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Double vision (Diplopia)

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Diplopia is the condition when a single object appearing as two objects. According to University of Michigan, Kellogg Eye Center, diplopia may be the result of a refractive error, where light from an object is split into two images by a defect in the eye's optical system. Cataracts might, for example, cause such a defect.

It goes on to add that the condition may also result from failure of both eyes to point at the object being viewed, a condition referred to as ocular misalignment. For a normal vision to happen both eyes look at the same object and the brain processes it to make a single picture. In cases of diplopia both the eyes look at different objects and the brain is not able to process both the images correctly, causing double vision.


Symptoms of Diplopia / Double vision

The only symptom for diplopia is seeing two image of one object.


Causes of Diplopia / Double vision

A cause of diplopia can be many and is often very important to ascertain. Diplopia can be cause due to a problem with the cornea that damages the surface of the eye. This damage can be due to an infection of the cornea or others issues like scars or the cornea drying up. 

Diplopia can also be caused due to a problem in the lens of the eye. Cataracts are a common problem that causes diplopia. If cataracts are present in both eyes, images from both eyes will be distorted.

Diplopia can also be caused due to weak eye muscles. This means both the eye movements are not synchronized, leading to double vision. Other problems could be more serious like an autoimmune illness called Myasthenia gravis or anything that causes a problem with the nerves. Examples of such nerve problems include multiple sclerosis, Guillain-Barre syndrome and diabetes. In severe cases the cause of diplopia can be traced to a problem in the brain like strokes, aneurysms and brain tumors.


Diagnosis of
Diplopia / Double vision

Often the basis of diagnosis is finding the cause of diplopia. Double vision is often easy to diagnose only through the symptoms and often extensive tests are not needed. According to Harvard Health Publications the first step is to determine whether your double vision is monocular or binocular. To do this, your doctor will ask you to cover one eye and then the other. If you have monocular diplopia, your doctor will evaluate you for conditions, such as cataracts, that could be causing the problem. 

In such cases an ophthalmologist will take care of the condition and further tests will be conducted. If the problem is binocular a doctor will try and determine if the patient has diabetes, Graves' disease or neurological disorders.

In diagnosing binocular diplopia Harvard Health Publication says a doctor has to first determine which eye muscles are affected. To do this, you will be asked to look at the doctor's finger as he moves it up, down, left and right. This lets the doctor see how far your eye can move in each direction. Your doctor also will cover one eye and then the other, while you focus on a target. If the doctor sees your eyes shift as the eye cover is moved, it means your eyes are not aligned properly.

Sometimes additional tests are called for to diagnose the level of thyroid hormone in the body. In cases where a problem with the nerve is suspected a doctor can ask for imaging tests like a magnetic resonance imaging (MRI) or computed tomography (CT) scan of the head.


Treatment of Diplopia / Double vision

According to University of Michigan, Kellogg Eye Center, treatment of double vision consists of eye exercises, surgical straightening of the eye or a combination of the two. Therapy is aimed at re-aligning the misaligned eye where possible without surgery and re-stimulating the part of the visual pathway to the brain which is not working correctly.


Prevention of Diplopia / Double vision

Double vision can only be prevented in cases where it is caused due to a trauma to your head. Head trauma can be prevented by wearing protective gear where there is the hazard of some accident and damage to your head. People with diabetes can decrease their chance of nerve damage, which can lead to double vision, by controlling blood sugar. 

Written by: Healthplus24 team
Date last updated: August 02, 2013 

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