Double Vision (Diplopia)

  • Medical Author:
    Patricia S. Bainter, MD

    Dr. Bainter is a board-certified ophthalmologist. She received her BA from Pomona College in Claremont, CA, and her MD from the University of Colorado in Denver, CO. She completed an internal medicine internship at St. Joseph Hospital in Denver, CO, followed by an ophthalmology residency and a cornea and external disease fellowship, both at the University of Colorado. She became board certified by the American Board of Ophthalmology in 1998 and recertified in 2008. She is a fellow of the American Academy of Ophthalmology. Dr. Bainter practices general ophthalmology including cataract surgery and management of corneal and anterior segment diseases. She has volunteered in eye clinics in the Dominican Republic and Bosnia. She currently practices at One to One Eye Care in San Diego, CA.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What is the treatment for double vision?

Once the underlying cause has been determined, treatment can be tailored to the underlying cause.

Most causes of monocular diplopia stem from poor focusing of light by the eye, and treatment is thus aimed at correcting the underlying cause of the blur. For example, refractive errors (myopia, hyperopia, astigmatism) can be corrected with glasses or contact lenses, dry eye with artificial tears and/or tear duct plugs, and cataracts (clouding of the natural lens) with surgery. Other conditions that interfere with proper focusing of light include corneal warping or scars and retinal conditions such as epiretinal membranes. Treatments are tailored to the specific condition believed to be causing the blurred images. Rarely is the underlying cause a medical emergency in cases of monocular diplopia.

Binocular diplopia on the other hand is produced by a misalignment of the eyes which can be caused by life-threatening conditions. For example, aneurysms, strokes, trauma, and cancers can interfere with the nerves that control the extraocular muscles (the muscles that move the eyes in different direction of gaze, much like the strings on a marionette). Diseases such as myasthenia gravis can interfere with the communication between the nerves and the eye muscles. And the eye muscles themselves can be damaged or compressed by conditions such as thyroid disease, orbital inflammations, vascular disease (as seen with diabetes and high blood pressure), and others. Following traumatic fracture of the orbital bones, muscles and orbital tissue may be trapped in the fracture, leading to misalignment due to restriction of eye movement in certain gaze directions. Sometimes the cause is relatively harmless, such as when the eye muscles or neurologic signals to the muscles weaken with fatigue or illness. Convergence insufficiency, or inability to align the eyes when focusing on a near object, is a common benign cause of intermittent binocular diplopia that can often be treated with glasses with prisms.

Medically Reviewed by a Doctor on 2/23/2015

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