C53123: Binocular vision walkthrough part 3 - diplopia

This is the third of four articles where you can decide on the best strategy when presented with different binocular vision challenges

Your quest continues. Do you accept a third challenge to help enlighten your knowledge of binocular vision? Do you have the skills and courage to solve your patient’s problems and create a loyal patient for life… take the test now!

Your challenge

Your last patient of the day is a 60-year-old builder who has come for an eye examination as he has experienced ‘something unusual’ with his vision. For the past three days he has found it difficult to read close print with his glasses and he has noticed that words appear to be going double. They are ‘one of top of the other’ and ‘slightly to one side’. He then noticed there was more doubling if he looks to the right at his wing mirror when driving. He has since found it more comfortable to shut one eye. He thought it would go away as he has had some very busy days ‘working on an extension’ and has felt very tired for the past month. His general health is fair; he jokes that, although he does manual work, he still needs to lose weight! He has taken blood pressure tablets for the past two years and, when measured a year ago, it was controlled. He denies any injuries and has only had foreign bodies removed from eye casualty in the past. There is no known family history of ocular or systemic disease.