Help! I’m seeing double!

Author: Ali Abdall-Razak / Editor: Steve Corry-Bass / Codes: / Published: 29/01/2022

A 29-year-old lady presents to the Emergency Department (ED) complaining of diplopia. You take a history, and she says it came on about 2 or 3 days ago and is now constant. She says its fine most of the time, but it gets really bad if shes looking to her left. She has no medical history, no allergies, is on no regular medications, and is not complaining of any other symptoms. She has no family history of any diseases either.

On examination, you note abnormal eye movements particularly on looking left, where her left eye has limited movement. The rest of her cranial nerve exam is normal. She has no other findings. Her vitals are: RR 12, SpO2 99% OA, BP 156/97, HR 76, T 36.7.

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