Treatments for Diplopia
Diplopia: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Diplopia may include:
Hidden causes of Diplopia may be incorrectly diagnosed:
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Book Excerpts: Treatment of Diplopia
Treatments of Diplopia: Online Medical Books
16 MEDICAL BOOKS ONLINE!
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for more information about the treatments of Diplopia.
Papilledema:
Treatment
(In a Page: Signs and Symptoms)
-
Pseudotumor cerebri may be self-limited with weight loss, discontinuation of offending medications; diuretics may be used (e.g., acetazolamide) to decrease CSF production, lumboperitoneal shunting or optic nerve sheath decompression may be indicated in some cases
-
Intracranial tumors may require resection
-
Hydrocephalus: Surgical correction of anatomic abnormalities, with or without VP shunt
- Intracranial hemorrhage: Conservative management versus surgical evacuation depends on size and location
–Acute subdural hematoma: Control elevated ICP with osmotic and loop diuretics and mild hyperventilation; emergent craniotomy for evacuation of hematomas that result in significant mass effect
–Epidural hematoma: Usually does not require surgery; hyperventilation and mannitol to decrease ICP
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Intracerebral infections require appropriate antibiotics
-
Encephalitis: Control ICP by hyperventilation, diuresis
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Malignant hypertension: Aggressive IV pressure control
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Diplopia:
Treatment
(In a Page: Signs and Symptoms)
-
Treat the underlying etiology
-
Patch one eye (usually the involved eye) as necessary
–In children <10 years old, avoid patching and monitor for development of amblyopia
-
Document magnitude of ocular deviation and/or diplopia to determine improvement or stability between exams (measured with prisms by ophthalmologist)
-
Prisms in glasses for small stable deviations
-
Strabismus surgery for symptomatic diplopia in primary and reading positions if deviation is stable for more than 6 months, for manifest head tilt, or for improving appearance
>>>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Diplopia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
If monocular, first consider a refractive cause or an ocular media compromise
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If binocular, critical to find the underlying cause
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Assess control of diabetes and other systemic concerns and remedy
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If diagnosis of myasthenia, manage systemically with Mestinon
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Neurologic or neurosurgical intervention may be necessary depending on cause
-
Relatively benign causes resolve on their own in 3 months, but patching or prism in glasses may be necessary
-
Prism in glasses or interventive strabismus surgery may be necessary in recalcitrant cases
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Papilledema (Optic Disc Swelling):
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Condition-dependent: Treatment of underlying systemic disease is often the only treatment
-
Pseudotumor cerebri and other causes of intracranial hypertension: Weight loss, Diamox or Lasix, planned recumbency, LP shunt or optic nerve sheath fenestration if loss of visual function
-
Space-occupying lesion or hemorrhage: Neurosurgical intervention
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Meningoencephalitis: IV antibiotics
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Infectious optic neuropathy: Treat underlying cause and consider systemic steroids (controversial)
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Optic neuritis: IV (not oral) steroids
-
Optic nerve glioma treatment controversial: Observation if slowly progressive, resection if only one nerve involved, radiation if chiasm involved, shunts if increased ICP
-
Toxic or nutritional: Stop offending toxin or supply nutritional supplementation
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Eye pain:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient's eye pain results from a chemical burn, remove contact lenses, if present, and irrigate the eye with at least 1 L of normal saline solution over 10 minutes. Evert the lids and wipe the fornices with a cotton-tipped applicator to remove any particles or chemicals. Eye pain from acute angle-closure glaucoma is an ocular emergency requiring immediate intervention to reduce intraocular pressure (IOP). If drug treatment doesn't reduce IOP, the patient will need laser iridotomy or surgical peripheral iridectomy to save his vision.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Eye pain [Ophthalmalgia]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient’s eye pain results from a chemical burn, remove contact lenses (if present) and irrigate the eye with at least 1 L of normal saline solution over 10 minutes. Evert the lids and wipe the fornices with a cotton-tipped applicator to remove any particles or chemicals. Eye pain from acute angle-closure glaucoma is an ocular emergency requiring immediate intervention to decrease intraocular pressure (IOP). If drug treatment doesn’t reduce IOP, the patient will need laser iridotomy or surgical peripheral iridectomy to save his vision.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Eye pain:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
To help ease eye pain, have the patient lie down in a darkened, quiet environment and close his eyes. Prepare him for diagnostic studies, including tonometry and orbital X-rays. Prepare to irrigate the eye, as ordered.
Patient teaching
Tell the patient that it’s important to seek medical help for eye pain and stress the importance of meticulous compliance with drug therapy to prevent an increase in IOP.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Eye pain:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient’s eye pain results from a chemical burn, remove contact lenses, if present, and irrigate the eye with at least 1 L of normal saline solution over 10 minutes. Evert the lids and wipe the fornices with a cotton-tipped applicator to remove any particles or chemicals. Eye pain from acute angle-closure glaucoma is an ocular emergency requiring immediate intervention to decrease intraocular pressure (IOP). If drug treatment doesn’t reduce IOP, the patient needs laser iridotomy or surgical peripheral iridectomy to save vision.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Scotoma:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Explain to the patient the importance of complying with prescribed drug therapy to prevent progression and complications of the disease. Tell the patient to report any eye discharge, blurred or cloudy vision, halos, flashes of light, floaters, or changes in size and location of scotomas.
Inform the patient with bilateral central vision loss of the visual rehabilitation services available to him. Special devices, such as low-vision optical aids, are available to improve the quality of life in the patient with good peripheral vision.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Diplopia:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Discuss safety measures with the patient and his family. Stress the importance of ambulating with assistance. Explain all diagnostic tests and procedures to the patient. Encourage the patient to express his concerns regarding diplopia. If necessary, orient the patient to his room and his meal tray.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Scotoma:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Take measures to provide for the patient's safety.
▪ Administer the prescribed drugs.
Patient teaching
▪ Teach the patient with a disorder involving the fovea centralis (or the area surrounding it) to periodically use the Amsler grid to detect progression of macular degeneration.
▪ Emphasize the importance of compliance with drug therapy.
▪ Explain the underlying disorder and its treatments.
▪ Discuss assistive devices available to help the patient.
▪ Teach signs and symptoms that require immediate medical attention.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Diplopia:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient's vital signs and neurologic status.
▪ Prepare the patient for neurologic tests such as a computed tomography scan.
▪ Provide a safe environment and assist with ambulation.
▪ Institute seizure precautions, if indicated.
Patient teaching
▪ Explain safety measures to the patient.
▪ Reinforce that the patient must not drive or operate heavy machinery upon discharge.
▪ Explain to the patient his diagnosis and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Eye pain [Ophthalmalgia]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ To help ease eye pain, have the patient lie down in a darkened, quiet environment and close his eyes.
▪ Prepare the patient for diagnostic studies, including tonometry and orbital X-rays.
Patient teaching
▪ Stress the importance of following instructions for drug therapy.
▪ Teach the patient about ways to protect the eyes.
▪ Tell that the patient that he should seek medical attention for any eye pain.
▪ Explain the underlying cause of the patient's eye pain and its treatment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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