Review of the orbital anatomy and cranial nerves involved in eye movement. Critical anatomic landmarks of each neural pathway Radiologic assessment: optimal MRI protocol. Etiologic assortment according to topographic division. Key radiological findings of representative cases within our hospital setting.

Diplopia means double vision and is the simultaneous perception of two images when observing a single object with both eyes open. These images can have a horizontal, vertical or oblique disposition.There are 2 types of diplopia: Monocular diplopia: secondary to ocular globe pathologies. Binocular diplopia: secondary to ocular misalignment due to impaired extraocular muscle function (ophtalmoplegia or ophtalmoparesia). It is caused by lesions located inside the orbital cavity or along the course of oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) cranial nerves....

IMAGING ASSESMENT OF BINOCULAR DIPLOPIA MRI is the recommendend imaging modality in the evaluation of patients with binocular diplopia because of its high image resolution in the assesment of the brainstem, subarachnoid spaces, cavernous sinus and orbital structures. It is critical to perform an MRI study in the following cases: new onset diplopia in patient less than 50 years old, presence of more than one neurologic symptom, symptom progression or history of cancer. Optimal MRI protocol should include: axial T2w of brain and brainstem axial/coronal...

Binocular diplopia can be caused by potentially life-threatening entities hence the vital importance of recognizing the anatomy of the neural courses of CN III, IV and VI.A thorough understanding of the patient setting as well as the spectrum of clinical presentations of ocular dysmotility is needed to provide a careful neuroimaging assessment so the quality of patient care can significantly improve when clinical and radiological findings correlate.

A. Micolich Vergara: Nothing to disclose B. Beltrán Mármol: Nothing to disclose A. Gené Orriols: Nothing to disclose M. Saint-Gerons: Nothing to disclose J. M. Maiques Llácer: Nothing to disclose

Kim, J. H., Kim, M., & Bae, Y. J. (2022). Magnetic Resonance Imaging in Diplopia: Neural Pathway, Imaging, and Clinical Correlation. Korean journal of radiology, 23(6), 649–663. https://doi.org/10.3348/kjr.2022.0101 Kirsch, C. F., & Black, K. (2017). Diplopia: What to Double Check in Radiographic Imaging of Double Vision. Radiologic clinics of North America, 55(1), 69–81. https://doi.org/10.1016/j.rcl.2016.08.008 Thatcher, J., Chang, Y. M., Chapman, M. N., Hovis, K., Fujita, A., Sobel, R., & Sakai, O. (2016). Clinical-Radiologic Correlation of Extraocular Eye Movement Disorders: Seeing beneath the Surface. Radiographics :...