Abstract
<jats:p>The management of diplopia requires a stepwise approach tailored to the underlying cause, the cranial nerve involved, and the patient’s functional needs. Initial observation is often appropriate, allowing for spontaneous recovery in cases such as ischemic palsies. During this period, patients may adopt a compensatory or alternate head posture to maintain single binocular vision and reduce symptoms. Adjunctive measures, such as targeted physiotherapy and orthoptic exercises, can help improve ocular alignment and fusion potential. Optical interventions, that is, Fresnel prisms, alleviate diplopia while monitoring progress. For selected cases, botulinum toxin injections offer temporary realignment by weakening overacting antagonist extraocular muscles. When conservative measures fail, surgical options, most commonly muscle transpositions, often performed in combination with other procedures, are considered to restore stable alignment and improve quality of life.</jats:p>