. Visual acuity in the affected eye was reduced on average by 3 lines. All patients maintained the same level of sensory fusion, with only 2 having reduced stereoacuity. Symptoms returned when the foil was removed or its density was reduced. Conclusion: Low-density Bangerter foils provide an effective, inexpensive, and aesthetically acceptable management for refractory binocular diplopia induced by macular pathology, allowing peripheral fusion to be maintained.

Original languageEnglish (US)
Pages (from-to)900-903
Number of pages4
JournalArchives of Ophthalmology
Issue number7
StatePublished - Jul 1999
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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    Silverberg, M., Schuler, E., Veronneau-Troutman, S., Wald, K., Schlossman, A., & Medow, N. (1999). Nonsurgical management of binocular diplopia induced by macular pathology. Archives of Ophthalmology, 117(7), 900-903.