Cerebral diplopia or polyopia describes seeing two or more images arranged in ordered rows, columns, or diagonals after fixation on a stimulus.[1][2] The polyopic images occur monocular bilaterally (one eye open on both sides) and binocularly (both eyes open), differentiating it from ocular diplopia or polyopia. The number of duplicated images can range from one to hundreds. Some patients report difficulty in distinguishing the replicated images from the real images, while others report that the false images differ in size, intensity, or color.[1] Cerebral polyopia is sometimes confused with palinopsia (visual trailing), in which multiple images appear while watching an object.[3] However, in cerebral polyopia, the duplicated images are of a stationary object which are perceived even after the object is removed from the visual field.[3] Movement of the original object causes all of the duplicated images to move, or the polyopic images disappear during motion.[4] In palinoptic polyopia, movement causes each polyopic image to leave an image in its wake, creating hundreds of persistent images (entomopia).[4][5]
Infarctions, tumors, multiple sclerosis, trauma, encephalitis, migraines, and seizures have been reported to cause cerebral polyopia.[1][6] Cerebral polyopia has been reported in extrastriate visual cortex lesions, which is important for detecting motion, orientation, and direction.[1] Cerebral polyopia often occurs in homonymous field deficits,[7] suggesting deafferentation hyperexcitability could be a possible mechanism, similar to visual release hallucinations (Charles Bonnet syndrome).