Double Vision: Types, Causes, Diagnosis, And Treatment

All About Double Vision

Double vision is also known as diplopia or ghost image is a condition where you can see two separate or overlapping images of a single object.

Types of Diplopia

There are mainly three types of double vision or ghost vision:

• Horizontal diplopia: In this type of diplopia the images are seen horizontally separated from each other.
• Vertical diplopia: In this type of diplopia images are seen in a vertical direction. One image is higher or on top of the other image.
• Monocular diplopia: In this type of diplopia ghost images are only seen in one eye. One eye is usually kept close and the other eye can see ghost images.

Causes of Double Vision

These are the main causes of injuries such as brain swelling, brain tumour, or any other head injury. Eye Problems may also cause double image like:

• Dry eyes: It can lead to ghost images. Ghost images are caused by poor quality tears. Dry eyes can be treated by prescription eye drops, plugs or vitamins.
• Refractive surgery: Surgeries such as LASIK and PRK helps remove glasses and contacts but the changing shape of the cornea it may lead to ghost images. The irregular shape of the cornea can cause corneal dryness and cause light to scatter and not focus on the retina properly. This is a temporary cause of double vision because it naturally goes away in a few weeks or by prescription drops. In very few cases another refractive surgery is needed to remove these images.
• Cataracts: Cataracts can cause ghost images but it is usually in one eye.

When you get a cataract there is a clouding of the eye’s lens which is on the pupil thus it causes the light rays to scatter in different directions that may cause this condition.

• Corneal irregularities: Corneal irregularities can lead to keratoconus and dystrophies. These cause double vision or ghost images. These conditions can be fixed by special contact lenses or surgery. The eye doctor will suggest the right thing which is required for you.
• Cranial nerve palsies: Sometimes double vision or ghost images are causes by paralysis or lack of coordination between muscles that control the eyes due to cranial nerve palsy. This condition is because of various reasons such as a tumour, injury, or meningitis. It can be treated with surgery, therapy, or special prism eyeglasses.
• Diabetes: High blood sugar level can damage nerves in the eyes which control the movement thus causing diabetes.
• Strabismus: This is a condition that affects children where the eyes are not properly aligned, (eyes may be crossed inwards to outwards) which may lead to double vision and ghost images.
• Thyroid dysfunction: The thyroid gland is an endocrine gland that produces thyroxine hormone. Any dysfunction in this gland can affect the muscles which control the eye leading to double vision or ghost images.

Diagnoses of Double Vision In Children

Children are unable to express the symptoms sometimes thus making it difficult for the doctors to diagnose. These are the commons symptoms found in children:

• Squinting of eyes to view objects
• Covering of one eye
• Turning of the head in an unusual way
• Viewing objects from the side and not front
• Flicking of eyes

Treatment For Double Vision

The general treatments for double vision include: (treatments depend on the cause of double vision)

• Vision Therapy: vision therapy program offers higher improvement rates for turned lazy eye and diplopia when compared to eye surgery, glasses, patching, and therapy. 
• Prism In A Glass: Prism glasses are prescription glasses designed specifically to correct certain types of double vision (diplopia). They work by refracting light before it enters the eyes to make sure it is directed onto the same area of each retina.
• Medications: Injecting botulinum toxin (Botox) into the stronger eye muscle to relax it and allow the weaker eye muscle to recover.
• Surgery: Using surgery to treat some muscular problems is less common.
• Eye exercises: Double vision can be easily cured with some eye exercises. These exercises are performed to increase smooth convergence, to increase jump convergence and more.

Before treatment, you should always get a comprehensive eye exam to determine that you have double vision.

Eye Exercises For Double Vision

To increase smooth convergence:

1. Focus on a target like a stick or text.
2. Hold the target at eye level and at one arm’s distance.
3. Try to keep the image as a single image for as long as possible.
4. Move the target towards the nose slowly.
5. When the image turns into two, focus intensely on the image and then bring the image closer again.
6. When it is not possible to re-join images repeat this process again.

Normally an eye doctor provides tools to assists these steps. To increase jump convergence:

1. Choose a target like a stick or text.
2. Keep the target at a 20 cm distance from the nose.
3. Fix the gaze at the target for a few seconds.
4. Keep another target at 3 meters away and then gaze at it for a few seconds.
5. Switch your vision between these targets.
6. Repeat this process till you are not getting ghost images.

Facts About Diplopia

1. Double vision is caused by many reasons.
2. It can affect an eye or both
3. It is a chronic disease
4. Temporary double vision can be caused by alcohol or drugs.
5. Treatments depend on the cause of double vision, it includes surgeries and medication

This medical condition is caused by many diseases and eye problems but can be treated easily without complications. You can get an appointment with well-trained and experienced ophthalmologists at “Eye mantra”. To book an appointment contact Ph: +91-9711115191.