Objective The author discuss the diagnosis and differential diagnosis of diplopia lacked certain abnormality after routine Laboratory examination and review relative articles to combine the study of the possibility etiology. Methods The clinical analysis date Result According to the clinical presentation and laboratory further provide investigation showed their etiology diagnosis for 21 cases. Ocular type Graves disease are 7 cases, Latent diabets are 8 cases ,Hypertension arteriosclerosis are 2 cases, High urine acid in serum are 2 cases ,rheumatic extrocular myoparalysis in l case and uncertain cause in 1 case. Discussion As to diplopia single extrocular myoparalysis or monoeuropathy for untipical syndrome, after excluded the routine neuropath and Occupation . Etiology diagnosis should consider some matabolism and endocrie disorder such as latent diabet ,Graves disease , high urine acid in serum etc, except for attention usual hypertension and artreiosclerosis diabet . Conclusion To improve the ability to diagnosis and differentiate diplopia, this paper recognised more attention to be paid to study and distinguish the possibility of d iplopia caused by vascular disease, especially by microrangium for some matabolism and endocrie disease.