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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Double Vision Be Treated?

I AM EXPERIENCING DOUBLE VISION IN MY RIGHT EYE. I HAD CATARACT SURGERY ON THE EYE AND THAT DIDN T CHANGE THE DOUBLE VISION. THE DOUBLE VISION OCCURS WHEN AM READING, HOLDING MY HEAD AT A CERTAIN ANGLE. I SAW A NEUROLOGIST, AND SPECIALITY EYE DR., AND THEY SAID IT WAS PROBABLY THE CATARACT. I HAVE BEEN LIVING WITH THIS FOR 6 MONTHS. ANY IDEA S TO THE CAUSE OF MY DOUBLE VISION. THANK YOU.
Wed, 25 Apr 2018
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Ophthalmologist,  's  Response
Hello,
The first thing we need to ascertain is if tour double vision or diplopia is monocular i.e. sen with only one eye open, or binocular i.e. when both the eyes are open. Secondly do you have a history of any other comorbidities like diabetes, blood pressure, high cholesterol, etc. Also was there any history of trauma before this double vision began. If the diplopia is monocular, it is most likely due to a shift in the position of yor intraocular lens, or in very rare cases due to a retina pathology ( both of which would warrant a visit to your ophthalmologist). On the other hand,if the diplopia is binocular it is most likely neurological. In diabetics there can be brief episodes of nerve palsies (luckily most of these resolve spontaneously without any treatment). This can be easily confirmed by a proper exam of your cranial nerves (by either an ophthalmologist or a neurologist). If however this condition is worsening then further investigations would be required to ascertain the cause. Finally in some cases , head trauma can damage the trochlear nerve which may cause diplopia mainly in downgaze ( i.e. noticed commonly when you are reading or climbing down a staircase). This again can be easily picked up with a simple evaluation kf your extraocular muscle motility.
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How Can Double Vision Be Treated?

Hello, The first thing we need to ascertain is if tour double vision or diplopia is monocular i.e. sen with only one eye open, or binocular i.e. when both the eyes are open. Secondly do you have a history of any other comorbidities like diabetes, blood pressure, high cholesterol, etc. Also was there any history of trauma before this double vision began. If the diplopia is monocular, it is most likely due to a shift in the position of yor intraocular lens, or in very rare cases due to a retina pathology ( both of which would warrant a visit to your ophthalmologist). On the other hand,if the diplopia is binocular it is most likely neurological. In diabetics there can be brief episodes of nerve palsies (luckily most of these resolve spontaneously without any treatment). This can be easily confirmed by a proper exam of your cranial nerves (by either an ophthalmologist or a neurologist). If however this condition is worsening then further investigations would be required to ascertain the cause. Finally in some cases , head trauma can damage the trochlear nerve which may cause diplopia mainly in downgaze ( i.e. noticed commonly when you are reading or climbing down a staircase). This again can be easily picked up with a simple evaluation kf your extraocular muscle motility.