Binocular diplopia differential diagnosis

Primer Telescopio Portátil De Nanotecnología Que Permite Lograr Hasta 300 Veces De Aumento. ZoomShot Pro: Ha Llegado El Telescopio Portátil De Próxima Generació Monocular and binocular diplopia can be differentiated from one another by covering one eye at a time. Monocular diplopia, which is when double vision affects only one eye, is pronounced when the unaffected eye is covered, and it appears to resolve when the affected eye is covered Because any eye muscle or motility pattern can occur in myasthenia gravis (MG), it should remain on the differential diagnosis of any patient with binocular diplopia. The pupillary examination should be normal and there should be no sensory symptoms (ie, pain or numbness) Diplopia is the subjective complaint of seeing 2 images instead of one and is often referred to as double-vision in lay parlance. The term diplopia is derived from 2 Greek words: diplous, meaning double, and ops, meaning eye The diplopia is predominantly vertical, alleviated by head tilt. Now associated with three days of right ptosis as well as two weeks of progressive weakness and fatigue - most notable when climbing stairs. Examination notable for right hypertropia increased on right or downward gaze suggestive of isolated inferior rectus weakness

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Binocular diplopia is most often due to a neurologic cause. The onset of true double vision is debilitating for most patients and commonly prompts immediate access to health care services as a consequence of functional impairment and concern for worrisome underlying causes. Although patients may s SUMMARY:Binocular diplopia is most often due to a neurologic cause. The onset of true double vision is debilitating for most patients and differential diagnosis, a prudent diagnostic evaluation, and, in some cases, an effective therapeutic strategy to mitigate symptoms Binocular diplopia, on the other hand, is often due to neuromuscular dysfunction causing misalignment of visual fields. Causes commonly include cranial nerve palsy, ocular muscle dysfunction, or brainstem pathology. Ergo, monocular diplopia can be appropriately managed with an ophthalmological referral and typically does not require neuroimaging

Binocular Diplopia: What Is It, Causes, Diagnosis, and

Foveal Displacement / Traction (e.g. ERM) can induce binocular diplopia (Central Peripheral Rivalry)** Sensory Deviation (but rarely diplopia) -e.g. Cataract, Optic Atrophy, ROP, Retinal Dystrophy 5. Strabismus-Primary, Familial, Decompensated-diplopia infrequent (e.g. suppression Diplopia & trauma. Fracture causing CN disruption. CT head without contrast. Diplopia & multiple CN involvement & numbness over CN5 (Unilateral, decreased visual acuity) Orbital apex pathology. CT orbits with contrast. Diplopia & multiple CN involvement & numbness over CN5 (Uni- or bilateral, normal visual acuity) Cavernous sinus thrombosis

Diplopia: Diagnosis and Management: Evaluation and Managemen

  1. INTRODUCTION Dysfunction of the extraocular muscles may be the result of an abnormality of the muscle itself or an abnormality of the motor nerve to the muscle. The major symptom associated with this dysfunction is binocular diplopia, which is present with both eyes open and absent when either eye is closed
  2. The symptom is diplopia. But what's the diagnosis? When your patient sees two images, you may need to consider 20 possible causes, and ruling out 19 of those can be a headache. T he various etiologies of diplopia comprise one of the most sweeping differential diagnoses in all of oph-thalmology. The patient who com-plains of double vision can hav
  3. diplopia. (III) Altered Gravity and the Effects on Binocular Misalignments. Unilateral lesion to the graviceptive vestibular pathways in the roll plane results in vestibular tone imbalance that causes perceptual tilt, head and body tilt, vertical misalignment of the visual axes (skew deviation) and ocular torsion. Figure 4. Translational VOR. 5
  4. a rapid diagnosis [29]. Transient diplopia Transient diplopia is the most embarrassing clinical presen-tation. Indeed, transient binocular diplopia may also be due to life-threatening vascular events, such as giant cell arteritis, aneurysm, transient ischemic attack heralding basilar occlusion, or brainstem hemorrhage
  5. ing the appropriate diagnostic approach

Diplopia (Double Vision) Differential Diagnose

to the final diagnosis: • monocular or binocular - if the diplopia continues when one eye is closed the condition is monocular. If the diplopia disappears it is due to a breakdown in the binocularity of both eyes • onset - sudden onset may indicate vas-cular origin while gradual deterioration may be due to a progres Lee MS. Diplopia: diagnosis and management. focal points. Vol 25. American Academy of Ophthalmology, 2007—A detailed description of diagnosis and management of diplopia. Rucker JC, Tomsak RL. Binocular diplopia. A practical approach. Neurologist 2005;11:98-110—A logical stepwise approach to assessing patients with diplopia Binocular vertical diplopia may be due to supranuclear processes, ocular motor nerve dysfunction, neuromuscular junction disease, diseases of eye muscle, mechanical processes causing vertical eye misalignment, and even retinal disease. In this article, the differential diagnosis of these processes is outlined., N2 - The assessment of a patient. Binocular Double Vision - A Review Abstract A 62-year-old male with history of hypertension presented to our emergency department with new onset diplopia. He denied Etiology, Differential Diagnoses, and Treatment of Diplopia Etiologies include vasculopathic, trauma, tumors, multipl What are the differential diagnoses for Diplopia (Double Vision)? Double vision as a presenting symptom in an ophthalmic casualty department. Binocular vertical diplopia. Mayo Clin Proc.

Differential Diagnosis of Diplopia - ddxo

Differential diagnosis. Binocular vertical diplopia has a limited differential diagnosis, which includes third nerve palsy, fourth nerve palsy, skew deviation, extraocular muscle restriction (for example, thyroid eye disease), and neuromuscular junction impairment (for example, myasthenia gravis) Grand Rounds A 51-year-old woman with binocular diplopia and unilateral ptosis Landon J. Rohowetz, BSa, and Anjulie K. Quick, MD b Author affiliations: aUniversity of Missouri - Kansas City School of Medicine, Kansas City, Missouri; bDepartment of Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas History A 51-year-old woman with a history of acute myeloi Diplopia. Detailed examination reveals no obvious extra ocular muscle weakness. Diplopia is due to failure of fusion of images. Types of diplopia: There are two types. Binocular; Uniocular; Uniocular Diplopia that persists even when patient closes one eye. Diplopia improves with pin-hole; What are the causes of Uniocular. Ocular causes: Example. Differential Diagnosis of Monocular Diplopia. diplopia , neurology , neuroophthalmology. Following are differential diagnosis of Monocular Diplopia. (a) Anterior segment causes, (b) Retinal abnormalities, (c) Cortical Diplopia

Differential diagnosis of cranial nerve lesions includes central and peripheral causes. Causes vary according to which cranial nerve is affected, and whether multiple cranial nerves are involved. See also Bulbar and pseudobulbar palsy. Causes. Multiple cranial nerve lesions. nasopharyngeal C Binocular diplopia = 'true diplopia', corrected by covering either eye. Related to orbital and neurologic disorders (in the orbit, superior orbital fissure, cavernous sinus, subarachnoid space anterior to the midbrain, brainstem and brain). (Tabel 1) Monocular diplopia persists despite covering the other eye Myasthenia gravis may mimic pupil-sparing third nerve palsies and must be considered in the differential diagnosis. Fourth Cranial Nerve Palsies.—Fourth cranial nerve palsies are a common cause of acquired binocular vertical diplopia. Fourth cranial nerve palsies may cause incomitant hypertropia, excyclotropia, and head tilt.2, 3 Cerebral Polyopia, also known as Cerebral Diplopia, is an extremely rare visual phenomenon characterized by the persistence of two or more duplicated images even after the stimulus is removed. These images uniquely present as ordered rows or columns of the patient's visual field [1]. Cerebral polyopia can occur both monocular bilaterally or binocularly, which means that the duplicated images. Binocular diplopia stems from dysfunction of a broad range of motor structures, ranging from muscle, neuromuscular -junction, nerves in their course within and outside the brainstem, and prenuclear brainstem control problems. This anatomic division is a useful approach to evaluation and differential diagnosis. + +

Wernicke's disease is always a valid differential diagnosis of binocular vertical diplopia, especially in the presence of pathological nystagmus and ataxia. If binocular vertical diplopia is associated with deficits of multiple cranial nerves, one should con- sider a demyelinating disease such as Miller-Fisher and Guillain-Barr6 syndrome The condition can affect balance, movement, and reading ability. If double vision affects just one eye, it is monocular. If it affects both eyes, it is binocular

Binocular Diplopia = pathology can exist in multiple locations, including: § Ocular § Ocular muscle § Cranial nerves (CN VI palsy a very common cause of diplopia) § Upper versus lower neuron disease § Ocular centre dysfunction in CNS § Brainstem 1) List the differential diagnosis (critical emergent, urgent) for Diplopia. Binocular vision dysfunction (BVD) encompasses a group of conditions where the two eyes have difficulty working together as a team, resulting in a vertical or horizontal (or both) misalignment between the line of sight of one eye with the other eye. When the amount of misalignment is large (strabismus or heterotropia) double vision or diplopia. Binocular = pathology can exist in multiple locations, including: Ocular; Ocular muscle; Cranial nerves (CN VI palsy a very common cause of diplopia) Upper versus lower neuron disease; Ocular centre dysfunction in CNS; Brainstem 1) List the differential diagnosis (critical emergent, urgent) for Diplopia (including at least 7 causes of binocular. Binocular Diplopia Objective: Differential diagnosis - Third nerve palsy - Myasthenia gravis - Miller-Fisher syndrome - Restrictive strabismus Keane JR 2005 Internuclear Ophthalmoplegia Seek and you shall find! INO. 1 Monocular double vision occurs due to a problem with one eye and is less common than binocular double vision. Many people with monocular diplopia report that one of the images will be very clear.

Differential Diagnosis of Diplopia Applie

Patients with hypotropia in Thyroid Eye Disease experience vertical binocular diplopia, which may improve in downgaze or when the patient adopts a chin-up head posture. In some cases, patients may experience vision loss or acute color vision changes from compressive optic neuropathy. Differential diagnosis. Differential diagnosis for. Topic: Binocular Vision Abstract Title: Diagnosis and Management of Strabismus Post Scleral Buckle Surgery Abstract: A patient presents with recent onset diplopia following scleral buckle surgery.This case reviews potential causes for acute onset diplopia and explores the use of vision therapy and prisms in restrictive strabismus post surgery

After one has ascertained that diplopia is not accompanied by any brainstem symptoms, knowledge of whether the diplopia is purely horizontal or purely vertical can help in shortening the differential diagnosis: abduction and, rarely, adduction deficits are usually responsible for producing purely horizontal diplopia and there are only 5 main. Etiology and Management of Diplopia Definition and Differential Diagnosis Diplopia, as defined in Dorland's Illustrated Medical Dictionary, is the perception of two images of a single object. 1 In fact, the word diplopia is derived from the Greek words diplous and ops, meaning double and eye, respectively. For the purposes. Evaluating the patient with acute constant vertigo or diplopia can be a daunting task for clinicians, who recognize that such symptoms can be the manifestation of potentially devastating disorders like stroke but may be uncomfortable eliciting and interpreting the key symptoms and subtle signs that distinguish dangerous from benign causes. We present a novel and highly instructive case of a. Diplopia Symptoms. If you have double vision, you may also notice: One or both eyes not lining up (a wandering eye or cross-eyed look) Pain when you move your eye. Pain around your eyes, like. Diplopia. Worth Four Dot testing is done with red and green glasses (red over the right eye) to dissociate the images from each eye. The test is performed at distance and near. Differential diagnosis. The main differential diagnosis of MED includes: Brown syndrome - characterized by limitation of elevation in adduction with Y pattern exotropi

Patient experiences intermittent binocular diplopia while

Clinical Features. Complete (isolated) third nerve palsy showing (a) left-sided ptosis, (b) restricted adduction movement of left eyeball, and (c) normal abduction movement of left eyeball. Eye deviates laterally and down. Pupil exam: If dilated/nonreactive likely secondary to space occupying lesion. If pupil is spared likely ischemic etiology Binocular diplopia on the other hand occurs secondary to disconjugate alignment of the eyes, and has a broad differential diagnosis. Cranial nerve palsies are the most common cause of binocular diplopia, typically involving cranial nerves 3, 4 or 6 On diagnosis, the double vision may appear monocular in which one or both eyes sees multiple images while testing them individually. But sometimes it may appear binocular which is characterized by the experience of double vision only when the both eyes are open and individually these see a single image separately Monocular diplopia is determined by the persistence of double vision when the unaffected eye is covered. The lesion can be localised to intraocular structures including refractive error, cataracts, lens dislocation and corneal opacity. 1. Binocular diplopia is determined by the absence of diplopia when either eye is covered

Neuro-ophthalmology Illustrated Chapter 13 - Diplopia 3

The differential diagnosis of a Brown's-type pattern of abnormal ocular motility includes the inferior rectus fibrosis syndrome, blow-out fracture, supranuclear paralysis of monocular elevation, myasthenia gravis, trochleitis, adherence syndromes and idiopathic, isolated paresis of the inferior oblique muscle Diplopia is defined as double vision when looking at a single object. Monocular diplopia is related to an ocular disorder and must be differentiated from binocular diplopia which is secondary to ocular misalignment. The examination of the patient with binocular diplopia is often challenging for non-specialists INTRODUCTION. Diplopia is the double vision of single objects. Neurologists need to differentiate between monocular and binocular diplopia, depending on whether it occurs with one eye or two eyes opened [].Binocular diplopia is a feature of both neurological (i.e., oculomotor nerve palsies, ocular myopathies, neuromuscular junction disorders) and ophthalmic disorders (i.e., decompensation of a.

Diplopia is the double vision of a single object, and can be binocular or monocular. Binocular diplopia is caused by the misalignment of the visual axes, with images falling on the fovea of the fixating eye and on the extra-foveal retina of the non-fixating eye, as a consequence of both neurological (i.e., oculomotor nerve palsies, ocular myopathies, neuromuscular junction disorders) and. This article provides a process for interviewing and examining these patients, explaining the rationale and differential diagnosis of various clinical presentations. Common causes of monocular and binocular diplopia are addressed by the pattern of diplopia described by the patient CASE REPORT: Three clinical cases of hospitalization due to isolated diplopia are presented here, illustrating different etiologies. CONCLUSIONS: The present article aims to address the differential diagnosis of this clinical condition and to warn of less frequent causes of diplopia, such as adverse effects of commonly used drugs

movements may therefore produce diplopia, leading to a broad differential diagnosis for the patient with diplopia. With a careful history and examination, the neurologist should be able to observe the patterns of diplopia that reveal the site of dysfunction, thus generating a shorter localization-specific list of possible etiologies. Examination o Differential diagnosis. Binocular vertical diplopia has a limited differential diagnosis, which includes third nerve palsy, fourth nerve palsy, skew deviation, ex-traocular muscle restriction (for example, thyroid eye disease), and neuromuscular junction impairmen In patients suspected of having diplopia or oscillopsia, it is essential to perform clinical examinations, required examinations, differential diagnosis, treatment, and surgery. Binocular diplopia and oscillopsia may be due to disease of the paretic strabismus, medial longitudinal fasciculus syndrome, one-and-a-half syndrome, ocular tilt.

Diplopia Tags - Differential Diagnosis ofNeuro-ophthalmology Illustrated Chapter 13 – Diplopia 3

Diplopia is more common in patients with multiple and bilateral GDD surgery. The prevalence of monocular diplopia and binocular diplopia unrelated to glaucoma surgery was similar among medical and surgical groups, says Dr. Khanna. That outcome indicates that it is important to counsel patients on the higher occurrence of diplopia associated. While there rarely may be serious causes behind monocular diplopia symptoms, this is much less often the case than with binocular diplopia. The differential diagnosis of multiple image perception includes the consideration of such conditions as corneal surface keratoconus, subluxation of the lens, a structural defect within the eye, a lesion in. Determining the diagnosis can be straightforward to challenging. This chapter provides an overview of the approach to the patient with double vision from the perspective of an internist, and we will cover common and some less common diagnoses which will be in the differential diagnosis for the neuro-ophthalmologist For example, the differential diagnosis of binocular diplopia includes myopathy, dysfunction of the neuromuscular junction (myasthenia gravis), cranial nerve palsies, and supranuclear disease. The diagnostic evaluation also requires neuroimaging techniques to help assess the orbital structures (extraocular muscles), cranial nerve palsies.

Expert Commentary. Diplopia is a rare but potentially dangerous chief complaint, making up approximately 0.1% of all ED visits. [1] In one study of 260 ED patients with non-traumatic, binocular diplopia, 64% had primary diplopia (i.e. no identifiable cause found, likely from microvascular ischemic disease) and 36% had secondary diplopia (i.e. caused by some discernible pathology) About This Issue. Nontraumatic visual disorders can have many causes, but they are potentially concerning for the patient as well as the emergency clinician. Four divisions can assist in considering the differential diagnosis: (1) unilateral or bilateral; (2) painful or painless; (3) presence or absence of diplopia; and (4) timing of onset Study The Wills Eye Manual: Differential Diagnosis of Ocular Symptoms (Chapter 1) flashcards from user delete's class online, or in Brainscape's iPhone or Android app. Learn faster with spaced repetition Differential diagnosis of diplopia following caratact, American Orthoptist Journal, 99-104. Publish Year. 1999. Journal. Binocular diplopia associated with subretinal neovascular membranes, Arch Ophthalmol, 311-7. Publish Year. 1980. Journal. Superior oblique myokymia, Am Orthopt J, 58-63 An Approach to Diplopia As for sudden visual loss, the first step is to determine whether the symptom is monocular or binocular (Fig. 1). For diplopia, the matter is easily settled by covering one eye. On covering one eye, a monocular diplopia will persist whereas a binocular diplopia will resolve. A monocula

RACGP - A masquerade presenting with diplopia"Experience Double Vision -- Learn about Binocular Vision"

Diagnosing Double Vision in Adults NYU Langone Healt

Therefore, thyroid autoantibodies could be helpful markers for the differential diagnosis of binocular diplopia in adults. This study had some limitations, resulting mainly from its retrospective. Diagnosing Double Vision. Double vision can result from minor eye problems such as dry eyes. But, it can also be a symptom of a life-threatening neurological condition. Our eye experts work quickly to pinpoint the underlying causes of double vision so that we can begin emergency treatment immediately, if necessary. Diagnostic Tests for Double. The Diagnosis of Binocular Diplopia. The Lesion Is in the Extraocular Muscles. Differential Diagnosis of Enlarged Extraocular Muscles; Thyroid Eye Disease. Clinical Presentation; Diagnosis; Treatment; Orbital Myositis. Clinical Presentation; Infectious Myositis; Noninfectious Inflammatory Myositis, or Idiopathic Orbital Inflammation.

Basic Approach to Diplopia - EyeWik

In an upcoming issue, I will describe the differential diagnosis of vertical diplopia and the methodology of isolating the correct diagnosis. Dr. Spector is in private practice. Contact him at 980 Johnson Ferry Road, Ste. 550, Atlanta, Ga. 30342 binocular diplopia: [ dĭ-plo´pe-ah ] the perception of two images of a single object; called also double vision . binocular diplopia double vision in which the images of an object are formed on noncorresponding points of the retinas. crossed diplopia horizontal diplopia in which the image belonging to the right eye is displaced to the left of.

Top Causes of Double Vision - Review of Optometr

Differential Diagnosis: Isolated, pupil-sparing oculomotor nerve palsy is most often due to a microvascular cause, whereas isolated pupil-involving oculomotor nerve palsy is most commonly due to compression from an aneurysm or tumor.(1) Because of the potential for imminent subarachnoid hemorrhage caused by an intracerebral aneurysm, emergent imaging (magnetic resonance angiogram or CTA) is. Binocular vertical diplopia may be due to supranuclear processes, ocular motor nerve dysfunction, neuromuscular junction disease, diseases of eye muscle, mechanical processes causing vertical eye misalignment, and even retinal disease. In this article, the differential diagnosis of these processes is outlined What differential diagnosis would you make? ANISOMETROPIC AMBLYOPIA -aniso refractive error, reduced VA in one eye, may improve with RX but likely amblyopia present due to form deprivation & abnormal binocular interaction, no squint present so just anisometropic amblyopi Right upper eyelid ptosis and binocular double vision . History of Present Illness. Acquired third nerve palsy, often presenting with ptosis and the eye in a down and out position, has a wide differential diagnosis including microvascular damage, tumors, aneurysms, post-neurosurgery, and trauma [1,2]. The incidence of acquired third nerve.

Diplopia - Double Vision - Differential Diagnosis

This is best done by using a differential diagnosis that follows the anatomy of the nerve to elucidate the cause. Treatment can then be directed to the underlying cause. Enhancing Healthcare Team Outcomes . Abducens nerve palsy is a relatively common presentation. Patients often present with horizontal diplopia (4) If the quality of fusion is poor, or there exists occasional suppression or diplopia, then the case can be regarded as one of binocular instability associated with fusion deficiences. The case must be treated as in the end treatment of Strabismus, restoring fusion and stereopsis before the fusional reserves can be built up

Approach to Diplopia - PubMe

Binocular Diplopia The eyes lose their simultaneous alignment with the object of regard in one or more directions of gaze Key clues Anomalous Head Position Vision Blurry in one gaze position, better in another Obviously misaligned eyes, proptosis Presence of partial ptosis Nystagmus Differential diagnosis: Restrictive disorder Paretic. Background:Diplopia is a symptom with very different etiologies. It may be caused by pathology in the eye, orbit, extraocular muscles, neuromuscular junction, or in the central nervous system. Case Report:Three clinical cases of hospitalization due to isolated diplopia are presented here, illustrating different etiologies. Conclusions:The present article aims to address the differential. Diplopia is the subjective complaint of seeing 2 images instead of one and is often referred to as double-vision in lay parlance. The term diplopia is derived from 2 Greek words: diplous, meaning double, and ops, meaning eye. Diplopia is often the first manifestation of many systemic disorders, especially muscular or neurologic processes. [] An accurate, clear description of the symptoms (eg.

Diplopia Evaluation and Management - emDOCs

The complaint of diplopia has a particularly important differential. The first step in approaching diplopia involves assessment of whether the diplopia is monocular or binocular. Monocular diplopia (present when one of the eyes is covered) is almost always localized to the eye itself (or to glasses or contact lenses) The differential diagnosis of a third nerve palsy includes microvascular causes, vascular compression from an aneurysm or mass, temporal arteritis, myasthenia gravis, thyroid eye disease, demyelination, internuclear ophthalmoplegia, infectious etiologies, trauma, and other conditions. 3 Given the potentially fatal implications of many third. Diplopia (Causes, Signs, and Symptoms) Definition: Diplopia, commonly known as 'Double vision' occurs when a person sees a double image where there should only be one. The two images can be side by side, on top of one another, or both. It is the simultaneous perception of two images of a single object that may be displaced horizontally, vertically, diagonally (i.e., both vertically and.

Man presents with acute-onset horizontal binocular diplopi

Many conditions can have double vision as a symptom. The most common are those involving weakened nerves or muscles within both eyes, or abnormalities of your retina or cornea within a single eye. Binocular double vision causes. Binocular double vision is the most common type. This means both eyes are involved Two types: monocular (ophthalmologic causes) and binocular (neurologic causes) Binocular and sixth nerve palsies most common; Diplopia is usually due to abnormal movement of the extraocular muscles (EOMs), which are innervated by 3 cranial nerves (CNs): CN 3 - superior, inferior, and medial rectus and inferior oblique muscle I do get monocular diplopia in both eyes. If i close one eye the ghost image stays above the actual image as well as if i close the other eye the same thing a ghost image above the actual image. I do not believe I am experiencing binocular diplopia. When i close either of my eyes the image stays the same. Its like i have stereo double vision

Dacryops is a lacrimal ductal cyst. It is known that it can cause globe displacement, motility restriction, and proptosis because of the mass effect. Diplopia due to dacryops has not been reported previously. Here, we present a 57-year-old man with binocular horizontal diplopia that occurred during left direction gaze due to dacryops binocular diplopia, worse with far-away objects, suggesting a deficit in eye abduction. A mild bilateral abducens palsy was appreciated on her initial neurological examination but was more evident on re-presentation ten days later. The differential diagnosis for bilateral abducens nerve palsy is broad, but if diplopia is of sudden onset, vascula Binocular diplopia is usually a problem of the nerves or muscles as in cranial nerve palsy, brain stem lesions, orbital infiltration, thyroid diseases, myasthenia gravis, and as in our case, a medication side effect causing myositis . Other important differential diagnoses for diplopia that should be considered and ruled out include stroke. Worsening binocular diplopia . This diagnosis carries an excellent prognosis for mortality, but the affected organs may sustain severe damage [2]. Epidemiology. muscle infiltration can be the presenting symptom of amyloidosis. Thus, amyloidosis should be considered in the differential for any patient with an atypical acquired strabismus.