People should visit a doctor immediately if they suddenly develop double vision or if they develop skew deviation, as such symptoms can be fatal if untreated.
Taipei Shu Tien Clinic doctor Huang Chi-hsun (黃啟訓) said the clinic had one case of double vision, also known as diplopia, and one of skew deviation, which were diagnosed as directly affecting the third, fourth and sixth cranial nerves.
The three pairs of nerves in the cranial nervous system coordinate eye movement, and damage to any one of the three can cause skew deviation, Huang said.
Photo: Chou Yan-yu, Taipei Times
The first case was the sudden development of diplopia in a 35-year-old patient surnamed Liu (劉), Huang said.
A computed tomography scan showed that the patient had sustained a brainstem aneurism, which was placing pressure on the patient’s third cranial nerve, Huang said.
The clinic performed surgery to remove the aneurism, Huang said, adding that had it not been removed, the patient could have sustained a cerebral hemorrhage.
An aneurysm occurs when part of an artery wall weakens, allowing it to widen abnormally or balloon out, which could be congenital or due to arteriosclerosis, which can occur with age or due to hyperglycemia, hypertension or hyperlipidemia, Huang said.
Liu’s vision returned to normal following the surgery, Huang added.
The second case involved a 79-year-old who had been diagnosed with diabetes, Huang said.
The patient visited the clinic after developing skew deviation and double vision, and had a glycated hemoglobin level of 8.2 — the standard for diabetics is 7, Huang said.
The patient was diagnosed with diabetic neuropathy, which damaged the fourth and sixth cranial nerves, Huang said, adding that the condition was due to improper blood sugar level control, which led to arteriosclerosis.
After medication and stricter blood sugar level control, the patient’s condition has stabilized, Huang said.
Patients with sudden development of skewed deviation or diplopia who are not in any pain should see a doctor to rule out the possibility of an aneurism, Huang said.
If not treated in time, aneurisms are fatal when they burst, Huang said, adding that diabetics should monitor their blood sugar levels.
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