DIPLOPIA (Double Vision)

Perception of two images of a single object seen near each other (horizontally, vertically, or obliquely) or overlapping.

There are many causes for diplopia, ranging from harmless to life-threatening. It is important for the doctor to do a careful history and physical exam to find out the cause and do the right treatment.

  • If one feels a headache and double vision at the same time occurring simultaneously, immediately proceed to the emergency room.
  • Images may appear to overlap each other or may appear adjacent to each other.
    • May differ depending on direction of gaze or with head turning or tilting.
  • It is critical to determine if diplopia is monocular or binocular.
    • Monocular – double vision is caused by a condition within one or both eyes and is not corrected when one eye is covered.
    • Binocular – eyes are misaligned; Each eye sees a single image when one eye is covered, but when both eyes are open, the brain perceives two adjacent images.

DIAGNOSIS

  • Physician may do/request:
    • History & Physical Exam
    • Specialized imaging
      • Topography, MRI, etc.

 

RECOMMENDED MEDICATIONS

  • Monocular diplopia – problems with the processing of light
    • Refractive errors (myopia, hyperopia, astigmatism) – glasses or contact lenses
    • Dry eye – artificial tears and/or tear duct plugs
    • Cataracts (clouding of the natural lens) – surgery
  • Binocular diplopia – misalignment of the eyes due to life-threatening conditions
    • aneurysms, strokes, trauma, and cancers
    • Myasthenia gravis
    • Eye muscle damage or compression
      • Thyroid disease, orbital inflammations, vascular disease
    • Fractureof the orbital bones
  • Sometimes the cause is relatively harmless,
    • Fatigue
    • Convergence insufficiency
      • Inability to align the eyes when focusing on a near object; harmless; corrected with glasses with prisms

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