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Old 02-28-2011, 08:37 PM   #1
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Double vision

I have seen four different doctors and have gotten mixed reviews:

I saw a neurologist in 2005 who diagnosed me with Lazy Eye (yeah, that is not the medical diagnosis, but the lay interpretation). However, I did not have any problems as a child and received regular vision checkups, so I know that I did not have lazy eye.

I went to my regular ophthalmologist who said my double vision was simply stress related as I was working on my Master's Degree.

Then I saw a neuro-ophthalmologist in 2008 who said that I had bilateral paralysis of the 6th Cranial Nerve. I lived with that one, but wondered because my vision varied. And I could read books. When the ophthalmologist tried to prescribe special glasses for double vision, he could not find a precise prescription because my vision varied too much.

Then in 2011, yet another neurologist said that I have vertigo and BPPV and that is causing the double vision.

I see double at night or in poor light conditions when I see two red traffic lights. Rarely do I see double in good lighting, but in full sunlight, I have had trouble driving, so I had to give up driving my car. When I am a passenger in a car during the day or night, I can see double. I will see two of one person or two stop signs.

 
Old 03-01-2011, 11:47 AM   #2
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Re: Double vision

Has anyone else here experienced double vision?

Could BPPV be the cause of double vision?

The MRI did not show any indication of a stroke or TIA.

 
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Old 03-04-2011, 06:02 PM   #3
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Re: Double vision

Try seeing an ophthalmologist who specializes in strabismus (also known as a pediatric ophthalmologist, but they see adults.) You might have a slight eye muscle imbalance.

 
Old 03-04-2011, 09:06 PM   #4
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Re: Double vision

Quote:
Originally Posted by JodieJ View Post
Try seeing an ophthalmologist who specializes in strabismus (also known as a pediatric ophthalmologist, but they see adults.) You might have a slight eye muscle imbalance.
Double vision can also be caused by M.S., by a tumor, or by a stroke.

Strabismus would have been picked up when I was a child, but no such "lazy eye" was ever discovered. In fact, my ophthalmologist told me that as an adult, a diagnosis of strabismus that is overlooked in childhood cannot be corrected after the teenage years. It apparently can only be corrected in children. A neuro-ophthalmologist who dealt with children told me this.

My current neurologist thinks that peripheral vestibular disorder is causing the double vision. I can only hope. I do know that my ophthalmologist is confused and that is why he referred me to a neurologist because he cannot arrive at a precise prescription for a set of prisms. Each time I got a prescription for a prism, the prescription changed ... even one hour later. Therefore, no prisms were prescribed.

During the exams for prisms, I got ranges for 1 to 3 for the prisms. It turns out that my daytime prescription (without the prism) is different from the night prescription. In fact, the night time prescription for myopia is less than the day prescription, so the doctor was surprised.

Last edited by MariaPatricia; 03-04-2011 at 09:07 PM.

 
Old 03-05-2011, 08:18 AM   #5
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Re: Double vision

I don't know what's causing your double vision, and I really hope that you find a doctor who can help you. But my own experience with double vision, which suddenly developed when I was about 50 years old, strongly suggests that some of the information you've received from the eye care professionals whom you've consulted is just plain WRONG. I received similar inaccurate information from the optometrists and ophthalmologists I consulted. I also received wrong prism corrections that didn't work and wasted my time and money.

My double vision was horizontal and for distance vision only, and it was related to an eye muscle imbalance (probably secondary to my use of monovision contact lenses). I did not have a lazy eye or a history of childhood strabismus. (You can have strabismus and not have a lazy eye.) My need for prism increased significantly from morning to evening. This was because my eye muscles became more tired as the day progressed, making my double vision problem worse--but a competent professional should be able to write a prescription for prism that works all the time. It's more difficult to fuse the images of each eye in dim lighting conditions (fewer peripheral vision cues) and in a moving vehicle. I had the same problems that you described in your first post.

If your current doctor isn't helping you, I'd strongly suggest that you try consulting a board-certified strabismus specialist. It was my experience that double vision can practically drive a person crazy. I opted to have a totally painless outpatient procedure that eliminated my problem.

Last edited by JodieJ; 03-05-2011 at 08:36 AM.

 
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Old 03-05-2011, 08:29 AM   #6
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Re: Double vision

I have worked with a neuro opthalmologist for several years. We used to see these problems all the time. The 6th nerve palsy resolves on its own. But sometimes if diplopia(double vision) is still present. Muscle surgery is required. I would look into having muscle surgery to resolve this issue or at least to minimize the double vision.

 
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Old 03-05-2011, 09:10 AM   #7
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Re: Double vision

Quote:
Originally Posted by JodieJ View Post
I don't know what's causing your double vision, and I really hope that you find a doctor who can help you. But my own experience with double vision, which suddenly developed when I was about 50 years old, strongly suggests that some of the information you've received from the eye care professionals whom you've consulted is just plain WRONG. I received similar inaccurate information from the optometrists and ophthalmologists I consulted. I also received wrong prism corrections that didn't work and wasted my time and money.

My double vision was horizontal and for distance vision only, and it was related to an eye muscle imbalance (probably secondary to my use of monovision contact lenses). I did not have a lazy eye or a history of childhood strabismus. (You can have strabismus and not have a lazy eye.) My need for prism increased significantly from morning to evening. This was because my eye muscles became more tired as the day progressed, making my double vision problem worse--but a competent professional should be able to write a prescription for prism that works all the time. It's more difficult to fuse the images of each eye in dim lighting conditions (fewer peripheral vision cues) and in a moving vehicle. I had the same problems that you described in your first post.

If your current doctor isn't helping you, I'd strongly suggest that you try consulting a board-certified strabismus specialist. It was my experience that double vision can practically drive a person crazy. I opted to have a totally painless outpatient procedure that eliminated my problem.

What kind of procedure was it?

I have bilateral horizontal and vertical vertigo (both ears are involved). Red traffic lights are doubled horizontally. If my husband swings around a curve suddenly without telling me, I get very dizzy, so the experience of horizontal centrifugal force is awful. Therefore, I cannot enjoy the Disney or amusement park rides. They are sheer terror for me.

I have been doing the Epley maneuvers for the left side this week and will do the ones for the right side next week. I see little improvement as I woke up dizzy this morning even though I got up slowly. Arising quickly can cause me to black out. A change in blood pressure from lying down to sitting up does not help either.

The audiologist said that I have a lot of issues going on with the double vision and double vertigo (affecting both right and left ears) and the changes in positions from lying down, to sitting up, to standing up causing changes in my blood pressure. So getting up in the morning is difficult. During the day, I am usually fine. Indeed, if I feel the need to take a nap during the day, I find it hard to wake up and need at least four to six hours of sleep, but doing that disturbs my sleep at night. Thankfully, anxiety is not an issue here. Like you, I tend to have more problems at night with double vision.

Also like you, my double vision is largely in the distant. However, I do have blurry vision when trying to catch a low ball (at or below my waist). One that is tossed up high in the air causes no problems. This is what alerted the physical therapists that there might be an underlying problem and that I had need of further evaluation by a neurologist. Surprisingly, it was the PTs, not the optimists and ophthalmologists who first noted the problems.

 
Old 03-05-2011, 10:01 AM   #8
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Re: Double vision

I had the rectus muscle of my left eye shortened. (I think it was by 4 mm.) My deviation was small enough that I only needed surgery on one eye, although both eyes had been affected. The procedure was done at a surgery center and took about 40 minutes total. IV sedation was used, and I experienced no pain at all during or after the procedure. It was like magic--driving home from the surgery center my double vision was GONE. (I don't know whether this is typical.) That afternoon I went shopping at the mall (wearing sunglasses to cover a red eye). I could drive the following day.

As Angie0303 points out, eye muscle surgery can sometimes be helpful for double vision related to neurological causes.

Before my eye muscle surgery, my double vision was pretty much controlled with prism--3 PD base in for each eye. (Previously only 1 PD had been prescribed by a general ophthalmologist, and that wasn't helpful. I think that prescribing prism is an art, and the best results can be obtained from a strabismus specialist regardless of what's causing the problem.) But I hated the weight of my prism glasses, and I was grateful to find another solution.

 
Old 03-05-2011, 10:24 AM   #9
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Re: Double vision

Quote:
Originally Posted by JodieJ View Post
I had the rectus muscle of my left eye shortened. (I think it was by 4 mm.) My deviation was small enough that I only needed surgery on one eye, although both eyes had been affected. The procedure was done at a surgery center and took about 40 minutes total. IV sedation was used, and I experienced no pain at all during or after the procedure. It was like magic--driving home from the surgery center my double vision was GONE. (I don't know whether this is typical.) That afternoon I went shopping at the mall (wearing sunglasses to cover a red eye). I could drive the following day.

As Angie0303 points out, eye muscle surgery can sometimes be helpful for double vision related to neurological causes.

Before my eye muscle surgery, my double vision was pretty much controlled with prism--3 PD base in for each eye. (Previously only 1 PD had been prescribed by a general ophthalmologist, and that wasn't helpful. I think that prescribing prism is an art, and the best results can be obtained from a strabismus specialist regardless of what's causing the problem.) But I hated the weight of my prism glasses, and I was grateful to find another solution.
My ophthalmologist has successfully prescribed prisms for others, but I am a difficult case. Although I was prescribed a 3 PD prism for both eyes, when he remeasured them an hour later, it was only a 2 PD prism. I went for a second opinion, and it was 1 PD prism. Both doctors said that they could not prescribe prisms due to the variation. Resting seems to bring the prescription down. So at night it could be a 3 PD prism. However, my nighttime myopia actually improves over my daytime myopia. That really confused the doctor.

Last edited by MariaPatricia; 03-05-2011 at 11:17 PM.

 
Old 03-05-2011, 09:15 PM   #10
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Re: Double vision

My deviation varied significantly from morning to evening. I had a second test for prism done during an evening appointment. 3 PD in each eye (total of 6 PD) just about completely eliminated my double vision, even very late at night (and after I'd had a glass of wine.) I think that the goal is to fully correct double vision at its worst with the least possible prism. It's possible to get temporary prism correction with Fresnel prisms that you stick on your glasses. That way you can try out a correction to see whether it helps before ordering new lenses.

Your deviation seems to be very close to what mine was. If you are a candidate for eye muscle surgery, you would probably need surgery on only one eye.

Last edited by JodieJ; 03-05-2011 at 09:21 PM.

 
Old 03-06-2011, 02:57 PM   #11
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Re: Double vision

Check out ocular myasthenia gravis.

Good luck.

 
Old 03-06-2011, 07:06 PM   #12
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Re: Double vision

Quote:
Originally Posted by Brocallie View Post
Check out ocular myasthenia gravis.

Good luck.
Thank you.

The ENG showed normal vertical and horizontal eye movements when following the moving dots.

Therefore, I am quite sure that MG has been ruled out.

Last edited by MariaPatricia; 03-06-2011 at 07:06 PM.

 
Old 08-31-2011, 02:37 PM   #13
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Re: Double vision

I was attthe doctor today and he is sending me to a specialist becaue I have a prism and they don"t have make glasses for how bad it is. Could anyone tell me what a prism is and if surgury alwag right

 
Old 08-31-2011, 08:16 PM   #14
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Re: Double vision

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Originally Posted by volleyball2 View Post
I was attthe doctor today and he is sending me to a specialist becaue I have a prism and they don"t have make glasses for how bad it is. Could anyone tell me what a prism is and if surgury alwag right
One way of correcting double vision without surgery is through the use of a prism or prisms. Prisms can add substantially to the weight of glasses and in some cases, they look like one is wearing a coke bottle bottom. So cosmetically, they can be very unattractive.

My vision fluctuates. At night, in poor light, or when I am ill with the flu, cold, or severe allergic reaction, the double vision worsens. If I take a nap during the day, immediately upon rising my vision shows improvement. My ophthalmologist did a test where she had me lie down for 30 minutes in a darkened room, and then retested my vision. My vision correction went from a prism size 3 to a prism size 1 in both eyes. That is significant. A prism size 3 is huge. As a result, the use of prisms was ruled out.

I have to go back and see the neuro-ophthalmologist later in September.

 
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