Double Vision (Diplopia)

Double vision, also known as diplopia, is a condition which affects hundreds of thousands of people each year, and it can be triggered by a wide variety of causes.

Double Vision (Diplopia) in Olympia

American Family Vision Clinic

What is Diplopia?

Diplopia, more well known as double vision, can be caused by a wide range of things, leading to around 850,000 visits to the doctor or emergency room each year by people suffering from it.

Double vision is what occurs when the brain is not properly processing and combining the visual input from each eye into a single, clear image. As a result of this dysfunction, you end up seeing the separate, sometimes overlapping images from each eye.

Diplopia can be either a short term issue or long lasting, and the severity of the double vision can vary as well.

There are a few types of double vision vision:

  • Vertical Diplopia: This is when one of the two images appears higher than the other.
  • Horizontal Diplopia: This is when the two images appear to be side by side
  • Monocular Diplopia: This type of diplopia occurs only in a single eye, and can be noticed when the other eye is closed.

What Causes Double Vision?

There are numerous potential causes of double vision, some more common than others.

Common causes include:

  • Convergence Insufficiency

Convergence insufficiency is a relatively common vision issue in which the eyes have difficulty working together. Among other symptoms, it can cause double vision. However, the double vision caused by convergence insufficiency is generally only noticed while especially fatigued or stressed.

  • Strabismus

Strabismus is a condition which occurs when the eyes are not properly aligned, and one turns in a different direction. This results in the patient seeing two different images of the same object. Strabismus is the most common cause of double vision, and those with this condition are likely to experience it. However, it is not guaranteed. In those other cases, something called suppression occurs, where the brain actively shuts off the incorrectly turning eye to avoid double vision. If the strabismus is left untreated, the suppressed eye can suffer permanent vision loss.

Other Causes

Many other conditions can cause double vision by impacting the nerves or ocular muscles that control eye movement and are key to the brain-eye link.

These include:

  • Diabetes
  • Stroke 
  • Brain swelling
  • Brain tumor
  • Brain aneurysm
  • Traumatic brain injury
  • Thyroid dysfunction
  • Cranial nerve palsy
  • Multiple sclerosis
  • Myasthenia gravis
What Causes Double Vision?
Monocular Double Vision

Monocular Double Vision

Monocular double vision is far less common than binocular double vision, and it can be caused by:

  • Dry eye
  • Keratoconus 
  • Black eye
  • Macular degeneration
  • Cataracts 

Temporary Double Vision

Temporary double vision describes instances where one experiences double vision, but only for a short period, not regularly (unless the action which caused it is repeated.)

These causes include:

  • Extreme fatigue
  • Excessive alcohol consumption
  • Certain drugs (such as opioids, benzodiazepines, and medications for seizures and epilepsy)
  • Head injuries like concussions
Monocular Double Vision

How is Double Vision Diagnosed?

Double vision can be tough to diagnose, since it can be caused by a wide range of conditions, especially binocular double vision. However, a comprehensive eye exam conducted by a certified neuro-optometrist will likely detect the double vision and help determine the precise cause of it.

It is important to seek emergency medical attention if you experience any type of double vision, so you can rule out or at least detect potentially serious health problems which may be causing your double vision. Even if it appears to go away on its own, it is vital to see a doctor as soon as possible. In addition to possibly signifying a serious underlying problem, diplopia can worsen if left untreated.

How is Double Vision Treated?

Treatments can vary based on the main cause of the double vision, and the severity. 

  • Botox injections can relax the eye muscles to reduce symptoms.
  • An eye patch or opaque contact lenses can be worn to manually suppress vision in one eye
  • Surgery can be used to treat some types of double vision.
  • Prisms may be used to shift the image to realign
  • Vision therapy performed by a neuro-optometrist, is designed to treat the underlying problem, not only the symptoms.

Vision Therapy as Treatment for Double Vision

The treatment process for double vision by a neuro-optometrist begins with a comprehensive evaluation which will give our doctor a better idea what the root cause of your problem is, what type of diplopia you have This will tell our doctor which visual skills need to be worked on, to enable the formulation of a personalized neuro-optometric rehabilitation treatment plan aimed at correcting the problem and restoring your quality of life to a level as close as possible to what it was prior to the onset of diplopia.

Neuro-optometric rehabilitation therapy utilizes specialized therapeutic lenses, filters, patches, and prisms along with exercises, to help you regain lost visual skills or develop new ones to move you back toward long-lasting clear vision.

What Causes Double Vision?
Dr. Zurcher cartoon

Summary

Double vision, or diplopia, is a vision problem which can be caused by a wide range of conditions. Due to this, it is important that if you experience double vision, even only briefly, you seek medical treatment immediately. Treatments such as neuro-optometric rehabilitation therapy are effective and available, but things become more complex and more difficult the longer you wait. If you have recently experienced double vision, or suffered a traumatic brain injury, contact us today to Book an Appointment for a comprehensive vision evaluation.

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