Double Vision(Diplopia): Causes, Symptoms, Diagnosis &Treatments

Double Vision Meaning

Have you ever experienced when you are doing something let’s say walking around or talking to a person and all of a sudden they split into two separate people they could be side by side, it could be up and down or even diagonally then this real serious medical issues known as double vision or diplopia as in medical terms.

 

What Does Double Vision Look Like?


Double Vision, Diplopia, Causes of Diplopia
Double Vision


Having a double vision can be:


- Alarming.


- Concerning and frightening.


- It is a serious medical condition.

 


Imagine a case, when you are driving down the road and you can see one car in front of you and all of a sudden it splits off into two of them and you're not sure which one is actually real in that type of situation it can be a big threat to you as well as other’s life.


 


Double Vision Causes: Double Vision in Both Eyes

There are many different causes for double vision in both eyes but among all of the most common are -


1. Strabismus

 

Strabismus for Double Vision

Sometimes the person who is new to this type of eye disorder then his brain hasn't adapted to it yet due to which these types of people can actually, see double vision.

 

It is also important to note that there are actually different types of strabismus or eye turn:


1. Eyes turning inward: Esotropia or Esophoria.


2. Eyes turn outward: Exotropia or Exophoria.

 

Due to these types, their double vision may vary from horizontally double vision to a vertical double vision or maybe diagonal sometimes.

 



2. Tired and Fatigue eye


Double Vision when Tired

A lot of people do experience double vision especially when they're tired or fatigued usually this type of diplopia doesn't last very long it's rather intermittent meaning it just sort of lasts for maybe a few seconds or a minute but once you kind of realize it blink your eyes a few times things suddenly snapback into focus.

 


3. Cataract

Cataracts can also cause double vision. In the case of cataract, our eye lens becomes cloudy due to which light passes through it will refract and this results in a double vision. But it is also important to note that this not happens with everybody having cataracts.


 

4. Cataract Surgery


Double Vision after Cataract Surgery

This type of Double vision complication after cataract surgery is first noted by Mitchell B. Strominger back in 2004 he sees typically two to four cases every week of diplopia after cataract surgery he estimated that this type of complications arise in nearly 10% of the cataract surgery cases.

 

The most important causes of post-cataract double vision(diplopia) is as follows:


- Anaesthesia related.

- Preexisting strabological disorders: Strabismus or crossed eyes.


Optical and refractive complications.


Sensory deprivation by dense cataract.

 

Optical and refractive reason for post-cataract double vision (diplopia) is:


- Lens implant decentration or subluxation is one of the monocular diplopia causes or double vision in one eye causes and require repositioning of the implant.

 

 


5. Thyroid Eye Diseases

Basically, thyroid problems stem from an autoimmune issue where your own immune cells attack your thyroid but not only that they also attack the back surface of the eyes and causes the muscles around the eyes to swell.

 

After swelling just because the orbit really doesn't have much place for those muscles to go it actually pushes on the eyes and causes them to kind of protrude outward and that kind of gives people this kind of bug-eyed appearance and that's classically known as Graves disease.

 

Thyroid Eye Diseases for Double Vision

The main issue with having thyroid disease is that it can cause these muscles to swell a little bit and it primarily is going to cause an issue with vertical double vision because it usually affects the lower eye muscles first, so it actually causes problems with your kind of looking and your eyes will be kind of staggered in a way and so you'll see things kind of split vertically.

 


 

6. Myasthenia Gravis


Myasthenia Gravis for Double Vision

Myasthenia Gravis, it's actually another autoimmune condition where your own immune cells like block the ability for your body to

really utilize acetylcholine which is a neurotransmitter that really speaks between your muscles and your actual nerve impulses because of this your own nerve impulses to move your muscles aren't really getting the signal and so your muscles aren't really working the way they're supposed to.

 

Signs of Myasthenia Gravis


- Loss of control of the eye muscles and the eyelids.

 



7. Multiple sclerosis (MS)


Multiple sclerosis for Double Vision

MS is an autoimmune condition where basically your own body starts to attack the myelin sheath this is the fatty sheath that surrounds all the different nerves in your body.

 


Multiple sclerosis or MS can be a very frustrating disease not only just for the patient who's actually experiencing it but also for the doctors.

 


MS can attack and affect people in so many different ways that it's highly variable one person can get it and there are only mildly affected where another person can develop a really severe form rather quickly and even at a younger age.

 



8. Brain Tumor or Lesion


Double Vision due to Brain Tumor

Brain tumor or mass lesion an eye exam is very much a neurological exam in many ways basically because we're testing so many cranial nerves all at once.

 

- Cranial nerve III involves a lot of the eye muscles including how the pupil works.


Cranial nerve VI controls eye muscle.


Cranial nerve IV controls your eye muscles.


Cranial nerve II is our optic nerve.


Because all of these cranial nerves originate in deeper parts of the brain they actually have long extensions that go to the eye so if a tumor or a lesion in your brain is occurring anywhere along these nerves it can affect the eye muscles.

 


Important  If you're ever experiencing any sort of new onset double vision and you haven't had it address before by your doctor, please make an eye examination with your local eye care physician so that you can get things checked out and make sure that everything's okay

 


Double Vision Symptoms

Symptoms of  Double Vision is closely related to its causes so in case of double vision this is most important to first identify the primary cause of it.


1. Improper alignment of one or both eyes (a "wandering eye" or "cross-eyed" appearance).


2. Pain while moving your eyes.


3. Headache.


4. Nausea.


5. Pain around your eyes.


6. Ptosis or Droopy eyelids.


Ptosis or droopy eye or blepharoptosis is an eye condition where your upper eyelid abnormally falls on your lower eyelid. This condition can be in one or both eyes.




Double Vision Diagnosis

Diagnosis procedure of double vision is only possible after finding its root cause or primary cause of its origin either it is double vision in both eyes or double vision in one eye. 


And to find your root cause of it you have to go through a series of tests and questions since, double vision can be a result of a variety of problems so it’s not possible to get an exact result from a single test.


These tests are:

- Blood Test.


Physical Exam/Test.


Computed Tomography or CT-scan.


Magnetic Resonance Imaging (MRI).


 

Series of Questions you have to go through:


- When did you first feel this strange type of vision or double vision?


- How worse you feel with this vision?


- What type of double vision is it whether it is vertical, horizontal, or diagonal?


- Is your double vision is presented in both eyes or only when one specific eye is open?


- What type of symptoms you feel other than having a double vision?


- Have you gone through any injury before all this started?


- Does tilting of the head creating any difference in your double vision it may improve or become worse?

 

You have to find the answers to all these questions and the only way to find your answers is by self introspecting and right answers to these questions are very-2 important for your health.

 

 


Double Vision Treatments

In order to treat double vision it’s important to treat its root cause because in this it’s more important to solve the cause then its result i.e. diplopia

 

1. If double vision is due to fatigue and stress which is a very normal one then it is treated by eye exercises or eye health vitamins.


2. Double Vision due to weak eye muscles or pinched muscle results from any type of injury is treated by eye surgery.


3. Double Vision resulting from Graves’ diseases can be treated by medicine or also by surgery.


4. Prism glasses are also prescribed in a type of double vision which is not variable means cases when sometimes you feel it and sometimes not in such cases you need many pairs of glasses for different variations and every morning you have to decide which one you need for that day.


5. Medications are also available to treat Myasthenia Gravis which ultimately treats your double vision due to it.

 



References

1. Capo H, Roth E, “Vertical strabismus after cataract surgery”, Ophthalmology.


2. U. Brandlhuber, C. Haritoglou, T. C. Kreutzer, and D. Kook, “Reposition of a misaligned Zeiss AT TORBI 709M® intraocular lens 15 months after implantation,” European Journal of Ophthalmology, vol. 24, no. 5, pp. 800–802, 2014.

View at: Publisher Site | Google Scholar   


3. Maciej Gawęcki and Andrzej Grzybowski , “Diplopia as the Complication of Cataract Surgery”, 2016 , Journal of ophthalmology.

View at: Hindawi

 

4. Double Vision or Diplopia by Webmd

 

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