Characteristics of diplopia as the presenting symptom to an ocular emergency room

The medical records of 350 patients (median age, 59 years) who presented emergently at Bascom Palmer Eye Institute from 2014 to 2019 for evaluation of diplopia were reviewed retrospectively. Diplopia was binocular in 305 cases (median duration, 5 days). Strabismus was present in 301 patients (horizontal in 49.2% of cases). The most common cause of binocular diplopia was cranial nerve palsy: of the 208 cases, 134 (64%) were microvascular. Nearly half of the neuroimaging scans obtained (102/205) were abnormal. Ten patients with abnormal scans required urgent neurosurgical evaluation.