Diplopia como primeiro sintoma de esclerose múltipla Diplopia as first symptom of multiple sclerosis

Objetivo: Determinar a frequencia e as caracteristicas clinicas das alteracoes da motilidade ocular extrinseca em individuos portadores de esclerose multipla, residentes no estado de Sao Paulo, em serie de casos consecutivos de 1996 a 2011. Metodos: Foram selecionados oitenta e tres individuos com esclerose multipla, com idade entre 17 e 59 anos. Todos foram submetidos a anamnese e exame ocular completo. Resultados: Alteracoes da motilidade ocular extrinseca foram encontradas em 17 ( 20,48%) dos 83 individuos. A diplopia ocorreu como primeiro sintoma da doenca em 11 (13,25%) individuos. Conclusao: A frequencia de diplopia como primeiro sintoma de esclerose multipla e relevante. Por esse fato, e fundamental ressaltar a importância da difusao do conhecimento desse achado para a realizacao de diagnostico precoce de esclerose multipla, tanto para o oftalmologista geral, como para o medico generalista, melhorando assim o prognostico dos pacientes que dela padecem. Descritores: Esclerose multipla/complicacoes; Diplopia/etiologia; Sinais e sintomas; Diagnostico precoce; Manifestacoes oculares Purpose: To determine the frequency and clinical features of the extrinsic ocular motility changes in patients with multiple sclerosis living in the state of Sao Paulo (Brazil), consecutive cases series from 1996 to 2011. Methods: Eighty-three consecutive multiple sclerosis subjects were enrolled, aged from 17 to 59 years. All patients had a history taking and a comprehensive ocular exam. Results: Extrinsic ocular motility changes was detected in 17 (20,48%) out of 83 individuals. Diplopia as the first symptom of the disease occurred in 11 (13,25%) individuals. Conclusion: Frequency of diplopia as first symptom of multiple sclerosis is relevant. According to this statement, crucial importance should be given concerning spreading of knowledge and skills to internal medicine and general ophthalmology practicing physicians about early diagnosis of multiple sclerosis, which would reduce a delay in diagnosis of the disease and would help patients in the prognosis of the disease which they endure.