Amblyopia / Strabismus > Double Vision
Double Vision
If you have diplopia (double vision or ghost images) you should see an Optometrist as soon as possible. A sudden onset of diplopia in children or adults is more of a concern than a longstanding one, but both warrant a visit to the Optometrist to diagnose whether the condition is temporary, or the result of a serious health problem.
Longstanding diplopia can be associated with developmental binocular problems when the ability to use both eyes together never developed properly. Temporary double vision can result from drinking too much alcohol or fatigue.
It can also result from a more serious problem such as:
- Stroke or cerebrovascular accident (leads to temporary or permanent cranial nerve palsy causing misalignment of the eyes.)
- Third nerve palsy from diabetes
- Traumatic or acquired brain injury
- Orbital fracture and trapped eye muscle
- Multiple Sclerosis
If you have a sudden onset of double vision, and a severe headache, or muscle weakness, call 911 immediately.
The main types of vision problems that cause double vision are:
- Strabismus
- Exophoria (convergence insufficiency) or Esophoria (convergence excess).
- Fusional instability: poor sensory ability to fuse two images from both eyes together to form a single 3 dimensional image. This may result in ghost images, unstable images, poor depth perception or intermittent double vision.
- Astigmatism: an optical problem resulting from incorrect focus of images on the retina.
Patching
Double vision can cause problems such as visual confusion, clumsiness, impaired balance and poor 3D vision or depth perception. This diminishes the ability to localize where objects are in space and can lead to poor eye hand or eye body coordination in sports (such as catching a ball or hitting a ball in baseball, free throws in basketball, tennis), driving (parallel parking), and judging the depth of stairs while walking.
Treatment for Double Vision / Diplopia
If your doctor determines that there is no serious underlying health reason for your double vision, the treatment choices include patching, strabismus surgery and Vision Therapy
Strabismus Surgery
Vision Therapy is a highly effective type of physical therapy that works on eye muscle control and coordination to improve eye muscle alignment non-surgically, and improve efficiency of visual motor input and processing. Vision Therapy consists of weekly office sessions with a therapist, under an Optometrist's prescription and guidance, combined with home therapy for reinforcement. The goal for patients with double vision is to eliminate the diplopia and associated headaches or eyestrain.
Strabismus surgery works by cutting the eye muscles and re-inserting them on the eye in a different position to straighten the eye. The effectiveness of surgery depends on the muscles involved, the direction of the eye turn, and the amount of the eye turn. Vision Therapy is recommended in conjunction with surgery to retrain the brain how to use the eyes together as a team, and how to see three dimensional images, etc. This increases the likelihood of success.