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31 year old woman with vertical diplopia for 2 months
Digital Journal of Ophthalmology 1998
Volume 4, Number 21
August 8, 1998
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Kenneth Graham, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA



Differential Diagnosis
Supranuclear processes: Skew deviation, Wernicke's syndrome, Vertical one-and-a-half syndrome
Ocular motor nerve dysfunction: 3rd or 4th cranial nerve palsy, ophthalmic migraine, superior oblique myokymia
Neuromuscular junction disease: Myasthenia gravis, Botulism
Disease of eye muscles: Graves disease, trauma, local anesthesia, chronic progressive external ophthalmoplegia, decompensation of a long standing phoria, metastasis, muscle ischemia (Giant cell arteritis)
Mechanical processes causing vertical eye misalignment: Status post surgery (strabismus, orbital, or retinal), Brown's superior oblique syndrome, pseudotumor, orbital tumors
Retinal disease: Foveal displacement
Other: Fictitious, hemifield slide phenomenon
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