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Double Vision

Double vision can occur due to an extensive variety of causes and it requires diagnosis and treatment from the eye doctor.

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Double vision, known medically as diplopia, occurs when one object is perceived as two separate images simultaneously. These two images can be displaced from each other horizontally, vertically or diagonally. Double vision could occur binocularly which is when both eyes are open and then when you close one eye the diplopia disappears. In general, this tends to be more serious than when double vision is experienced when only one eye is open at a time. There are countless possible causes of double vision, some being more serious than others. Some people experience temporary double vision if they’re overtired or if they drink too much alcohol and these are not reasons to be concerned. However, double vision could be the first sign of a serious underlying condition and therefore, it’s essential to be checked by your eye doctor right away. If you experience sudden unexpected double vision you must seek emergency care as it could be caused by a variety of reasons which include conditions that cannot wait to be treated.

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Symptoms

Double vision may occur on its own or along with certain other symptoms that indicate the presence of another issue. Depending on the underlying cause of double vision, you may also experience one or more other symptoms, such as:

  • Pain when you move your eyes
  • Pain in the surrounding area of the eyes, such as the eyebrows or temple area
  • Misalignment of the eyes
  • Headaches
  • Nausea
  • Droopy eyelids
  • Loss of balance

If you notice these symptoms or experience changes in your vision and find it difficult for you to perform your daily activities, please schedule an eye exam with your eye doctor.

Treatment 

In order to treat diplopia, it is crucial to identify the root cause. If double vision is caused by weak eye muscles, then surgery can help treat diplopia. If a certain disease is the cause for double vision, it is important to properly treat the underlying condition. For example, there are medications that can help treat diabetes or myasthenia gravis which are illnesses that could lead to double vision. Cataract could also lead to double vision and this can be treated with cataract surgery.

Double vision sometimes goes away on its own and in 70% of the cases it is treatable with medication or surgery which help deal with the root cause. Sometimes double vision is a permanent condition and there are ways to help cope with this kind of vision. There are eye patches or prisms which can make the effects of diplopia more manageable. There is also vision therapy which uses exercises to train the brain to properly work with the eyes in the most optimal manner and this can help greatly to train your visual system how to properly overcome or deal with diplopia.

Causes of Double Vision

Causes of Double Vision

There are a vast number of causes for diplopia, some of which include:

  • Strabismus - a misalignment between both eyes can lead to double vision
  • Eye conditions such as keratoconus, cataract or dry eyes - monocular diplopia is usually due to an eye condition
  • Refractive error - if you are wearing the wrong prescription glasses or contact lenses it can cause double vision, usually in one eye   
  • Brain injury or condition such as a stroke, aneurysm or brain tumor
  • Cranial nerve palsies - the eye muscles could become paralyzed or lose some function due to a variety or reasons, including diabetes, high blood pressure, or meningitis 
  • Various diseases - for example: myasthenia gravis which is an autoimmune disease and double vision could be one of the first signs of this illness, or Graves’ disease which is when there is a problem with the thyroid

There are many more causes than the ones mentioned above. If you think you are experiencing double vision, please see an eye doctor immediately to ensure that the proper diagnosis and treatment can be provided.

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Prevention

For many causes of diplopia, there is no prevention, while for others there are certain precautions that could be taken. For example, when engaging in activities that carry a risk of damaging the eyes, make sure to wear the proper protective gear and goggles. In addition, be sure to wear your seat belt to avoid injury from car accidents. If you have diabetes, maintaining proper control of sugar levels can help prevent double vision due to diabetes.

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Common Questions

A double vision problem that appears suddenly and cannot be explained requires emergency care from your nearest eye doctor or urgent care center. There are a variety of causes for this condition which range from being mild to severe underlying conditions so any delay in diagnosis could lead to a series of complications. The eye doctor will do a thorough examination to find the main cause of the double vision that you are experiencing. Some of these include: Eye movement tests Blood tests Physical examination CT Scan MRI The best way to help your doctor find out the exact cause of the problem is by sharing all of the important health related information. The eye doctor will want to hear about other symptoms aside from the double vision. Some of the questions that you might be asked include: When did you first notice that you’re seeing double? At what time of the day is double vision worse? At night or when you’re tired? Is double vision present in one eye or both? Was there a head injury or were you in a car accident? Did you fall or become unconscious at any given point in time recently? Do you have the habit of tilting your head to one side? Once a diagnosis is reached the proper treatment can be provided.
You know if you have monocular diplopia if when you look at one object you see it twice and this type of double vision occurs when one eye is open and the other is closed. It could occur in either the right eye and/ or the left eye but when only one eye is open. Binocular diplopia occurs when there is double vision when both eyes are open and when you close one eye the double vision goes away. There are very different causes for monocular and binocular diplopia and monocular diplopia usually has a more mild cause than binocular double vision.
There is usually no need for concern when experiencing double vision, as it usually only lasts for a few seconds to minutes. It can be brought on by fatigue and lack of sleep or even drinking too much alcohol. It is important to consult our optometrist right away if you notice double vision more frequently, as it may be caused by an eye condition like cataracts, astigmatism, strains, or even a brain condition like stroke, brain tumor, swelling, or aneurysm. If you experience double vision for more than a brief period it is extremely important that you undergo a functional vision exam, which is an extended exam that looks at the full scope of your vision including the neurological processes involved in vision. A functional eye exam is performed by a functional or developmental optometrist and is a longer exam.
An optometrist, a medical doctor who specializes in eye and vision care, typically treats double vision. They have the training to diagnose the cause of your diplopia and provide appropriate treatments which may include eye exercises, corrective lenses, medications, or even surgery. You may also be referred to a neurologist if the issue is believed to be related to the nervous system.
Common causes of double vision include strabismus (misalignment of the eyes), nerve damage impacting eye muscle control, brain conditions such as stroke or tumors, and issues related to the cornea or lens, like cataracts. In some cases, systemic diseases like diabetes and multiple sclerosis can also lead to double vision.
While less common, vitamin deficiencies can potentially lead to double vision. For instance, a deficiency in vitamin B12, which is crucial for nerve function, can cause various neurological symptoms including diplopia. Also, a lack of Vitamin A, essential for good vision, may contribute to eye problems. As always, a balanced diet is key for maintaining overall health, including eye health.
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Summary

Double vision is when you see two images when only looking at one object. It can occur for a variety of reasons, some being mild while other causes are serious underlying conditions and therefore it’s crucial to be checked immediately if you suddenly notice double vision. The proper diagnosis from an eye doctor can help prevent complications and can lead you to the right treatment.

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