Hi All,

New member here....1st time !!

For the past 2 1/2 to 3 years, I have had double vision (diplopia) and it causes me alot of discomfort.
My docs (opthamologist & optometrist both) said I am "stuck" with this problem and prescribed me rather thick glasses with prisms. This does help alot but I would like to get rid of double vision for good! I hate it, believe me. The eyeglasses are like a crutch/lifeline, since when I take them off, I see two of everything..
The docs say it is a muscle imbalance/weakness, but offer no solutions.
Does anyone know if eye exercises, surgery, etc can help? Anything?!

Thanks!

Hi, its a bore isn't it, I have it too, when I get tired the glasses don't fully correct the double vision.
In fact if your glasses don't quite correct it, it makes your muscles work a bit and it can improve to a degree, and my double vision is not as bad as it used to be! My brother had such a big problem with his eye muscles, and couldn't get one of his eyes to look up high enough to look ahead, and he had the operation to tighten the muscles. same thing as correcting a squint. it seems it is extremely difficult to get the muscles in balance and whilst he was hugely improved, it wasn't perfect. I really can't recomend that route unless you can't get corrected by glasses.


[This message has been edited by Corinna_H (edited 09-10-2003).]

Have you been to see a pediatric ophthamologist who has experience in treating adults with strabismus? Is your optometrist experienced in using vision therapy to treat strabismus? If the answers to these questions is "NO" then you owe it to yourself to get some more opinions. You need an actual diagnosis not just muscle imbalance, so that you can educate yourself about the options open to you. I have "A" pattern exotropia due to +2 overaction of the superior oblique muscles. I guess my PO could have jusgt said "You have a muscle imbalance" but it wouldn't have helped me to be proactive about my care.

It may be that the prisim glasses ARE the best option as surgery is not always a great idea. However, I think you need to get enough information to make your own educated choice.

I can tell you from personal experience that strabismus repair is a tradeoff with risks and benefits, and is not for everyone. If you do not understand why it won't help you then keep asking questions until you understand.

Good luck.

Thanks Shaman for your reply.

Yes, I will have to keep on finding ways to get rid of or treat this double vision. Also, the hard part is to find a GOOD doctor! Some are so "lazy" and say deal with it and that's that. Especially when they got a waiting room full of patients and can't or won't give you extra time for helping you.
It sounds like you had surgery?? If you did, were there any side effects? Did or do you regret it?

As for now, I got a book which has a small section on "eye exercises", published by AVI (American Vision Institute). I'll give this a go.

One has to keep on looking for solutions, especially for a vexing problem like this!

Good Luck to you too!

WarBonds,

While I understand why you want to try on your own because you haven't found a PO or VTOD to help, I must caution you that it is dangerous to practice eye exercises without professional guidance. Because your visual system is already "shaky" (as evidenced by the diplopia) you are just as likely to make matters worse, as better if you do incorrect exercises. VT,improperly done can cause "Horror fusionous" or incurable diplopia. I urge you to look for an optometrist with experience in vison therapy to guide you.

Is the ophthamologist you are seeing a PO? If not, you should consider seeking an opinion from a member of AAPOS or at least someone who has experience with strabismus. You really need to get someone to give you an actual diagnosis and explain it to you. Have you had strabismus repair or other treatment in the past? Was it an accident that started all of this?

Yes, I have had strabismus repair, twice. I do not regret it because I went in to surgery fully understanding the risks I was taking, and with a full understanding that despite surgery, I will always have strabismus and my eyes will never be perfect. My eyes look straight now, but I do have eye pain/strain that I never had before. Many, many adults who have the surgery comment on the post-op pain/strain. Most, including me, are willing to take the bad with the good and are happy. You need to understand that surgery, if possible, will not be a cure all.

Please let me know if I can help you find a PO or VTOD.

Hello Shaman,

Thanks very much for your reply; your advice makes sound sense to me.
Yes, I will have to look for a PO for help. What is a VTOD ?? (I assume VT means vision therapy).

I certainly do not want to make matters worse doing eye exercises which may be harmful! When looking for a PO, is that under "optometrists" in the yellow pages or do I just look under "physicians"?
This stuff is new to me.
As stated in the thread above, my opthamologist said I am stuck with this double vision. He said eye exercises wouldn't help and that if I got new glasses, do NOT get glasses with a stronger prism, since as he put it: "my eyes will eat up more prism".
By that he meant, the more prism I give my eyes, the more it wants. No other solution was given by him to me. I feel uptight when I think of surgery; personally I would like to avoid that route.....

Also, I hope all goes well with your vision/eyes too;
hopefully your eye/muscle pain isn't too bad on an ongoing basis. Good luck to you.

Thanks again!
WarBonds

Shaman,

....I almost forgot: any advice on locating a PO or VTOD would be appreciated....if you would like to share any other advice, that'd be great as well!

Thanks,
WarBonds

WarBonds,

A PO, Pediatric Ophthamologist, should be listed under physicians. Sometimes they stick them in with the other ophthamologists, sometimes they stick them under pediatrics. You are going to have to call each office and ask them if they treat adults with strabismus because not every PO is willing to work with adults. The American Association of Pediatric Ophthamolgy and Strabismus, AAPOS for short, keeps an up to date list of members all over the world, so you can cotact them and ask for a name in your area, or tell me where you live and I can post a couple of names for you.

A VTOD is an optometrist that practices vision therapy. The one that I know of is Merrill D. Bowan. I think he keeps lists of VTODS. Be aware that many POs do not believe in VT. Pretty much they will always say "It won't help". They aren't trained in it, and don't really have any experience to go on. That is why you have to go to someone who actually uses it so that they can tell you if they think it will work.

If you wish t avoid surgery, the prism glasses may well be your best bet. You don't say if you are eso (eye turned) or exo (eye turned out) but exo repsonds better than eso to VT. Check out AAPOS and Merril D. Bowan. That should be enough to get you started.

I don't know where you are, but in a lot of places the wait to see a PO is 3-4 months, so plan on this taking a while. Took me over 2 years to get from thinking about having surgery to actually scheduling it.

Good luck

Shaman,

Thanks very much again for all your info....yes, that should be enough to get me started.
I'll look into the info you gave me and take it from there; I live in Southern Ontario (Canada), so I'm sure there should be some PO's around who treat adults. My left eye is normal, but my right eye points or turns inwards, causing double vision when I remove my glasses.

I agree with you when traditional docs scoff at "alternative" therapy and they're not trained in it. When I mentioned vision therapy (eye exercises) to my opthamologist, he waved his arm and said, "they don't work", and that was that. Period.

I bet you were glad to get your surgery over with and onto a new life with better vision....2 yrs goes by fast but not when you're waiting for a problem to be fixed..

Thanks for yr help,
WarBonds

WarBonds,

Strabismus repair did not affect my vision. I have been exo since birth and never had surgery as a child or young adult. Lifetime strabs are usually asymptomatic UNLESS they have had surgery. That is why I wonder if you had strabismus repair as a child? It is quite unusual to develop double vision if you have had strabismus all of your life without intervention. In fact, one of the big risks that I took was post-op double vision because pre-op prism testing showed I had it when fully corrected. When/why your strabismus developed will have a great influence on if surgery is indicated and how successful it is likely to be.

May I suggest you read the "Strabismus Minute" It was written for ophthamologists by an ophthamologist so at first you may need to look up a few of the words, but you can learn a lot. It covers everything from the basics of what strabismus is to more technical surgery info. It will give you some pretty interesting places to start in reading about strabismus so that you can understand your PO when he talks about your diagnosis. Once you have an actual diagnosis you will be able to do web searches for that and get a lot more targeted information.

VT is going to be more difficult for you because you are eso. Expect to commit at least 3-4 months to see improvement if the VTOD thinks it might help.

Good luck with your search for a PO. Make sure that you find one you like and can communicate with. I went to three different ones and ended up back with the first one I saw. I should of just listened to the ophthamologist who told me I would like the first guy. I wanted to be sure because I was risking my eye. Meeting with the other two convinced me that I was in the right hands with the first one! "Bedside" manner DOES make a difference. There seem to be quite a few POs listed on AAPOS in Ontario but my geography skills being what they are, I'm not sure how close they are to you. I hope you find one you feel comfortable with.

I hope you find a solution.

Shaman,

No, I never had strabismus repair as a child or ever. I have been near sighted since age 14 and worn eyeglasses ever since. No other problems.

In fall of 2000, I started to have problems with a new pair of glasses and after a bunch of tests and examenings, the doc (optometrist) discovered that I had slight double vision. Then I was prescribed a new pair of glasses with prisms built in. I think the prism glasses have worsened my double vision; it has made my eyes dependant and "lazy" on them. In fact, MY opinion, I think doc prescribed too strong a prism, when I only need a weaker strength of prism. Now I am trying to undo what these overly-prescribed prism glasses have done! @#^&*(%$#

(Might also mention, I was fender-bended in a car accident in Spring 2000, but my family doctor said firmly that accident would have done nothing to harm my eyes/vision. During this accident I hit my forehead on the window, a nice whack!! Also, the opthamalogist said maybe the accident could've done it or maybe not. What a wishy washy answer. I am getting to the point where I don't trusts doctors. Moneygrubbers!!).

What to do, what to do............

WarBonds

WarBonds,

God love your family doc, but I can't agree with him! Anything that disrupts fusion/vision temporarily can indeed cause sensory strabismus OR decompensate a previously undiagnosed strabismus. Nerve palsy can also happen after a head trauma, so the accident may well have something to do with all of this.

Have you gotten in touch with a PO or VTOD yet? You really need to find someone who has experience in using prisms theraputicaly rather than just to compensate. If the PO or VTOD that you see does not have experience in this area, ask them who does. Its time to find out if you can get copies of the relevant records from the accident and after. If push comes to shove, you are going to need them. The absolute authority on strabismus treatment and double vision is Dr. David Guyton in Baltimore MD. If no one else knows what to do, Dr. Guyton is often willing to review medical records and do an e-consult (via e-mail). Often, he has provided treatment advice that has allowed people who were told there was no hope to return to a normal life. Don't give up hope at this point. Keep pushing for a proper diagnosis. Keep the faith, its a marathon not a sprint!

Shaman,

Once again, thanks very much for all your info!
You've given me lots to think about and look into....

Yes, I'll try to keep the faith and positive attitude or else I'll just let it slide....

On a positive note, I did have a cat scan on my head one year after the accident and everything was A-Okay. No evidence of brain damage or anything else. That was a relief to hear; it was my family doctor, by the way, who ordered the cat scan to be done.

Have a great day and everyday !

Warbonds

Hi. New poster here. Just wanted to share my situation with ya'll. I'm in my late 20's, and have had vertical strabismus for as long as I can remember. The cause is 4th nerve palsy in the right eye, resulting in weakening of the superior oblique muscle, and overaction of the inferior oblique in the same eye. Because the condition is congenital, my brain has learned to ignore one or the other eye is a particular field of gaze, so as to prevent diplopia. Also, I employ a slight leftward head tilt much of the time.
Nonetheless, I have begun to decompensate, and can feel my eyes straining constantly, even in frontal gaze. Currently, my primary deviation is 20 prism diopters.This problem has proved psychosocially painful to me, since I can't make and keep eye contact without the onset of diplopia and/or confused vision, and having my right eye go up substantially more than it normally sits. Both the cosmetic (asymmetry =lonliness in the animal kingdom) and functional aspects have driven me to take the relatively radical (for me, at least) step of having surgery. I'm scheduled to undergo dual eye surgery in January, with retraction of the right inferior oblique, as well as an adjustable suture procedure on the left inferior rectus. The surgeon claims a 90% or so success rate, both cosmetically and functionally for this dual eye procedure. I don't want to put too much faith in this procedure, but I'm hoping it will help out with my self-value and potential to be more social. Even if the surgery was purely cosmetic, I would still be willing to risk it at this point, since reality is that surface is just about everything in dictating how you are treated in this world. Not to be a cynic, but I think I have real world experience and observational evidence aplenty of this. I'd love to hear any opinions, expert or otherwise, on my proposed surgery, and other people's similar experiences, thoughts, and feelings. thanks.-UM

UM,

I am sorry that you are struggling with this issue. I can understand why you waited so long to have surgery (i waited until I was 33), and can also understand why you want to have it. What pushed me to have my surgery was getting irritated when I would talk to people and they would look over their shoulder to see who I was speaking to. The surgery you are going to have can be very successful especialy when adjustable sutures are used. Please be aware that your eyes are going to be VERY red and swollen post-op. I thought I knew how bad it was going to be, but frankly, it was scary looking in the mirror afterwards. I ended up missing a lot more work than I expected because I am in sales and I did nt look normal until six weeks after the surgery. Going in I was told to expect one maybe two weeks of redness. If you don't work with the public, this may not matter, but just so you know.

I am sending you positive vibes for a quick and painless recovery and perfect stable alignment.

May I ask who is doing your surgery?

UM,

just a quick note to wish you luck with your surgery in January. You say your lenses were 20 diopters thick? Believe me, I am no expert but that sounds very thick to me indeed. I could see why you would still opt for the surgery even if just for cosmetic reasons alone and cynic or not, we know the world treats us on our appearances, be it whatever. That'll never change, I'm afraid.

As stated above, I have diplopia (double vison). Went to a new optometrist yesterday who does vision therapy. I am doing the vision therapy to eliminate or reduce drastically the double vision and therby *hopefully* get rid of my "thick" prism glasses! The optometrist said firmly right out, that I have my work cut out for me to rid or reduce the diplopia, since my eyes have become so very dependant on these prism glasses for just over 2 1/2 years now. But I am determined to give it a real good try!! On a positive note, the optometrist said my vision, as such, has improved, for reading print near and far.

Let us know how you make out in the next few months, UM.

Best wishes,
WarBonds

Warbonds,

I am so happy that you have found someone who is willing to support you in improving your situation rather than just mask the problem with more prism! I know that you are going to have a tough few months at first waiting for results, but hang in there. I really, really, hope that you can get rid of your prisms altogether.

Are you going to keep wearing your prisms full time? Did he say anything about changing your rx as VT progresses?

You will be in my thoughts.

Shaman,

Thank you for your kind words! I really appreciate hearing from you, always.

Yes, I was determined to find an optometrist who does VT and luckily I found one without too much problem.
She said it would be alot of work for me to get rid of or drastically reduce the double vision. But I am DETERMINED to give it a go! It will take months to achieve my goal (at least 3 months, prob longer?).
It is hard to say how long exactly, everyone progresses at a different pace/speed. You are quite right in saying that it is a marathon and not a sprint!
I will continue to wear my prism glasses for now and then try to wean myself off them, as time goes by.
I have a prism-less pair of glasses at home, which I bought 4 years ago, which I haven't been able to wear hardly at all since I got them in 1999 !! It is my goal to wear them one day...I hope.........The lenses in this pair are so thin and light.

The VT sessions are 30 mins. in length and I go every 1 or 2 weeks for a session. Also, I will be given eye exercises to do at home between sessions.
Again, thanks kindly for all your help, advice, and support, Shaman! You have been great!

I will keep you posted as to what happens along the way.

WarBonds

I have double vision too... and the doc suggested prisms but also said that in order to keep seeing one image for the rest of my life, the prisms would have to keep getting stronger and stronger... so i opted not to get them. I have put up with so much ____ with my eyes already in my 20 years of life... why not one more thing? lol... too much stuff to get into tonight as it would take a while... lol... one doc did tell me to do eye exercises or i would lose my sight! lol... he told me to hold a pen out as far as i need to to see one image... then slowly bring it towards my face but focusing really really hard to keep it one image... i went home and tried it and i almost threw up it made me so naseous... ! So needless to say, I dont do these exercises any longer! I think he was a quack anywayz...
Lexi

Lexi,

I hear exactly what you're saying, I certainly can relate to what you're going thru....
At this point, I won't repeat my "history" of double vision and what I've been through, you can read that in the previous threads, BUT...

If I were you, I would NOT get prism at all, they just ruin and make you eyes lazy and dependent on them. Avoid prism only if you can. Can you do daily activities, driving, working, etc without prism ?? Just how bad is your double vision? My gut feeling only....you did the right thing in not getting glasses with prism. Do the eye exercises though, under care from a qualified optometrist who does vision therapy, find an optometrist who you like and can talk to easily..that would be my suggestion to you, my opinion.
.............avoid the quacks, I've met a few.... :)

Feel free to tell us anything, dish! We're here to listen and support

Best wishes

WarBonds

ps...your doctor was right...the more prism you give your eyes, the more prism your eyes want! Avoid that nightmare.

Lexi,

My only advice to you is to find out what your actual medical diagnosis is, and then educate yourself regarding your condition and the treatment options open to you.

Good luck.

have you been check by your gp? i know of someone who was troubled by double vision and come to find out, she has an autoimmune disorder, myasthenia gravis. check it out.