Diplopia, also known as double vision, is a complex condition that in some cases may be a sign of a serious disorder.
When the eyes are aligned and working properly, the images seen by each eye are merged or fused in the brain, forming a single “binocular” image. When viewing objects through properly aligned and focused eyes, the images have a three dimensional or stereoscopic quality that is not present when viewing through one eye alone. If the eyes are misaligned and are not focusing properly, the images cannot be fused and double vision (diplopia) will result.
Types of diplopia
The first step in treating double vision is to conduct a complete medical history and thorough eye exam. Ultimately, these help to determine the specific type of diplopia:
- Binocular diplopia: In this type, which is more common, the double vision goes away when either eye is closed. This typically results from a misalignment of the eyes, and it may be a sign of a serious muscular or neurological disorder.
- Monocular diplopia: In this type, which is less common, the double vision goes away only when one specific eye is closed.
Issues with any part of the vision system can cause double vision. This may include problems with the:
- Cornea: Corneal causes of diplopia include infections, keratoconus (corneal scarring) and dry eye disease
- Lens: Cataracts are the most common lens problem that can cause diplopia
- Muscles: Muscular conditions that can cause double vision include myasthenia gravis and Graves disease (a thyroid condition)
- Nerves: Nerve-related conditions that can cause diplopia include multiple sclerosis and Guillain-Barre syndrome (an autoimmune disease)
- Brain: Brain conditions that can cause double vision include aneurysms, stroke, brain tumors and trauma
Following the eye exam and history, additional tests, such as an MRI or CT scan, may be necessary. Specific treatment depends on the underlying cause of the diplopia, and may include:
- Eye patching
- Eye exercises
Your Henry Ford pediatric ophthalmologist will recommend the best treatment based on your child’s unique needs, and work with you every step of the way.
Diplopia in adults
Because pediatric ophthalmologists have considerable experience with eye muscle related conditions, they are often involved in the evaluation and treatment of adults with diplopia and strabismus:
- Adults who develop new onset strabismus will be particularly bothered by double vision
- Adults with a history of strabismus may occasionally note double vision, which may change or worsen as they age
Diplopia in children
Double vision in children is more rare. This is because infants and young children can rapidly adapt to a misalignment of the eyes, by learning to suppress (or shut off) the second image. Once suppression develops, amblyopia and visual loss often follows. Prompt evaluation and treatment of strabismus in children allows each child to develop their maximum individual binocular visual potential.
At Henry Ford, patients come first.
The Henry Ford Department of Ophthalmology is committed to providing our patients with compassionate, personalized care. We feature the most advanced treatments in eye care and are dedicated to vision research – always staying at the forefront of innovation. A leader in Michigan, as well as one of the largest ophthalmology practices in the United States, we treat more than 55,000 patients per year at 12 locations throughout southeast Michigan. In addition, our team works closely with Henry Ford Medical Group physicians in other departments, providing multidisciplinary, coordinated care for those patients who need it.