Diplopia or double vision
What is diplopia?
Diplopia, also called double vision, is the perception of two images of a single object. Diplopia is a symptom that often leads to disability. Many types of strabismus in adulthood are associated with diplopia as the main symptom.
Eye examination of these patients requires a specific study of strabismus and sensoriality to identify its cause and decide on the best treatment for the patient.
Diplopia can be corrected at all ages, but a previous review must be done to assess the patient’s condition.
Causes of diplopia
The causes of diplopia or double vision can be of different origin. The most frequent are:
- Keratoconus or superficial corneal irregularity
- Refractive errors
- Strabismus
- Trauma
- Dislocation of lens
- Retinal scars
- Cranial nerve palsy (III, IV, or VI)
- Myasthenia gravis
- Infiltration of the orbit
- Cataract
- Giant cell arteritis
- Glaucoma drainage implant
- Idiopathic intracranial hypertension
- Microvascular palsy of the cranial nerve
It is important to do a previous examination of the patient to diagnose what has caused the diplopia and apply the most appropriate treatment.
When double vision is suffered in both eyes, its cause may be linked to strabismus because the gaze is misaligned.
Types of diplopia
The types of diplopia or double vision depend on whether it is suffered in one or both eyes and according to the position of the perceived double image:
- Monocular: When double vision is perceived by a single eye.
- Binocular: When double vision is suffered with both eyes. It is usually linked to strabismus by presenting a misalignment in the gaze.
- Landscape: Images usually appear side by side.
- Vertical: Images usually appear on top of each other.
- Torsional: Images can appear vertically or horizontally but rotated.
- Intermittent: Double vision is not constant, but it occurs at some point of the day
When diplopia is horizontal, the images appear laterally displaced.
Evaluation
Diagnostic techniques
The ophthalmologist should be visited to make a complete evaluation of the patient’s ocular and systemic status, where vision will be evaluated at different distances and at different positions. Similarly, a series of neurological and ophthalmic tests will be performed to dismiss conditions that could cause double vision.
The tests to be performed are:
- Red Filter
- Cover test
- Measurement with Prisms
- Gazelab (video-oculography)
- OCT
- Retinography
- Craneal Magnetic Resonance Imaging
Cover Test Technique.
The videooculograph is a high-tech device that allows to accurately measure and diagnose complex deviations and eye movements typical of strabismus.
OTHER SPECIALITIES
Treatment of diplopia
Your treatment will be based on the causes of the disease. The most common treatments include:
- Corrective lenses
- Patch to cover the eye
- Surgery to correct the cause
- Correction with prisms
- Conventional surgery
- Refractive surgery for accommodative strabismus
Treatment of diplopia with corrective lenses.
Frequently Asked Questions
Yes, in patients with a pathological background.
If you suddenly see double, visit your ophthalmologist as soon as possible.
Yes. There are exercises to correct double vision and they are called “vision therapy“, which can be applied in some cases.
One of the functions of strabismus surgery is to correct double vision, which usually improves in 80% of cases depending on the pathology of each patient.
Not necessarily, if the patient does not have a previous pathology.
Yes, but in all cases, it is recommended to do a previous visit to assess the patient’s condition.
Yes, but in all cases, it is recommended to do a previous visit to assess the patient’s condition.
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