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DP Eyecare Update: Double Vision?

Double Vision BlogQ:  I have noticed seeing a ghost image or maybe a double vision image lately.  Am I just tired or what could be causing this?

A:  There could be many causes, but “being tired” is not likely the answer.  We have 12 muscles,  6 per eye, that hold our eyes steady and move them accurately….as a team.   Someone once “calculated” that our eye muscles are about 600 times as strong as they need to be!  We can use them all day, reading, driving, whatever…..any they really never get tired.

First of all, cover one of your eyes.  Do you still see double?  If so, that may be good news.  Many treatable conditions could cause that: from dry eyes to vision prescription changes.  Your family eye doctor can diagnose and treat those conditions. 

But if covering one eye makes the double image go away, it indicates a problem with the innervation to those 12 muscles.  In children, this can be a genetic or developmental disorder and successfully treated with vision therapy or “orthoptics” in most cases.  Rarely, but possible, would be eye muscle surgery to solve this pediatric condition.  Amazingly, most children with double vision never complain about it, so parents are completely unaware.

In adults, the potential causes are many….from a mild binocular misalignment worsened by prolonged near vision work ( think hours on your computer ), to serious medical problems like a nerve palsy or stroke or aneurysm. We can use “prismatic” prescription built right into your glasses to help merge those annoying double images into one normal image.

 If your family eye doctor cannot sort out the cause and treat it, likely you will be referred for imaging like a CT or MRI scan.  In some cases, a consult with a neurologist or neuro-ophthalmologist is needed to determine the cause.

Because of the unlikely, but very serious nature of possible causes, time is of the essence.   Schedule a complete eye health exam with your eye doctor as soon as you can.  If you wear glasses or contacts, wear them or take them with you.  Be sure to convey your complete medical history and current medications as well.  If a referral is indicated, be sure to keep that appointment.  Much more than your vision may be at stake.