Understand Double vision: Symptoms and Treatments

Double vision, also known as diplopia, is a symptom identified by seeing two images of a single object. It is often indicative of an underlying condition affecting the eyes, muscles, or nerves responsible for coordinating eye movements. Therefore, double vision itself is a symptom rather than a standalone condition.

Double vision is the condition in which a person perceives two images when there should only be one. One image can be stacked one over the other, placed next to each other, or both.

The illness may cause problems with mobility, balance, and reading comprehension. It is called monocular double vision if it only affects one eye. If any of the eyes are affected, it is binocular. Depending on the reason and kind, treatments could involve surgery, specialized glasses, and eye exercises.


What is Double Vision?

Double vision, also known as diplopia, is the condition in which you perceive two distinct objects in your field of vision as opposed to one distinct and distinct depiction of each object. Permanent or transient double vision is possible. Double vision may also occur in one eye.

Double vision can result from a variety of situations or illnesses, varying in severity from a little inconvenience to a major or even fatal issue. There are three possible orientations for double images: vertical, horizontal, or skewed. Polyplopia is the perception of one item in three or more opposing representations.

According to its origin, it can be of two types:

  • Binocular: The most common type is when the eyes are not properly aligned with one another. Most often, it has to do with strabismus.
  • Monocular: A much less common variant when one eye produces double vision. It is linked to an anomaly of the eyes, like astigmatism or cataracts.

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Symptoms of Double Vision

If you have double vision (diplopia), you may notice these symptoms:

  • Seeing Two Images: Seeing two images of one object, side by side, on top of each other, or both.
  • Blurred Vision: Trouble seeing clearly with fuzzy images.
  • Difficulty with Focus: Trouble keeping a clear and steady image.
  • Eye Strain: Tired or uncomfortable eyes.
  • Headaches: Persistent or recurring headaches with vision issues.
  • Disorientation: Feeling confused or having trouble with spatial orientation due to overlapping images.
  • Misalignment: Noticing that eyes may not appear to be correctly aligned.

If you have double vision, it’s important to see a healthcare professional for the right diagnosis and treatment.


Causes of Double Vision

Stroke, head injury, a tumor of the brain, brain swelling, or aneurysm of the brain:

  • Double vision can occur out of nowhere and be caused by a brain tumor, stroke, head injury, or other similar disorder. After an examination, you can be referred by your ophthalmologist to a specialist for more testing and treatment, like a neurologist or neurosurgeon.
  • Corneal Irregularities: Corneal diseases like keratoconus can lead to double vision. Treatments for dry eyes include eye drops, punctal plugs, or contact lenses, while surgical options like Intacs implants or corneal transplants may be needed. 
  • Dry Eyes: Eye drops, earplugs, eye vitamins, eyelid hygiene practices, or a mix of these treatments can be helpful for many individuals with dry eyes.
  • Refractive Surgery: After LASIK, PRK, or similar surgeries, temporary double vision may occur due to changes in the corneas or uneven surfaces. This usually resolves within a few days or weeks. In some cases, a second surgery might be needed to correct the issue entirely.
  • Cataracts : Cataracts can cause double vision because the eye's natural lens becomes opaque, scattering light rays and creating multiple images. Cataract surgery typically resolves this issue.
  • Cranial Nerve Palsy : Double vision can also result from paralysis or loss of control over one or more muscles that control eye placement and coordination due to cranial nerve paralysis. Cranial nerve paralysis can be brought on by diabetes, cerebral damage, stroke, multiple sclerosis, meningitis, high blood pressure, clogged arteries, or aneurysms.

What is the Double Vision Test

  • Visual Acuity Test: Measures vision sharpness.
  • Eye Alignment Test: Checks if eyes work together properly.
  • Cover Test: Observe eye adjustment when one eye is covered.
  • Prism Test: Diagnoses and measures double vision extent.
  • Ocular Motility Test: Assesses eye movements and coordination.
  • Slit Lamp Examination: Examines the cornea and lens for irregularities.
  • Neurological Examination: Identifies underlying neurological issues.

When to visit a Doctor?

Double vision frequently requires a medical check to determine the cause. Having double vision is a sign that something is wrong with your neurological system, brain, or eyes. A thorough assessment is required to determine the cause of the issue. 

A curable disease is often the cause of the additional picture that appears in your range of vision. However, if your vision suddenly changes, you should get medical help right once. Certain disorders require immediate medical intervention in order to avoid life-threatening complications or permanent visual loss.


Diagnosis of Double vision

Pay attention to the present condition of your health

You and your doctor may spend some time updating your medical history. This includes:

  • A complete history of your symptoms: Your doctor can help you check out potential reasons and determine which tests would be beneficial if you fully describe your vision problems. If you have noticed any unexpected symptoms, even if you don't think they have anything to do with your visual issue, make sure you report them to your doctor.
  • Your personal health history: Your doctor may consider underlying factors such as diabetes, thyroid problems, or neurological disorders that could be causing your vision problems.
  • Your family health history: Inform your doctor if any members of your family suffer from conditions that can cause double vision. These issues may serve as a solid basis for your diagnosis.

Physical examination

A thorough physical examination can assist your physician in determining the potential cause of your double vision. This exam may include:

  • blood tests to look for an infection
  • eye exam and dilated eye exam
  • eye movement tests
  • toxicity tests
  • blood sugar readings
  • imaging tests, such as a CT scan or MRI

Treatment for  Double vision

This will depend on the underlying cause.

Causes for Double Vision

Treatment will depend on the cause.

  • Astigmatism: This is a cornea that is atypically curled. Curvature may frequently be countered and the way incoming light enters the eye is corrected with glasses that are corrective or contact lenses. An additional alternative is laser surgery. The cornea is laser-reshaped during this process.
  • Cataracts: Generally, surgery is the best choice. The influencing and the reason for double vision are eliminated during the surgical treatment. Prompt treatment will typically cure complications, which include infection, discomfort, and possibly ongoing blurred or double vision.
  • Dry Eye:The eyes may get sore and inflamed if they don't tear up enough or dry out too soon. It may cause double vision as a result. Usually, the symptoms can be relieved with prescription medication for tear replacement eye drops.

Treatments for Double Vision

This will depend on the underlying cause.

  • Wearing glasses
  • Eye exercises
  • Using an opaque contact lens
  • Injections of botulinum toxin (Botox) into the eye muscles, causing them to remain relaxed
  • Wearing an eye patch
  • Surgery on the eye muscles to correct their position
  • An adhesive prism, placed between the eyes in the centre of the glasses frame, can also help realign the images from each eye.

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Prevention of Double vision

Prevention of diplopia begins with prevention of the underlying cause. To keep your eyes safe, here are some tips:

Manage your diabetes

Patients with diabetes who adhere to their treatment regimens are less likely to experience double vision. People who eat a healthy, balanced diet, exercise frequently, and keep up a healthy weight are also far less likely to develop type 2 diabetes and, consequently, double vision because diabetes can be caused by lifestyle choices.

Prevent the development of cataracts.

Avoid cataracts and maintain the health of your eyes by eating a balanced diet, quitting smoking, and wearing sunglasses.

Soothe Dry Eyes

Keeping your eyes adequately lubricated can prevent double vision. Although prolonged computer use tries to lower intraocular pressure, it can cause dry eyes.

Protect yourself from Head Injuries.

Wearing seat belts in cars, a sturdy helmet when riding a bike or motorbike, and appropriate eyewear and a helmet when operating heavy machinery or participating in sports can all help prevent brain injuries.

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Frequently Asked Questions

1. What is double vision a sign of?

Double vision that affects both eyes is usually a symptom of strabismus. This is where problems with the eye muscles or nerves cause the eyes to look in slightly different directions.

2. What neurological conditions cause double vision?

They include neurological conditions, such as myasthenia gravis or multiple sclerosis, or they may be associated with a systemic disorder, such as hyperthyroidism. It can also be a symptom of a stroke, aneurysm, or head or facial trauma, especially around the eye socket.

3. Can mobile phones cause double vision?

Long-term use of smartphones could lead to an acute eye condition in which one of the pupils turns inward, causing double vision and making a person appear cross-eyed.

4. Can lack of sleep cause double vision?

Lack of sleep or excessive alcohol consumption can also cause double vision, but it will only be temporary. Chronic double vision is a serious condition and needs to be treated right away.

5. Is double vision serious?

Double vision can occur with one or both eyes. If it's in one eye when the other is closed, it's less of a concern but still serious. If it occurs when both eyes are open, it could indicate a greater disorder.

6. What causes sudden temporary double vision?

Sudden temporary double vision can be caused by issues such as muscle weakness, nerve damage, or a misalignment of the eyes, often resolving once the underlying cause is addressed. Seeing an eye care professional promptly is crucial for accurate diagnosis and treatment.

7. How to cure double vision naturally?

Natural remedies for double vision may include eye exercises to strengthen muscles, maintaining a healthy lifestyle with adequate hydration and nutrition, and practicing good eye habits like avoiding excessive screen time. However, it's essential to consult with an eye care professional for proper diagnosis and personalized treatment.

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