Recently acquired diplopia in adults with long-standing strabismus.

BACKGROUND The evaluation and management of recent-onset diplopia in an adult with a history of long-standing strabismus can be perplexing and challenging. No guidelines exist, to my knowledge, for the examination of such patients. DESIGN A retrospective medical record review. SUBJECTS Patients seen in my practice with a history of recently acquired diplopia and a history of strabismus dating back to childhood. RESULTS One hundred fifty-two patients who met the enrollment criteria were identified. Using the treatment approach outlined herein, 132 patients were relieved of their symptoms of diplopia. In most cases, the onset of the diplopia could be correlated with a change in the patient's ocular alignment, refractive needs, or refractive management. Returning patients to their motor status before the onset of symptoms or addressing the change in refractive needs or management usually resulted in relief of symptoms. CONCLUSION In most cases, adult patients with a history of long-standing strabismus and a recent onset of diplopia can be effectively treated.