Diplopia, also commonly known as double vision, is seeing two images of one object. This is seeing images as double, when in reality it is not. The double images will be seen by side or on top of another. This visual problem can lead to difficulty in maintaining reading and physical movement. Risk factors in children include a childhood squint (or strabismus) or eye turn; while risk factors of temporary double vision for adults can be caused by alcohol or other recreational drugs. Treatments for this include eye exercises, eye surgery or eyeglasses that are specifically intended for double vision.
Double vision can affect one eye or both eyes. Monocular is when only one eye is affected with double vision; while binocular occurs when both eyes have been affected. Monocular diplopia occurs when the cornea is affected. The cornea which is the eye’s clear window that’s responsible for focusing light. Damage on the cornea will cause double vision and these damages can be caused by keratoconus (when cornea becomes cone-shaped), infections (such as shingles or herpes), eye scar and eye dryness. Damage on the lens also causes monocular diplopia. The lens sits behind the pupil which is the eye’s opening and helps in focusing light into the retina in the back of the eye. Common lens problem include cataracts.
Binocular diplopia involves the muscles that control eye movement and is responsible for keeping the eyes aligned. If one eye has weak muscles, this hinders the synchronization with the other eye. This can be caused by having problems with the nerves controlling the muscles. Another cause is Myasthenia Gravis which is an autoimmune illness that prevents the nerves from transmitting messages to the muscles on what to do. This can be treated by medication. Graves’ disease which is a thyroid condition also causes vertical diplopia (seeing one image on top of the other). Surgery or medication is used to treat this condition.
Another part involved is the nerves which are responsible for sending information from the brain to the eyes. Multiple sclerosis affects nerves on the brain or spinal cord. Guillain-Barre syndrome causes growing weakness on the nerves. Diabetes also causes nerve damage on eye muscles which can be treated through insulin and medications to control blood sugar level. All these can cause double vision. The brain also plays a role in here because the nerves that control the eyes connect directly to it wherein the images are being handled. The eyes create the image’s environment while the brain combines the representation of each eye and perceive it into one clear picture. Strokes, aneurysm, increased pressure (due to injury, bleeding or infection), tumors and migraine headaches also cause double vision.
Some symptoms of Double Vision include wandering eye or cross-eyed look (when one or both eyes do not align), pain experienced during eye movement, pain around the eyes (especially in the temples or eyebrows), eye weakness, droopy eyelids, headache and nausea. Diagnosing Double Vision is done through blood tests, physical exam, CT exam or an MRI. If Double Vision is found out to be causes by weak muscles or damaged muscles, a surgery might be recommended.
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