Persistent Binocular Diplopia After Cataract Surgery

Ocular motility findings in chronic progressive external ophthalmoplegia

“…For example, patients with asymmetric keratoconus may develop suppression, 24 and long-standing dense cataract in adults can permanently disrupt binocular function. [25][26][27] The adult visual system may be more plastic than previously recognised, and the finding of suppression does not prove that an ocular deviation dates from childhood. We did not demonstrate anomalous retinal correspondence in any of our cases, although one author has suggested that this may occur in CPEO.…”

Diplopia following cataract surgery: a review of 150 patients

“…Patients with congenital or long-standing superior oblique palsy develop large fusional amplitudes and their control may be disrupted by reduced vision in the cataractous eye or by cataract surgery. 7,21 It is possible that myotoxicity of the ipsilateral inferior rectus could be masquerading as a contralateral superior oblique palsy. However, the presence of large fusional amplitudes and lack of significant restriction of elevation in the operated eye are not consistent with inferior rectus restriction.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Rainin and Carlson 8 were the first to suggest that myotoxicity from the local anaesthetic could result in temporary or permanent extraocular muscle paresis.…”

“…However, the substantial benefit of visual acuity improvement resulting from cataract extraction can be reduced by the introduction of post-operative diplopia. Most of the recent literature regarding the cause of this complication [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] has focused on anaesthetic myotoxicity, trauma during infiltrational anaesthesia, or the use of a rectus bridle suture.…”

Regional anaesthesia for intraocular surgery

“…~64 EXTRAOCULAR MUSCLE INJURY: DIPLOPIA Transient diplopia after cataract surgery is common, asymptomatic sensory deviation having been unmasked by the optic correction. 165 Rainin and Carlson in 1985 drew attention to the association of diplopia and retrobulbar anaesthesia. 163 Subsequently, many cases of vertical diplopia due to inferior rectus muscle restriction following cataract surgery with retrobulbar anaesthesia were reported.…”