Nonsurgical management of binocular diplopia induced by macular pathology

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

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

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
Volume117
Issue number7
StatePublished - Jul 1999
Externally publishedYes

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Diplopia
Pathology
Visual Acuity
Central Serous Chorioretinopathy
Epiretinal Membrane
Refractive Errors
Paresis

ASJC Scopus subject areas

  • Ophthalmology

Cite this

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

Nonsurgical management of binocular diplopia induced by macular pathology. / Silverberg, Mark; Schuler, Eileen; Veronneau-Troutman, Suzanne; Wald, Kenneth; Schlossman, Abraham; Medow, Norman B.

In: Archives of Ophthalmology, Vol. 117, No. 7, 07.1999, p. 900-903.

Research output: Contribution to journalArticle

Silverberg, M, Schuler, E, Veronneau-Troutman, S, Wald, K, Schlossman, A & Medow, NB 1999, 'Nonsurgical management of binocular diplopia induced by macular pathology', Archives of Ophthalmology, vol. 117, no. 7, pp. 900-903.
Silverberg M, Schuler E, Veronneau-Troutman S, Wald K, Schlossman A, Medow NB. Nonsurgical management of binocular diplopia induced by macular pathology. Archives of Ophthalmology. 1999 Jul;117(7):900-903.
Silverberg, Mark ; Schuler, Eileen ; Veronneau-Troutman, Suzanne ; Wald, Kenneth ; Schlossman, Abraham ; Medow, Norman B. / Nonsurgical management of binocular diplopia induced by macular pathology. In: Archives of Ophthalmology. 1999 ; Vol. 117, No. 7. pp. 900-903.
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