Seeing sets of pictures of the same object can be confusing at times and even frightening. double vision which is also known as Diplopia, may present suddenly or do so over a period of time. It may affect one eye or both eyes and may be a constant or intermittent issue. New or persistent symptoms should be noted in which they may be a result of eye muscle, nerve or neurological issues.
What Is Diplopia?
Diplopia is the term for perceiving two of a single object. Images may present themselves side by side, on top of each other or at an angle. In a double vision diagnosis, an eye specialist first will determine if the issue is monocular or binocular. This distinction also helps to identify which is the likely diplopia causes.
| Type | What Usually Happens | Possible Associations |
| Monocular | The second image remains when the other eye is covered. | Dry eye, astigmatism, cataract or corneal irregularity |
| Binocular diplopia | The second image usually disappears when either eye is covered. | Eye misalignment, muscle or nerve problems, thyroid eye disease or neurological causes |
Common Causes
Monocular double vision is a result of an issue within one eye. Dry eye, cataract, astigmatism and corneal irregularities cause problems in how light focuses on the retina.
Binocular diplopia is a result of eyes which are not working in unison. Causes may be a squint, weak eye muscle, issues with cranial nerves, diabetes related nerve damage, thyroid eye disease, head injury or certain neurological conditions. As the diplopia causes are many, the presentation and timing of symptoms is important in evaluation.
According to the NHS report on double vision we see that symptoms in both eyes may be a result of eye muscle or nerve issues and in monocular cases we are looking at conditions within the affected eye.
Symptoms to Notice
The primary symptom of diplopia is that the patient reports two of a single object. Also some people have eye strain, headaches, difficulty in focus or balance. The images may be horizontal, vertical or diagonal and also may present in a certain direction of gaze.
Sudden onset of double vision requires prompt medical care also if you have a severe headache, uneven pupils, weakness, speech impairment, eye pain or if it follows a head injury.
How Is It Diagnosed?
A double vision diagnosis will start with a detailed patient history. At the exam the eye doctor may ask when the issue began, whether it comes and goes, and what difference closing one eye makes. We may also do visual acuity, refraction, pupil reaction, eye alignment and eye movement tests.
| Test or Assessment | Purpose |
| Visual acuity and refraction | Checks whether a focusing problem is contributing |
| Cover and eye-movement tests | Assesses alignment and helps identify binocular diplopia |
| Slit-lamp and retinal examination | Looks for eye conditions that may cause visual doubling |
| Neurological tests, imaging or blood tests | Used when the examination suggests an underlying medical cause |
The American National Library of Medicine report (Official NLM/NIH reference) reports that diplopia is seeing two images from what should be a single object and they also note monocular and binocular forms. This is the reason why we see value in a thorough double vision diagnosis which in turn will inform which treatment to use.
Treatment Options
The right diplopia treatment is based on its cause. We may update your glasses if a refractive error is to blame. In some cases of strabismus we may prescribe prism lenses or temporary occlusion. Should a cataract, dry eye, thyroid eye disease, diabetes related nerve issues or some other condition be the cause we put focus on treatment of that.
In some cases the issue of diplopia treatment with eye muscle surgery or specialist neurological care. At Vasan Eye Care an eye specialist will do an eye exam, determine the root cause and go over what options for eye treatments are available.
When Should You Seek Eye Care?
Arrange for an eye exam at an eye hospital if diplopia is new, persistent, recurring or related to reading, walking, work or driving. Early assessment of diplopia is key to determine its cause, also in the case of sudden symptoms which present with neurological warning signs seek immediate attention.
Conclusion
This issue may be a result of an eye issue, misalignment, muscle weakness, nerve dysfunction or some other health condition. We begin proper diplopia treatment once we determine what is at the root of it. If you have had persistent or sudden double vision it is time to see an experienced eye specialist at Vasan Eye Care for prompt and personal eye care.
Frequently Asked Questions
1. Is diplopia the same as double vision?
Yes. Diplopia is a term used for double vision which reports a single object as two images.
2. Can double vision go away on its own?
Some issues improve when the base problem goes away, but new symptoms should still be assessed.
3. What is binocular diplopia?
Binocular diplopia results from eye misalignment which in most cases improves when either eye is covered.
4. How is a double vision diagnosis made?
A double vision diagnosis may at times also present with vision tests, cover tests, eye movement evaluation and if needed other tests.
5. Is sudden double vision serious?
Sudden onset of symptoms which include severe headache, pupil changes, weakness or speech difficulty require prompt medical attention.
References Links
- NCBI Bookshelf, U.S. National Library of Medicine – Diplopia (StatPearls) https://www.ncbi.nlm.nih.gov/books/NBK441905/
- PubMed, U.S. National Library of Medicine – Approach to Diplopia – https://pubmed.ncbi.nlm.nih.gov/31584541/