Abstract
THE SYMPTOM of diplopia can usually be attributed to 1 of 2 causes. Most frequently, it occurs in patients with no prior history of strabismus and, hence, no abnormal sensory adaptation who develop an ocular misalignment after visual maturity.1,2 This commonly occurs in patients with Graves disease or with acute paralytic strabismus or after an orbital fracture.3 Treatment of these patients usually involves correcting the misalignment of the visual axes, with surgery, botulinum toxin type A (Botox Allergen Inc, Irvine, Calif), or prisms. A second common cause of diplopia is the surgical overcorrection of patients with long-standing strabismus. For example, patients with intermittent exotropia or superior oblique muscle palsy will predictably develop diplopia if they have experienced a surgical overcorrection.

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