Double vision is seeing two images instead of just one. In order to see normally, your eyes, the muscles, and the nerve send images to your brain and then the brain has to work correctly and together with the other parts. If there is a problem with any of these parts, it can cause double vision. Double vision can happen in one or both of your eyes. It can be vertical or horizontal. Images may also be oblique and be separated diagonally. There are a number of conditions that can cause double vision.
Binocular vs. Monocular Double Vision
Your eye doctor will classify double vision as binocular, occurring in both eyes, or monocular, occurring only in one eye. Monocular double vision is when you use only one eye at a time and can appear as a shadow. Binocular double vision is there when both eyes are open at the same time and goes away when you cover one of your eyes. Monocular double vision is typically less serious and is more common, while binocular double vision is caused by a more serious underlying condition.
Symptoms of Double Vision
Besides just seeing double, there are other symptoms associated with double vision. These can include nausea, dizziness, pain when you move your eyes, or blurred vision.
What Causes Double Vision?
Some causes can be minor, while others are more life-threatening, such as a stroke.
Your cornea is the clear layer that covers the front of your eye. The main purpose is to focus incoming light into the eye. Problems with your cornea can distort the surface and this can create double vision. Some of these issues can be caused by infection, injury, or disease, infections such as herpes zoster or shingles, dry eyes, or astigmatism.
Keratoconus can also cause double vision and happens when the cornea loses its shape. Usually, the cornea is round but when you have keratoconus, it causes the cornea to bulge outward and this change in shape can cause double vision.
The lens works with your cornea to focus light into the back of the eye. The lens changes shapes as it focuses and is behind the pupil. A cataract is the most common lens problem that can cause double vision. A cataract is the clouding of a normally clear lens because of aging. Removing cataracts with outpatient surgery can help fix the issue.
Eye Muscle Problems
There are six muscles found in your eye socket that control the eye movement to each side, in rotation, and up and down. If there are problems in these muscles, including paralysis or weakness, it can prevent one eye from moving in coordination with the other eye. These muscle problems can include Graves’ disease or misaligned eyes. Graves’ disease is a thyroid condition and can cause vertical double vision. Misaligned eyes happen when there are paralyzed or weakened eye muscles that prevent your eyes from properly aligning.
There are certain cranial nerves that connect the brain to the eye muscles to control eye movement. Conditions that can lead to damage to the nerves include diabetes, myasthenia gravis, multiple sclerosis, and Guillain-Barre syndrome. Diabetes affects the body’s ability to process blood sugar and this can lead to nerve damage, including the nerves in the eyes. Myasthenia gravis is an autoimmune disease, where your immune system attacks the nerves involved in eye movement. Multiple sclerosis is a neurological disease that affects the central nervous system and can damage the nerves that control movement. Guillain-Barre Syndrome is a nerve condition and the early symptoms happen in the eyes and cause muscle weakness.
There are several areas in the brain that help process visual information as it’s transmitted from the eyes through your nerves. If any of these areas are affected by injury or illness then double vision can happen. Some brain conditions that can lead to double vision include stroke, the pressure inside the brain from trauma, infection or bleeding, migraines, brain tumors, or a brain aneurysm.
Giant Cell Arteritis
Also known as Temporal Arteritis, Giant Cell Arteritis happens when the arteries located near the temples become inflamed and this leads to reduced blood flow. These vessels can be responsible for eye nourishment and if there is reduced blood flow then anterior ischemic optic neuropathy can happen. Some of the symptoms that occur with this condition include double vision, vision loss, dizziness, persistent headaches, fatigue, and blurred vision.
Monocular double vision is usually caused by iris abnormalities, ill-fitting contact lenses or glasses, dry eyes, astigmatism, or cataracts. Binocular double vision is typically caused by misaligned eyes, strokes, brain aneurysms, and cranial nerve issues.
Diagnosing Double Vision
Since double vision can come from just a minor eye problem to something more life-threatening, it’s important to pinpoint the underlying cause so that treatment can begin immediately if it is necessary. If you start to experience double vision, visiting an eye care professional as soon as possible is important. You will be given an eye exam to look at the health of your eyes and check for eye movement. During the exam, the eye doctor will also ask questions to know which specific diagnostic tests are needed, depending on what could be causing double vision. You should tell the doctor if your symptoms are in both eyes or just one eye, intermittent or constant, sudden or gradual, at far or near vision, horizontal or vertical, or if they change with your eye direction or head position.
Treatment for Double Vision
Once you get a diagnosis for what is causing your double vision a treatment plan can be developed. When the underlying cause is minor, such as dry eyes or astigmatism, the treatment will also be relatively simple. For more complex causes of double vision, such as multiple sclerosis or diabetes, you need to see other specialists along with an ophthalmologist. You may even need emergency treatment if the condition is serious, such as a brain aneurysm.
Blurring or Blocking the Vision of One Eye
This can minimize double vision and you can use an eye patch, a Fresnel prism applied to your glasses, or an occlusive lens applied to glasses or a contact lens.
Injecting botulinum toxin into the stronger eye muscle in order to relax it can help the weaker eye muscle recover. This can either be a permanent or temporary solution, depending on the cause.
Surgery is a less common option, but it can be used to treat some muscular problems.
Treating Other Medical Conditions
You may need to coordinate care with other physicians in order to treat other underlying medical conditions. You may need to see an endocrinologist for thyroid disorders or diabetes. You may need a neurologist if you have myasthenia gravis or damage to cranial nerves that are causing your double vision. If double vision is being caused by cancer in the brain then you will need to see an oncologist.
How soon double vision will go away will depend on what’s causing it. Some cases can even go away on their own, but others will get better after you get your treatment. If you need surgery to correct an issue in the eye then it could take you a few weeks to get better.
Can You Prevent Double Vision?
There aren’t any specific ways to prevent double vision, but making sure you take good care of your eyes and see your eye doctor regularly to catch any issues can help.
Contact Florida Eye Specialists and Cataract Institute
If you are experiencing double vision, it’s important to seek treatment as soon as possible. The specialists at Florida Eye Specialists and Cataract Institute are here to help diagnose the cause of your double vision and make sure you get the treatment you need. Make an appointment today for an eye doctor in Riverview, an eye doctor in Ruskin, or our other locations today.