Goseki T, et al. - Researchers evaluated a retrospective observational case series of 945 patients (mean age: 66.5 years) who presented to the Stein Eye Institute with binocular diplopia between January 2015 and December 2018 in order to investigate sagging eye syndrome (SES) and other causes of acquired binocular diplopia in these adults. SES was identified to be the most common cause of diplopia (31.4%). Patients with SES were older at 71.2 years and more predominantly female at 59.9% than other patients (52.0%). Among all diplopic patients, an increase in the relative proportion of SES patients was observed with age from 4.7% under age 50 years to 60.9% over the age of 90. They identified age-related distance esotropia in 35% and cyclovertical strabismus in 65% of cases of SES. Fifty percent of cases of SES reported undergoing strabismus surgery; the surgery led to a decrease in mean esotropia at distance, a decrease in hypertropia and resolution of diplopia in all cases.