Diplopia following cataract extraction.

Diplopia following cataract extraction occurs in approximately 1% of cases or less. With over 1.5 million cataract extractions per year, this can lead to a considerable morbidity. It is typically a small vertical deviation and is distressing if unanticipated. The most common etiologies include surgical manipulation of orbital tissue from a bridle suture, extraocular muscle trauma from a retrobulbar needle or anesthetic, and unmasking an underlying strabismus or systemic condition with extraocular muscle involvement. Care must therefore be taken by obtaining a complete preoperative history and examination, document any preexisting strabismus and systemic condition, and avoid any direct extraocular muscle trauma or manipulation.