Understanding the Diagnosis and Treatment of Double Vision

Double vision, or diplopia, can affect one or both eyes, and can be caused by various underlying conditions. At Broberg Eye Care, accurate diagnosis is followed by the appropriate treatment to address the disorder. Contact us today to learn more.

Diplopia occurs when a person sees a double image. These images can appear side by side or one on top of the other. In some instances, patients will experience both of these effects simultaneously. Aside from severely impeding vision, diplopia can result in difficulties navigating your surroundings. For example, double vision can cause interruptions in movement, balance, and reading ability. It is important to have an Ophthalmological consultation right away if you are experiencing double vision, as it can significantly hinder your quality of life.

Both eyes work together harmoniously to create depth of vision. When one element of this intricate system falters, it can result in diplopia. There are a number of potential conditions that can lead to double vision. Some of these include:

  • Eye Infections: Certain infections, such as herpes or shingles, can exacerbate diplopia.
  • Keratoconus: A degenerative condition, keratoconus can cause thinning of the cornea.
  • Misalignment: If the eyes are not properly aligned, it can lead to double vision. This can be due to eye muscles that are weak, paralyzed, restricted, or overactive. It can also occur if there are abnormal nerves controlling the eye muscles.
  • Scars or Dryness: If the eye dries out too quickly, or it does not produce sufficient tears, diplopia can result.
  • Cataracts: Double vision can be an early warning sign of a cataract.
  • Issues with Nerves inside the Eye: If the nerves controlling the eye become damaged in some way, diplopia can develop.
  • Brain Conditions: Strokes, trauma, and tumors can all contribute to the development of double vision.
Because there are so many possible factors involved in the development of double vision, a thorough evaluation must be made before a personalized treatment plan can be created. While recommended interventions vary from case to case, there are a number of measures that can be taken to address double vision, including:

  • Wearing corrective eyewear, such as glasses or contacts
  • Attaching ultra-thin, clear plastic prisms to glasses
  • Eye exercises
  • Botox® injections to relax overactive eye muscles
  • Wearing an eye patch
  • Wearing an opaque contact lens
  • Undergoing a surgical procedure to reposition the eye muscles

Once the underlying cause of a patient’s diplopia has been accurately identified, the proper course of treatment can be laid out:

  • Astigmatism: Depending on the severity of irregularity, it may be possible to correct the astigmatism through a laser eye surgery procedure such as LASIK or PRK. Alternatively, some patients may be able to achieve good results by wearing soft toric contact lenses, while others may have to wear rigid contacts.
  • Cataracts: If a cataract is causing double vision, it can be surgically removed and replaced with an intraocular lens (IOL).
  • Muscle disorders: If muscle disorders are determined to be causing a patient’s diplopia, conservative vision therapies such as prisms and occlusion will comprise the first course of treatment. If these are not successful, eye muscle surgery may be recommended.
  • Serious health conditions: If serious health conditions are diagnosed, then we will work together with your primary physician to ensure that the management of your ocular health is coordinated with the treatment of your underlying health condition.

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