Monocular central-field occlusion for intractable diplopia.

This report describes several methods of degrading imagery through the central portion of a spectacle lens to provide a cosmetically acceptable means of obtaining single vision in the central field of patients with intractable diplopia. For 2 strabismic patients with annoying diplopia, we applied to 1 spectacle lens a centrally placed disc (about 1 inch diameter) consisting of (1) translucent tap,a (2) a +7 D Fresnel lens,b or (3) stippled, clear lacquer. For 1 patient, the lacquer was the most acceptable; for the other, the tape was best. We present here the case reports for these 2 patients, showing why they preferred different image-degrading methods and how these and other methods of central-field image degrading can be advantageous even when diplopia is present across most of the visual field.