Diplopia (Double Vision)


Diplopia, commonly known as double vision, happens when the nerves that control your eye movement muscles become damaged. Normally, these eye movement muscles work together, but when double vision develops, a persons’ eyes may no longer work in tandem. When the images produced by each eye do not match, the brain misinterprets the information as two misaligned objects.

Occasionally double vision may only occur when someone is looking in specific directions, for example, all the way to the side, or straight ahead. It may also be aggravated by fatigue or time of day. Cranial nerve palsies are the most common cause of binocular diplopia (67%) with half of these being abducent nerve palsies.¹

Managing Double Vision

A neuro-ophthalmologist will be able to prescribe the best options for your situation.

  • Patching one eye to block out one of the two images
  • Eyeglasses with specialized prizm lenses to realign images
¹To evaluate the causes and outcomes for patients presenting with diplopia to an eye casualty department. Patients presenting with diplopia as a principal symptom, who were referred to the Orthoptic Department from Moorfields Eye Casualty over a 12-month period, were retrospectively investigated. One hundred and seventy-one patients were identified with complete records in 165 cases. There were 99 men and 66 women with an age range of 5-88 years. Monocular diplopia accounted for 19 cases (11.5%), whereas 146 patients (88.5%) had binocular diplopia. Cranial nerve palsies were the most common cause of binocular diplopia accounting for 98 (67%) of cases. Isolated sixth nerve palsy was the largest diagnostic group (n=45). Microvascular disease (hypertension or diabetes mellitus, or both) was present in 59% of patients with cranial nerve palsies, and of this group, 87% resolved spontaneously by 5 months rising to 95% by 12 months. Patients with clinically isolated single cranial nerve palsies associated with diabetes or hypertension are likely to recover spontaneously within 5 months and initially require observation only. However, patients with unexplained binocular diplopia and those who progress or fail to recover should be investigated to establish the underlying etiology and managed as appropriate.
Causes and outcomes for patients presenting with diplopia to…. Available from: https://www.researchgate.net/publication/7051048_Causes_and_outcomes_for_patients_presenting_with_diplopia_to_an_eye_casualty_department 
Sources: Superficial siderosis is a rare neurologic disease characterized by progressive sensorineural hearing loss, cerebellar ataxia, pyramidal signs, and neuroimaging findings revealing hemosiderin deposits in the spinal and cranial leptomeninges and subpial layer. The disease progresses slowly, and patients may present with mild cognitive impairment, nystagmus, dysmetria, spasticity, dysdiadochokinesia, dysarthria, hyperreflexia, and Babinski signs. Additional features reported include dementia, urinary incontinence, anosmia, ageusia, and anisocoria. Superficial siderosis MedGen UID: 831707 •Concept ID: CN226971 •Finding Orphanet: ORPHA247245
Living With SuperficialSiderosis Website PubMed Reference Library 
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