Double vision, or "seeing double," occurs when two nonmatching images are sent to the part of the brain that is responsible for processing visual input. If this occurs over the long term, the brain will eventually compensate for the two signals by suppressing one signal, so that a single image is perceived. The suppressed eye may eventually become amblyopic ("lazy eye") with resultant vision loss.
Double vision can result from impairment in any part of the vision system, including the cornea, eye muscles, lens, nerves, or the brain. The most common cause of diplopia is misalignment of the two eyes that can arise from several different conditions. Some diseases such as myasthenia gravis and Graves' disease can cause weakness of the eye muscles, leading to misalignment of the eyes and double vision. Poorly controlled diabetes can ultimately result in nerve damage that can manifest as diplopia, and diplopia can arise as a result of stroke, head injury, or other brain damage. While diplopia can be a symptom of the conditions listed below, it is not always present in these conditions.
Other causes of double vision
- Convergence Insufficiency
- Increased Intracranial Pressure
- Infection of the Cornea
- Medication Side Effects
- Rare Complication of Surgery Such as LASIK
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Causes of Double Vision
Alcoholism and Alcohol Abuse
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Botulism is an illness caused by a neurotoxin produced by the bacterium Clostridium botulinum. There are three types of botulism: food-borne, wound, and infant. Symptoms include muscle paralysis, dry mouth, constipation, slurred speech, and blurred vision. If food-borne and wound botulism are detected early enough, they may be treated with an antitoxin.
A brain aneurysm (cerebral aneurysm) is caused by microscopic damage to artery walls, infections of the artery walls, tumors, trauma, and drug abuse. Symptoms include headache, numbness of the face, dilated pupils, changes in vision, the "worst headache of your life," or a painful stiff neck. Immediate treatment for a brain aneurysm is crucial for patient survival.
A brain tumor can be either non-cancerous (benign) or cancerous (malignant), primary, or secondary. Common symptoms of a primary brain tumor are headaches, seizures, memory problems, personality changes, and nausea and vomiting. Causes and risk factors include age, gender, family history, and exposure to chemicals. Treatment is depends upon the tumor type, grade, and location.
A cataract is an eye disease that causes the eye's lens to become cloudy and opaque with decreased vision. Causes of cataracts include diabetes, hypothyroidism, certain genetic illnesses, hyperparathyroidism, atopic dermatitis, and certain medications. Cataract symptoms and signs include a decrease in vision and a whitish color to the affected eye. Treatment for cataracts may involve cataract surgery.
Chronic Fatigue Syndrome (CFS or SEID)
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Giant Cell Arteritis (GCA or Temporal Arteritis)
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Graves' disease is an autoimmune disease that affects the thyroid. Some of the symptoms of Graves' disease include hand tremors, rapid heartbeat, trouble sleeping, enlarged thyroid, thinning of the skin or fine brittle hair. Causes of Graves' disease are thought to be multifactorial such as genes, gender, stress, and infection. Treatment for Graves' disease is generally medication.
Guillain-Barré syndrome is an autoimmune disease of the nervous system due to damage to the myelin sheath around nerves. It is the most acquired nerve disease (neuropathy) and usually follows a virus infection but can also be associated with immunizations, surgery, and childbirth. The cause is unknown but appears to be related to autoimmune reaction. Symptoms include weakness beginning in the legs and progressing upward, lost reflexes, and in severe cases, breathing can be affected. Patients can expect a slow but progressive recovery over several months maintaining vital functions and passively exercising the muscles. Plasmapheresis (removing toxic substances from the blood) has been shown to improve outcomes and shorten the disease as well as intravenous immunoglobulin.
Head Injury (Brain Injury)
In the United States, head injuries are one of the most common causes of death and disability. Head injuries due to bleeding are generally classified by the location of the blood within the skull, these include epidural hematoma, subdural hematoma, subarachnoid bleed, intracranial bleed, sheer injury, edema, and skull fracture. Some common symptoms of a head injury include vomiting, bleeding from the ear, speech difficulties, paralysis, difficulty swallowing, and body numbness. Treatment of a head injury depends on the type and severity of the injury.
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Multiple Sclerosis (MS)
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Myasthenia gravis, a chronic autoimmune neuromuscular disease. Varying degrees of weakness of the voluntary muscles of the body are the main characteristics. A defect in the transmission of nerve impulses of the muscles is the cause of myasthenia gravis. Myasthenic crisis is when the muscles that control breathing weaken, which requires immediate medical attention. Symptoms include weakness of the eye muscles, facial expression, and difficulty swallowing. Treatment of myasthenia gravis includes medical therapies to control the symptoms of the disease.
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A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking, or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
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