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Causes and Treatment of Double Vision (Diplopia)
When the eyes are working properly, each sees slightly a different view of the same object. A complex system involving muscles, nerves and the brain puts these two views together to create one true 3D image. When the eyes point or focus incorrectly, or the vision processing system isn't working properly, you may find yourself seeing two of each object. This is typically referred to as double vision and the medical term for it is diplopia.
Occasionally, double vision may be a temporary problem; if you are overtired or have consumed a lot of alcohol, your eyes may have trouble focusing and working together. But double vision is often a symptom of a more serious condition, so if your symptoms persist, keep recurring, or there is no obvious cause, you should consult an eye doctor as soon as possible for a diagnosis.
Below are some of the more common causes of double vision.
Stroke or brain condition
Double vision may be the first sign of a stroke, brain swelling, aneurysm or tumor, which is why it should be taken very seriously. Sufferers need to rule out these more serious conditions or get them treated urgently. A head injury can also cause double vision to occur suddenly. Your eye doctor may refer you to a specialist such as a neurologist for further tests and treatment.
Cranial nerve palsies
Cranial nerve palsies can cause the eyes to look in separate directions, resulting in double vision. These palsies are often caused by diabetes, but can also be the result of a head injury, tumor, multiple sclerosis, meningitis, high blood pressure or an aneurysm. The diplopia is usually resolved when the underlying condition is treated but some people may require additional help such as vision therapy, special eyeglasses or surgery.
Corneal irregularities
Ghost images can be caused by conditions such as keratoconus (cone-shaped cornea) or corneal dystrophies, when the corneal structure deteriorates. These problems can sometimes be helped with special contact lenses, though sometimes surgery is required to insert corneal implants.
Eye herpes and shingles can also cause corneal changes which can lead to double vision.
Refractive surgery
Occasionally, double vision is a side effect of refractive surgery such as LASIK. This happens when the surface of the cornea, which is usually smooth, becomes rough and irregular or dry, causing light rays to scatter instead of focusing clearly. The condition often improves over time as the eye heals, and the use of eye drops may help too. (Consult your surgeon or eye doctor before using any over-the-counter drops after surgery.)
Severe dry eye
While they probably don't seem like much, tears are actually an important part of the visual system. They affect how light rays pass through the cornea and are focused, so if you have severely dry eyes, you may find yourself seeing ghost or shadow images. Simple eye drops, punctual plugs, oral medication to promote tear production, lid hygiene techniques or a combination of all these treatments can relieve chronic dry eye and, in turn, clear up the double vision.
Cataracts
If an eye’s lens is clouded with a cataract, this can cause incoming light rays to scatter, creating incomplete images, especially when looking at lights. If you wear eyeglasses, getting an anti-glare coating on them may give some temporary relief, but you will likely need cataract surgery to cure the problem long-term.
Other causes of double vision
- Severe migraine
- Eye alignment problems, such as strabismus (crossed eyes)
- Thyroid disorders
- Autoimmune disorders (including Graves' disease and Myasthenia gravis)
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