{"id":3863,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/diplopia\/"},"modified":"2026-01-28T12:03:31","modified_gmt":"2026-01-28T12:03:31","slug":"diplopia","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ophthalmology\/diplopia\/","title":{"rendered":"Diplopia"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">\u200bGather as much information as possible about the diplopia.\nClarify what the patient means by double vision. Is it true diplopia or blurred\nvision? Is there a precipitating injury? Is it vertical or horizontal diplopia?\nAre the images completely separated or joined? Is it monocular (diplopia\nremains when the patient shuts one eye) or binocular (on shutting one eye the\nvision returns to normal). Is it worse in one direction of gaze e.g. every time\nthe patient looks down or every time they look right? Does tilting their head\nimprove the diplopia? Is it associated with a headache or ptosis? <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Past Medical History is important including relevant\nfeatures such as BP, diabetes, cholesterol, thyroid disease and any recent\nblood results relating to cardiovascular risk. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">On examination is there any restriction of eye movements? Is\nthere a ptosis\/abnormal pupils\/pupillary response\/nystagmus? <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Please see the <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Ophthalmology-Diplopia-Patient-Pathway.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Ophthalmology-Diplopia-Patient-Pathway.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">diplopia algorithm<\/a>  which can help you work through the symptoms to reach a differential diagnosis. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Please advise patients to not drive if they have ongoing\ndouble vision. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">JC &amp; BC 28\/1\/26<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Ophthalmology-\u2013-Lothian-GP-and-Optometry-Ophthalmology-Referral-Pathway.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Ophthalmology-\u2013-Lothian-GP-and-Optometry-Ophthalmology-Referral-Pathway.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Please see Lothian GP and optometry ophthalmology referral pathway<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Urgency-of-the-condition.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Urgency-of-the-condition.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Urgency of the condition<\/a>&nbsp;for details on how soon patients should receive an appointment.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>We require a referral letter for EVERY patient<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The preferred referral process is via SCI Gateway. If sending\/forwarding a referral via SCI gateway please include past medical history, allergies and medications<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you do not have access to fax or SCI Gateway e.g. if you have arranged an appointment out of hours please send a written referral letter with the patient to bring to their appointment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Only if SCI Gateway is unavailable should a letter be typed or handwritten. Please write legibly and include your examination findings.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have arranged an appointment in the acute referral clinic and you are referring from within another hospital in Lothian please use TRAK to type the referral letter.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&#8203;Gather as much information as possible about the diplopia. Clarify what the patient means by double vision. Is it true diplopia or blurred vision? Is there a precipitating injury? Is it vertical or horizontal diplopia? Are the images completely separated or joined? Is it monocular (diplopia remains when the patient shuts one eye) or binocular<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4212,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[471],"class_list":["post-3863","page","type-page","status-publish","hentry","category-diplopia"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/ophthalmology\/diplopia\/\" rel=\"tag\">Diplopia<\/a>","rttpg_excerpt":"&#8203;Gather as much information as possible about the diplopia. Clarify what the patient means by double vision. Is it true diplopia or blurred vision? Is there a precipitating injury? Is it vertical or horizontal diplopia? Are the images completely separated or joined? Is it monocular (diplopia remains when the patient shuts one eye) or binocular","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3863","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3863"}],"version-history":[{"count":16,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3863\/revisions"}],"predecessor-version":[{"id":26376,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3863\/revisions\/26376"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4212"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3863"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}