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Presentation type	E-poster
Title	Acquired diplopia without oculomotor palsy : a case series of 25 patients

Purpose	Purpose : This study aims to investigate the causes and treatments of acquired binocular diplopia in adult without oculomotor palsy.
Methods	Methods : We reviewed records of 25 consecutive patients who presented acute and persistent diplopia without oculomotor involvement at a tertiary hospital's Neuro-ophthalmology department over a six- month period. These patients underwent an exhaustive neuro-ophthalmic and orthoptic examination.
Results	Results : Between January and June 2023, 25 patients were enrolled (18 F, 7 M). The age of the patients ranged from 51 to 91 years old with a mean age of 74 years old. Among them, 21 presented a binocular deviation: 10 horizontal (7 esotropia, 3 exotropia), 6 vertical and 5 oblique. The reasons for fusion disruption were often multifactorial: central and/or peripheral visual impairment, aniseikonia, refractive changes from multifocal IOL and head injury. Fusion may be worsened by medications (anxiolytic, antidepressive) or neurological disorders (4 Parkinson's disease, 1 Lewy body dementia, 1 stroke). The proposed treatments consisted of 6 IOL implantations, 1 vitrectomy, 1 strabismus surgery and 11 prism adaptations.
Conclusion	Conclusion : Diplopia due to fusional disorders without oculomotor palsy should be considered in elderly patients. Treatment can be challenging. However, in most patients, fusion can be restored after improvement of visual acuity with surgery, careful subjective refraction and, if needed, prism adaptation. Strabismus surgery is not always recommended as patients’ fusion is often unstable, especially in older population.
Conflict of interest	No

Authors 1

Last name	ZAHER
Initials	S
Department	Cliniques Universitaires Saint-Luc
City	Bruxelles

Authors 2

Last name	BOYER
Initials	C
Department	Cliniques Universitaires Saint-Luc

Authors 3

Last name	HEMPTINNE
Initials	C
Department	Cliniques Universitaires Saint-Luc

Authors 4

Last name	COUTEL
Initials	M
Department	Cliniques Universitaires Saint-Luc

Authors 5

Last name	BOSCHI
Initials	A
Department	Cliniques Universitaires Saint-Luc