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Binocular diplopia associated with retinal wrinkling.

Four patients with retinal wrinkling and epiretinal membrane formation presented with a unique clinical syndrome consisting of comitant, small angle hyperdeviations with intractable vertical diplopia, and unstable single vision with a failure to respond to conventional prism therapy. The pathophysiology underlying this presentation appears to be the establishment of a rivalry between central and peripheral fusional mechanisms due to mechanical macular distortion.