Neuronal (Non-Comitant) Neuromuscular Junction Extraocular Muscle Restriction/Entrapment Binocular Monocular Diplopia Horizontal and/or Vertical Strictly Horizontal (Cranial Nerve VI problem)Cannot Abduct Cranial Nerve III Eye depressed, abducted, ptosis, large/unreactive pupil Cranial Nerve IVEye cannot depress when looking medially Grave's Ophthalmopathy Refractive Error Cataract/Lens Dislocation Functional Corneal Distortion/Scarring Vitreous Abnormalities Myasthenia Gravis Orbital Inflammation Orbital Tumor Orbital Floor Fracture Ischemia Diabetes Mellitus Aneurysm Tumor Trauma Ischemia Diabetes Mellitus Aneurysm Trauma Ischemia Diabetes Mellitus Aneurysm Trauma Subdural HemorrhageDIPLOPIAClinical Pearls:Diplopia is almost always binocular. CN VI palsy is a red flag for intracranial masses. Look for ptosis with CN III palsy. Examine both eyes to determine which is affected. Neurologic symptoms suggest a mass as the cause. Myasthenia Gravis is fatiguable. Migraine is a diagnosis of exclusion. Hyperthyroidism|

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