WordNet

visual impairment in which an object is seen as two objects; "diplopia often disappears when one eye is covered" (同)double_vision
used of flowers having more than the usual number of petals in crowded or overlapping arrangements; "double chrysanthemums have many rows of petals and are usually spherical or hemispherical"
increase twofold; "The population doubled within 50 years" (同)duplicate
a base hit on which the batter stops safely at second base; "he hit a double to deep centerfield" (同)two-base hit, two-bagger, two-baser
someone who closely resembles a famous person (especially an actor); "he could be Gingrichs double"; "shes the very image of her mother" (同)image, look-alike
a stand-in for movie stars to perform dangerous stunts; "his first job in Hollywood was as a double for Clark Gable" (同)stunt man, stunt woman
a quantity that is twice as great as another; "36 is the double of 18"
twice as great or many; "ate a double portion"; "the dose is doubled"; "a twofold increase" (同)doubled, twofold, two-fold
consisting of or involving two parts or components usually in pairs; "an egg with a double yolk"; "a double (binary) star"; "double doors"; "dual controls for pilot and copilot"; "duple (or double) time consists of two (or a multiple of two) beats to a measure" (同)dual, duple
having more than one decidedly dissimilar aspects or qualities; "a double (or dual) role for an actor"; "the office of a clergyman is twofold; public preaching and private influence"- R.W.Emerson; "every episode has its double and treble meaning"-Frederick Harrison (同)dual, twofold, two-fold, treble, threefold, three-fold
having two meanings with intent to deceive; "a sly double meaning"; "spoke with forked tongue" (同)forked
bridge: make a demand for (a card or suit)
do double duty; serve two purposes or have two functions; "She doubles as his wife and secretary"
downward and forward; "he was bent double with pain"
hit a two-base hit
large enough for two; "a double bed"; "a double room"
two together; "some people sleep better double"
the perceptual experience of seeing; "the runners emerged from the trees into his clear vision"; "he had a visual sensation of intense light" (同)visual_sensation
a religious or mystical experience of a supernatural appearance; "he had a vision of the Virgin Mary"
a vivid mental image; "he had a vision of his own death"
increase by a factor of two; "doubling with a computer took no time at all"
raising the stakes in a card game by a factor of 2; "I decided his double was a bluff" (同)double
badminton played with two players on each side
tennis played with two players on each side

PrepTutorEJDIC

(数量・強さ・重さ・価値などが)『2倍の』,倍の / 『二重の』,二様の;複の,対の,2人用の / 表裏のある,二心ある / (意味が)二様にとれる,あいまいな / (花が)八重の,重弁の / 『2倍に』,2倍だけ(twice) / 二重に,二様に / 対をなして,二人いっしょに / 〈U〉『2倍』[の数量・価額など] / 〈C〉2倍のもの / 〈C〉よく似た人(物),生き写し / 〈C〉(映画の)代役 / 《複数形》《単数扱い》(テニスなどの)ダブルス / 〈C〉(獲物が追っ手を逃れるときなどの)逆走,急転回 / 〈C〉2塁打 / 〈C〉(ブリッジの点の)倍加 / 〈C〉(競馬・ドッグレースの)重勝式のかけ,複式 / …‘を'『2倍にする』 / …‘を'『二つ折りにする』 / …‘の'2倍の数(量)がある / 〈二役〉‘を'ひとりで演ずる / 〈船が〉〈岬〉‘を'回る / 『2倍になる』 / (…の役を)兼ねる《+『as』+『名』》 / (急に)取って返す,逆戻りする《+『back』》 / 二つ折りになる / (ブリッジで)相手のせり高を倍加する / 2塁打を打つ
{U}『視力』,視覚 / 〈C〉《単数形で》《文》非常に美しい光景(人など) / 〈U〉(将来への)『見通し』,先見の明;想像力,直観力 / 〈C〉『心に描くもの』,空想,想像 / 〈C〉(…についての)考え,見解《+of+名》 / 〈C〉(…の)『幻』,幻影《+of+名》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/05/06 20:27:30」(JST)

wiki en

"Double vision" redirects here. For other uses, see Double vision (disambiguation).

Diplopia, commonly known as double vision, is the simultaneous perception of two images of a single object that may be displaced horizontally, vertically, or diagonally (i.e. both vertically and horizontally) in relation to each other.^[1] It is usually the result of impaired function of the extraocular muscles (EOM's), where both eyes are still functional but they cannot converge to target the desired object.^[1] Problems with EOM's may be due to mechanical problems, disorders of the neuromuscular junction, disorders of the cranial nerves (III, IV, and VI) that stimulate the muscles, and occasionally disorders involving the supranuclear oculomotor pathways or ingestion of toxins.^[2]

Diplopia is often one of the first signs of a systemic disease, particularly to a muscular or neurological process,^[3] and it may disrupt a person’s balance, movement, and/or reading abilities.^[1]^[4]

Classification

Binocular

Binocular diplopia is double vision arising as a result of the misalignment of the two eyes relative to each other, such as occurs in esotropia or exotropia. In such a case while the fovea of one eye is directed at the object of regard, the fovea of the other is directed elsewhere, and the image of the object of regard falls on an extra-foveal area of the retina.

The brain calculates the 'visual direction' of an object based upon the position of its image relative to the fovea. Images falling on the fovea are seen as being directly ahead, while those falling on retina outside the fovea may be seen as above, below, right or left of straight ahead depending upon the area of retina stimulated. Thus, when the eyes are misaligned, the brain will perceive two images of one target object, as the target object simultaneously stimulates different, non-corresponding, retinal areas in either eye, thus producing double vision.

This correlation of particular areas of the retina in one eye with the same areas in the other is known as retinal correspondence. This relationship also gives rise to an associated phenomenon of binocular diplopia, although one that is rarely noted by those experiencing diplopia: Because the fovea of one eye corresponds to the fovea of the other, images falling on the two foveas are 'projected' to the same point in space. Thus, when the eyes are misaligned, the brain will 'project' two different images in the same visual direction. This phenomenon is known as 'confusion'.

The brain naturally guards against double vision. In an attempt to avoid double vision, the brain can sometimes ignore the image from one eye; a process known as suppression. The ability to suppress is to be found particularly in childhood when the brain is still developing. Thus, those with childhood strabismus almost never complain of diplopia while adults who develop strabismus almost always do. While this ability to suppress might seem an entirely positive adaptation to strabismus, in the developing child this can prevent the proper development of vision in the affected eye resulting in amblyopia. Some adults are also able to suppress their diplopia, but their suppression is rarely as deep or as effective and takes longer to establish, and thus they are not at risk of permanently compromising their vision. Hence, in some cases diplopia disappears without medical intervention, but in other cases the cause of the double vision may still be present.

Monocular

More rarely, diplopia can also occur when viewing with only one eye; this is called monocular diplopia, or, where the patient perceives more than two images, monocular polyopia. In this case, the differential diagnosis of multiple image perception includes the consideration of such conditions as corneal surface keratoconus, a structural defect within the eye, a lesion in the anterior visual cortex (rarely cause diplopia, more commonly polyopia or palinopsia) or non-organic conditions. Also, sub-luxation of the lens.

Temporary

Temporary diplopia can be caused by alcohol intoxication or head injuries, such as concussion. If temporary double vision does not resolve quickly, one should see an ophthalmologist immediately. It can also be a side effect of the anti-epileptic drugs Phenytoin and Zonisamide, and the anti-convulsant drug Lamotrigine, as well as the hypnotic drug Zolpidem and the dissociative drugs Ketamine and Dextromethorphan. Temporary diplopia can also be caused by tired and/or strained eye muscles or voluntarily. If diplopia appears with other symptoms such as fatigue and acute or chronic pain, the patient should see a doctor immediately.

Voluntary

Some people are able to consciously uncouple their eyes, either by over focussing closely (i.e. going cross eyed) or unfocusing. Also, whilst looking at one object behind another object, the foremost object's image is doubled (for example, placing one's finger in between one's face whilst reading text on a computer monitor). In this sense double vision is neither dangerous nor harmful, and may even be enjoyable. It makes viewing stereograms possible.^[5]

Causes

Diplopia has a diverse range of ophthalmologic, infectious, autoimmune, neurological, and neoplastic causes.

Damage to the third, fourth, or sixth cranial nerves, which control eye movements.
Cancer
Trauma
Multiple sclerosis
Fluoroquinolone antibiotics^[6]
Botulism
Guillain-Barré syndrome
Brain tumor
Sinusitis
Abscess
Wernicke's syndrome
Graves disease
Drunkenness
Orbital myositis
Myasthenia gravis^[7]
Anisometropia
Salicylism
Strabismus
Lyme Disease

Treatment

The appropriate treatment for binocular diplopia will depend upon the cause of the condition producing the symptoms. Efforts must first be made to identify and treat the underlying cause of the problem. Treatment options include eye exercises,^[1] wearing an eye patch on alternative eyes,^[1] prism correction,^[8] and in more extreme situations, surgery^[4] or botulinum toxin.^[9]

References

^ ^a ^b ^c ^d O'Sullivan, S.B & Schmitz, T.J. (2007). Physical Rehabilitation. Philadelphia, PA: Davis. ISBN 978-0-8036-1247-1.
^ Blumenfeld, Hal (2010). Neuroanatomy through Clinical Cases. Sunderland MA: Sinauer. ISBN 978-0-87893-058-6.
^ Rucker, JC. (2007). "Oculomotor disorders". Semin Neurol. 27 (3): 244–56.
^ ^a ^b Kernich, C.A. (2006). "Diplopia". The Neurologist 12 (4): 229–230.
^ http://www.focusillusion.com/Instructions/ Instructions on how to view stereograms such as magic eye
^ Fraunfelder FW, Fraunfelder FT (September 2009). "Diplopia and fluoroquinolones". Ophthalmology 116 (9): 1814–7. doi:10.1016/j.ophtha.2009.06.027. PMID 19643481.
^ http://www.merck.com/mmpe/sec09/ch098/ch098e.html
^ Phillips PH. (2007). "Treatment of diplopia". Semin Neurol. 27 (3): 288–98.
^ Taub, M.B. (2008). "Botulinum toxin represents a new approach to managing diplopia cases that do not resolve.". Journal of the American Optometric Association 79 (4): 174–175.

^ Cassin, B. & Solomon, S. (1990) Dictionary of Eye Terminology. Gainesville, Florida: Triad Publishing Company

External links

Common Cause of Double Vision
All About Double Vision
International Orthoptic Association
All About Lazy Eye
FAQ -- Eye Muscle Surgery Information
Brain Injuries and Double Vision
Some more info about diplopia
Addtl info about diplopia
What is Stereovision?
What is Vision Therapy?
VisionSimulations.com | What the world looks like to people with various diseases and conditions of the eye
GPnotebook

Look up diplopia in Wiktionary, the free dictionary.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 複視の概要 overview of diplopia
2. 視覚変化が認められた小児患者に対するアプローチ approach to the pediatric patient with vision change
3. 成人における第三脳神経（動眼神経）麻痺 third cranial nerve oculomotor nerve palsy in adults
4. 鼻腔の腫瘍 tumors of the nasal cavity
5. 眼筋型重症筋無力症 ocular myasthenia gravis

English Journal

Superior oblique muscle palsy after frontal sinus mini-trephine.

Bartley J, Eagleton N, Rosser P, Al-Ali S.SourceDepartment of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.
American journal of otolaryngology.Am J Otolaryngol.2012 Jan;33(1):181-3. Epub 2011 Jun 21.
OBJECTIVE: The aim of this study is to present a case of superior oblique muscle dysfunction after a frontal sinus mini-trephine.METHODS: This is a case report of an 18-year-old woman where a mini-trephination approach and endoscope were used to open and marsupialize a symptomatic, opacified type IV
PMID 21696855

[Acute right proptosis due to spontaneous orbital hemorrhage.]

Stingl K, Schüttauf F, Besch D.SourceDepartment und Forschungsinstitut für Augenheilkunde, Universitätsklinikum Tübingen, Tübingen, Deutschland.
Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft.Ophthalmologe.2011 Dec 2. [Epub ahead of print]
A 46-year-old woman presented with a sudden onset of non-traumatic periorbital hemorrhage, painless proptosis, conjunctival chemosis and injection as well as motility restriction of the right eye with double vision. Magnetic resonance imaging (MRI) revealed an extraconal mass in the medial orbit wit
PMID 22130730

Japanese Journal

前立腺生検による前立腺炎後に発症した急性一側性外転神経麻痺の1例

慎武,弓狩一晃,高玉勝彦,吉田利夫
日本泌尿器科學會雜誌 102(4), 655-658, 2011-07-20
症例は64歳男性.健診におけるPSA高値を主訴に当院受診した.直腸診にて前立腺は中等度腫大しており,弾性硬であった.採血上,PSA 24.38ng/mlと高値のため,前立腺癌の疑いにて経直腸的20ヵ所前立腺針生検施行.病理結果は尖部の2コアからAtypical small acinar proliferation(ASAP)が検出された.生検翌日に悪寒戦慄を伴う発熱を認め,前立腺炎との診断で補液と …
NAID 110008688080

モノと潜在性 : タルド的視点に基づく機械の民族誌の試み(<特集>動くアッサンブラージュを人類学する)

森田敦郎
文化人類学 76(1), 33-52, 2011-06-30
本論文では、19世紀フランスの社会学者ガブリエル・タルドに着想を得た「モノ」への新しいアプローチを構想を試みる。近年、タルドへの関心が人類学で復活しつつある。この関心は、人間の行為の所与の条件となる単一の「自然」と、人間の創造的行為の産物である多数の「文化」の二項対立という従来の枠組みを乗り越える方法を模索する中から生まれてきた。そこで暗示されているのはモノについての言説ではなく、その構成そのもの …
NAID 110008672896

Related Pictures

★リンクテーブル★

リンク元	「複視」「polyopsia」「vertical diplopia」「monocular diplopia」「horizontal diplopia」
関連記事	「double」「doubling」

「複視」

Diplopia
	Classification and external resources
	; Photo showing how a patient experiences diplopia
ICD-10	H53.2
ICD-9	368.2
DiseasesDB	31225
eMedicine	oph/191
MeSH	D004172

　　[★]

dipl opia
英: diplopia, double vision
関: 両眼視

概念

ある視標を見たときにものが二重に見える状態を複視という。(SOP.269)

分類

仮像の出現する方向

同側複視 homonymous diplopia：患眼(内斜視)と同じ方向に仮像がある複視
交叉性複視 crossed diplopia：患眼(外斜視)と反対方向に仮像がある複視

両眼・単眼の別

両眼複視：両眼で物が二重に見える場合。動眼神経麻痺、滑車新家麻痺、重症筋無力症、眼窩吹き抜け骨折など
単眼複視：単眼で物が二重に見える場合。正乱視、不正乱視、あるいは白内障が原因となる。

鑑別疾患

単眼視したときに物体が二重に認識される状態 monocular diplopia

水晶体脱臼(外傷、マルファン症候群)
早期白内障
角膜白濁(corneal opacities)
二重虹彩(手術や外傷)
ヒステリー

両眼視したときに物体が二重に認識される状態 biocular diplopia

DIF

外眼筋麻痺：MINT

malformation 筋強直性ジストロフィー、眼筋麻痺
inflammatory 皮膚筋炎、眼窩蜂窩織炎
neoplasm 眼窩/外眼性の甲状腺腫　orbit and exophthalmic goiter
trauma 眼窩骨折、外眼筋の裂傷/打撲

神経筋接合部

重症筋無力症

脳神経末梢：VINCE

venous 静脈洞の静脈血栓症
inflammatory 梅毒性髄膜炎、結核性髄膜炎、ジフテリア後神経炎、蝶形骨洞副鼻腔炎、錐体炎、脳圧亢進
neoplasm 下垂体腫瘍、鞍上部腫瘍、鼻咽頭腫瘍、脊索腫、蝶形骨縁髄膜腫
congenital 動静脈奇形
endocrine 糖尿病性ニューロパチー

脳神経核：VINDICATE

vascular 脳底動脈血栓症/出血/塞栓症/動静脈奇形。片頭痛？
inflammatory 梅毒性脳炎、結核性脳炎、ウイルス性脳炎
neoplasms 脳幹神経膠腫、転移性脳腫瘍、ホジキンリンパ腫
deficiency ウェルニッケ脳症
intoxication ボツリヌス症、臭素・ヨウ素中毒
congenital 水頭症、アーノルド・キアリ奇形
autoimmune 多発性硬化症、感染後脳症、ループス脳症
traumatic 硬膜下血腫、頭蓋底骨折、橋血腫
endocrine 糖尿病による脳底動脈血栓症

核上性

松果体腫瘍、脳血栓/脳出血のconjugate plasy、局在性皮質てんかんのconjugate gaze、テント切痕への早期ヘルニアにおける瞳孔の拡張

検査

バゴリーニ試験 Bagolini test

「polyopsia」

　　[★]

多視

関: diplopia、double vision、horizontal diplopia、monocular diplopia、vertical diplopia

「vertical diplopia」

　　[★]

垂直複視

関: diplopia、double vision、horizontal diplopia、monocular diplopia、polyopsia

「monocular diplopia」

　　[★]

単眼複視

関: diplopia、double vision、horizontal diplopia、polyopsia、vertical diplopia

「horizontal diplopia」

　　[★]

水平複視

関: diplopia、double vision、monocular diplopia、polyopsia、vertical diplopia

「double」

　　[★]

adj.

同: outlet right ventricle

「doubling」

　　[★]

n.

倍加

関: double

[osullivan-0] O'Sullivan, S.B & Schmitz, T.J. (2007). Physical Rehabilitation. Philadelphia, PA: Davis. ISBN 978-0-8036-1247-1.

[1] Blumenfeld, Hal (2010). Neuroanatomy through Clinical Cases. Sunderland MA: Sinauer. ISBN 978-0-87893-058-6.

[2] Rucker, JC. (2007). "Oculomotor disorders". Semin Neurol. 27 (3): 244–56.

[kernich-3] Kernich, C.A. (2006). "Diplopia". The Neurologist 12 (4): 229–230.

[4] ttp://www.focusillusion.com/Instructions/ Instructions on how to view stereograms such as magic eye

[pmid19643481-5] Fraunfelder FW, Fraunfelder FT (September 2009). "Diplopia and fluoroquinolones". Ophthalmology 116 (9): 1814–7. doi:10.1016/j.ophtha.2009.06.027. PMID 19643481.

[6] ttp://www.merck.com/mmpe/sec09/ch098/ch098e.html

[7] Phillips PH. (2007). "Treatment of diplopia". Semin Neurol. 27 (3): 288–98.

[8] Taub, M.B. (2008). "Botulinum toxin represents a new approach to managing diplopia cases that do not resolve.". Journal of the American Optometric Association 79 (4): 174–175.

Diplopia
Classification and external resources
Photo showing how a patient experiences diplopia
ICD-10	H53.2
ICD-9	368.2
DiseasesDB	31225
eMedicine	oph/191
MeSH	D004172

匿名

検索

案内

double vision