Double Vision (Diplopia): Causes, Symptoms, Diagnosis, and Treatment

Double vision, or diplopia, is a symptom to take seriously. Some causes of diplopia are relatively minor, but others need urgent medical attention. MedicoPK takes a look at the causes, symptoms, and treatments for double vision.


What Causes Double Vision?


Opening your eyes and seeing a single, clear image is something you probably take for granted. But that seemingly automatic process depends on the orchestration of multiple areas of the vision system. They all need to work together seamlessly:


-> The cornea is the clear window into the eye. It does most of the focusing of incoming light.

-> The lens is behind the pupil. It also helps focus light onto the retina.

-> Muscles of the eye — extraocular muscles — rotate the eye.

-> Nerves carry visual information from the eyes to the brain.

-> The brain is where several areas process visual information from the eyes.


Problems with any part of the vision system can lead to double vision. It makes sense to consider the causes of diplopia according to the part of the visual system that has the problem. Double vision is not normal and should be reported promptly.


Cornea problems. Problems with the cornea often cause double vision in one eye only. Covering the affected eye makes the double vision go away. The abnormal surface of the eye distorts incoming light, causing double vision. Damage can happen in several ways:


> Infections of the cornea, such as herpes zoster, or shingles, can distort the cornea.


> Corneal scars can alter the cornea, creating unequal visual images.

> Dryness of the cornea can create double vision.


Lens problems. Cataracts are the most common problem with the lens that causes double vision. If cataracts are present in both eyes, images from both eyes will be distorted. Cataracts are often correctable with minor surgery.


Muscle problems. If a muscle in one eye is weak, that eye can’t move smoothly with the healthy eye. Gazing in directions controlled by the weak muscle causes double vision. Muscle problems can result from several causes:


> Myasthenia gravis is an autoimmune illness that blocks the stimulation of muscles by nerves inside the head. The earliest signs are often double vision and drooping eyelids, or ptosis.


> Graves’ disease is a thyroid condition that affects the muscles of the eyes. Graves’ disease commonly causes vertical diplopia. With vertical diplopia, one image is on top of the other.


Nerve problems. Several different conditions can damage the nerves that control eye muscles and lead to double vision:


> Multiple sclerosis can affect nerves anywhere in the brain or spinal cord. If the nerves controlling the eyes are damaged, double vision can result.

> Guillain-Barre syndrome is a nerve condition that causes progressive weakness. Sometimes, the first symptoms occur in the eyes and cause double vision.

> Uncontrolled diabetes can lead to nerve damage in one of the eyes, causing eye weakness and double vision.


Brain problems. The nerves controlling the eyes connect directly to the brain. Further visual processing takes place inside the brain. Many different causes for double vision originate in the brain. They include:


> Strokes

> Aneurysms

> Increased pressure inside the brain from trauma, bleeding, or infection

> Brain tumors

> Migraine headaches


 

How Is Double Vision Treated?


With double vision, the most important step is to identify and treat the underlying cause. In some cases, double vision can be improved by managing or correcting its cause.

If weak eye muscles are the cause, or if a muscle has been pinched as a result of injury, surgery may help.

Myasthenia gravis can be treated with medications.

Graves’ disease is often curable with surgery or medical therapy.

Blood sugar in diabetes can be controlled with medicines and/or insulin.


If double vision can’t be reversed, treatments can help people live with double vision. Sometimes, this requires wearing an eye patch or special prism glasses to minimize the effect of double vision.

6)Some contact lenses have UV protection built into the lenses but you should still use sunglasses because the contact lenses will only protect the part of youreye that it covers.


7)You should wash and dry your hands thoroughly before removing contact lenses. After removing them, gently rub them with cleaning solution and store them in a case filled with solution.

 

8)Falling asleep while wearing disposable contact lenses is a common problem. Sleeping with your contact lenses in your eyes can cause damage and discomfort.


9)You should always have a back-up pair of eyeglasses – even if you wear your contacts all the time.


10)Contact lenses are extremely popular world over as fashion statements. Avoid wearing coloured contact lenses as they can cause conjunctivitis, cornealoedema, allergic reactions, corneal abrasions and reduction in vision.


11)You must follow the rules of hygiene recommended by the contact lenses manufacturer and doctor. The lenses must be stored correctly and never worn beyond the stipulated time.


12)Always consult a doctor if there is any eye redness or irritation.


13)Always buy contact lenses from reputable manufacturers and follow the instructions given by the doctor about wear and tear.


14)Insert contact lens before applying eye makeup and remove lenses before removing the makeup.


15)The lens solutions must be recommended by a doctor. Keep the tip of the lens solution bottles clean and never use expired solutions.


16)Protect your eyes against infections by never using saliva, strange soaps, and un-sterilised water or solutions to clean the lenses.:):):)

.

 •Trachoma—a sequela of ocular disease in developing countries—continues to be a leading cause of preventable infectious blindness worldwide.

 

•The trachoma-hyperendemic areas of the world are in northern and sub-Saharan Africa, the Middle East, drier regions of the Indian subcontinent, and Southeast Asia. In hyperendemic areas, the prevalence of trachoma is essentially 100% by the second or third year of life. Active disease is most common among young children, who are the reservoir for trachoma.

 

•Trachoma is transmitted through contact with discharges from the eyes of infected patients.

 

•Transmission is most common under poor hygienic conditions and most often takes place between family members or between families with shared facilities.

Instillation of Eye Gtts..