Diplopia (Double Vision): Causes, Symptoms, Treatment

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The medical term for double vision is diplopia. It can indicate a serious medical condition and should never be ignored. Although minor issues like dry eye syndrome can sometimes cause double vision, your eye care professional must determine the exact cause of diplopia.

Types of Diplopia

Horizontal diplopia:

This means the double images are side by side.

Diplopia in one eye:

This occurs when the double vision persists even when one eye is closed.

Vertical diplopia:

This means one of the double images is above the other.

Each of these conditions includes one of the double images appearing fainter than the others. This weaker image is often referred to as the ghost image.

Causes of Double Vision

Astigmatism

This is the most common cause of double vision in one eye. It’s benign and typically responds well to treatment with eyeglasses, contact lenses, or refractive surgery like LASIK.

Astigmatism is caused by an imperfect curvature of the eye’s cornea or lens. This imperfection can be mild, moderate, or severe. It can also cause blurry, fuzzy, or double vision, as light entering the eye is not focused on the retina correctly.

Strabismus

Strabismus is often called crossed eyes and is often found at birth. This condition may cause double vision because the two eyes are not correctly aligned. This misalignment can come and go, and when it does, it is called intermittent strabismus. This intermittent type is more likely to cause double vision than other forms are.

Cataracts

As cataracts develop in the eye’s lens, they can cause several eye problems, including double vision. Cataracts can only be permanently treatable with surgery.

Cataracts occur when the eye’s lens becomes clouded with protein deposits over time. The lens is normally crystal clear. These deposits obscure light entering the eye and cause worsening vision over time.

Cataract surgery involves removing this diseased lens and replacing it with an artificial one. Recovery is typically quick, and cataract surgery is usually highly successful.

Keratoconus

This progressive eye disease causes the cornea to bulge outward into a cone shape. Keratoconus often causes double vision in one eye, similar to that seen in astigmatism.

Dry Eyes

Double vision caused by dry eyes is benign and will tend to come and go. It’s treatable with lifestyle changes, reduced time on a phone or computer screen, rest, and lubricant eye drops.

Stroke, Head Injury, Brain Injury, or Tumor

Additional Causes of Double Vision

Alcohol and Drugs

Both recreational and medically prescribed drugs can cause double vision. So can alcohol. If recreational drugs are a problem for you, seek help to learn how to stop.

For double vision caused by prescription drugs, speak to your doctor about a possible change of medication.

Fatigue and Lack of Sleep

Both can cause double vision, which is especially dangerous while driving. Get plenty of sleep, and don’t drive when you’re overly tired.

Palsy of the Cranial Nerves

Specific cranial nerves control eye movement. A dysfunction or palsy of these nerves can be caused by diabetes, multiple sclerosis, aneurysms, head injuries, tumors, or strokes. This can result in double vision.

Vision Correction Surgery

Often called refractive surgery, this procedure corrects vision problems like myopia and astigmatism. It is also called LASIK, and it’s not uncommon for double vision to occur during the recovery period.

If double vision persists, your eye surgeon may perform an enhancement procedure to clear it up.

Diabetes

The occurrence of this severe metabolic disease is rising worldwide. Diabetes can damage the eyes and result in symptoms like double vision, changing visual quality, eye floaters, flashes of light, and blurry, wavy, and fuzzy vision.

Diabetes complications of the eye or anywhere else should be avoided in the first place. You can do this by getting regular physical exams with lab tests to check for diabetes, annual eye exams to diagnose any diabetic eye problems, and, most importantly, controlling your diabetes if you are diagnosed with it.

By normalizing your blood glucose levels as much as possible, you have the best chance to protect your eyes, heart, kidneys, blood vessels, nerves, and limbs from diabetic damage.

Other Diplopia Symptoms

Symptoms that may occur along with double vision include:

Nausea
Dizziness
Loss of balance
Ataxia
Headache
Eye pain

Double Vision Treatment

Treatment depends on the cause, but you should always consult with your eye doctor immediately for any double vision, especially if it happens suddenly. This could signal an impending stroke, aneurysm, or the presence of a brain tumor.

Your eye doctor will need to determine the cause of your double vision before treatment can begin. If strabismus is the cause, vision therapy, eyeglasses, prisms, or surgery may resolve the problem.

However, more serious causes, such as cranial nerve palsy, may only be treatable, if at all, by addressing the underlying medical condition. In some cases, such as double vision caused by brain damage from a stroke, diplopia may not be curable.

In that case, the patient may have to adapt and learn to live with double vision. Many medical conditions, such as diabetic damage to the cranial nerves, are tough to manage once they occur.

This is why it’s so important to control chronic diseases like diabetes, heart disease, and high blood pressure. Follow your doctor’s advice about lifestyle changes and medications. You may be able to avoid serious complications down the line.

Additional Treatments

Diplopia is sometimes helped by special eyeglasses containing prisms designed to reduce double vision. Patching one eye or using special contact lenses are two other possibilities.

Find a Top Eye Doctor Near You

Whether you have concerns about your eye health, need a regular exam or new eyeglasses, or for any other reason, we can help you find a top-rated eye doctor near you. We look forward to assisting you.

Published on: Apr 28, 2022

Last Updated:
Sept 26, 2022