What Causes DOUBLE VISION (Diplopia) – 5 Common Causes for Diplopia
So have you ever experienced double vision or diplopia. As the medical term where you can be sitting with a friend and all of a sudden they split into two separate people. They could be side by side it could be up and down or even diagonally and there’s gonna be real serious medical issues that could be causing that.
Well in this video I’m gonna go over five medical causes for diplopia or double vision let’s take a look hello and welcome this to dr. Allen here from the doctor eye health helping. You learn about the eyes and vision and this channel, you’ll see us do a lot of vision stock reviews around glasses and contacts.
As well as educational videos just like this one so if you’re new here to the channel hit that subscribe button down below and turn on notifications so that you don’t miss any of my future videos. Now having double vision can be very alarming and concerning imagine.
You are driving down the road and you can see one car in front of you and all of a sudden it splits off into two of them and you’re not sure which one is actually real so yes this can be really concerning and frightening.
And it could actually be serious medical reasons for causing this now certainly there are many different causes for double vision and this short list is not every single possible cause for double vision however I’m just gonna go over the five main things that.
I’m thinking about when a person comes into the clinic experiencing some form of double vision number one strabismus, strabismus is the medical term for a kind of an eye turn not necessarily a lazy eye but it’s where one eye usually ends up turning inward in some fashion.
If this is something that’s newly experienced in the brain hasn’t adapted to it yet people can actually see double vision there’s actually different types of strabismus or eye turns. You could have somebody with an eye turning inward which we call an esotropia or possibly an esophoria versus somebody where the eye kicks outward.
Which we call an exotropia or an exophoria in some cases now believe it or not many people’s eyes naturally do not rest looking straight ahead even though my eyes are straight right now I actually have an eye that wants to just kind of wander and drift away especially.
When I’m very tired we can call this a decompensating thoria and in fact a lot of people do experience this again especially when they’re tired or fatigued usually this type of diplopia doesn’t last very long it’s rather intermittent meaning it just sort of lasts for maybe a few seconds or a minute but once.
You kind of realize it blink your eyes a few times things suddenly snap back into focus usually in the clinic we can measure for some type of strabismus or other type of phoria or the alignment of the eyes by doing what is called a cover test.
You’ll actually see the doctor ask you to focus on a single object and then they’ll cover one eye and go back and forth a few different times and they’re actually looking for eye movement at that time and the good thing is that if someone does have strabismus there are many different solutions for it.
There are prism glasses possibly vision therapy and in really extreme cases even saw some ice surgeries can help number two side eye disease. Now I actually see a lot of people on treatment for some problem with their thyroid and seems to be coming very common. And i’ve actually read a couple of different blog posts out there with people with these kind of different ideas of why that could be.
In fact if you’re somebody who has a thyroid problem yourself or if you’re maybe in medical care and you have some sort of ideas of why so many people have issues with their thyroid go ahead and comment in the section below.
I’d love to hear what your thoughts are basically thyroid problems stem from an autoimmune issue where your own immune cells attack your thyroid but they also can attack the back surface of the eyes and causes the muscles around the eyes to swell.
And because the orbit really doesn’t have much place for those muscles to go it actually pushes on the eyes and causes them to kind of protrude outward and that kind of gives people this kind of bug-eyed appearance and that’s classically known as Graves disease and in the clinic we actually do measure people’s eyes of how their protruding forward.
You can use some what’s called an exophthalmometry, I know that’s kind of a funny word sounds like all I care terms are made up i’ve actually had some friends tell me that I sound like I’m talking from a dr. Seuss book sometimes but the main issue with having a thyroid disease is that.
It can cause these muscles to swell a little bit and it primarily is gonna cause an issue with vertical double vision so it can cause effect on all the eye muscles but it usually affects the lower eye muscles first.
So it actually causes problems with you kind of looking and your eyes will be kind of staggered in a way and so you’ll see things kind of split vertically but usually if somebody’s experiencing new double vision I start to have at least some suspicion of thyroid eye disease.
So we’ll order a thyroid panel and make sure things are doing okay nowadays medical professionals are pretty easy to catch sigh roid issues and thyroid idd specifically so it usually doesn’t get too really extreme cases however occasionally it still happens and people will have to go under surgery for orbital decompression basically.
They do surgery to open up the orbits so that you can actually have more space for the eyes and the eye muscles they also do this that the optic nerves don’t get pinched which can ultimately kill the optic nerve and therefore make you blind and again thankfully.
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We usually catch this pretty easily and with proper treatment usually I don’t have to worry number three Myasthenia Gravis, now if you’ve never heard of myasthenia gravis before it’s actually another autoimmune condition where your own immune cells like block the ability for your body to really utilize acetylcholine.
Which is a neurotransmitter that really speaks between your muscles and your actual nerve impulses because of this your own nerve impulses to move your muscles aren’t really getting the signal and so your muscles aren’t really working the way.
They’re supposed to and one of the first signs of myasthenia gravis is typically the loss of control of the eye muscles and the eyelids so basically all eye doctors are trained to at least suspect myasthenia gravis whenever somebody has an eyelid droop or are also called a ptosis additionally we also suspect this for anybody.
Who’s having double vision that is quite variable and usually gets worse toward the end of the day or under events of extreme fatigue and we can test for this a couple ways in the clinic we can use medications.
We can actually do an icepack test we can have patients try to look up and hold their eyelids looking straight up for a while and if they are having issues then the muscles get tired really quickly and then later to start to sink really fast but the biggest concerns for myasthenia gravis is that because you can lose your ability to control your own muscles.
You can actually have difficulty swallowing and potentially even breathing and you could probably guess that not being able to breathe or swallow could be a real problem doctors also have to be concerned in this condition for the patient developing a tumor within their thymus called a thigh moment occurs about 20% of patients begin thankfully for this condition.
We can usually identify the patient who’s having this issue we can refer them to a neurologist or a doctor who’s more familiar with tree this type of disease and usually with treatment they do much better for multiple sclerosis now multiple sclerosis or MS can be a very frustrating disease not only just for the patient who’s actually experiencing it.
But also for the doctors ms can attack and affect people in so many different ways that it’s highly variable one person can get it and there are only mildly affected where another person can develop a really severe form rather quickly and even at a younger age ms is an autoimmune condition where basically your own body starts to attack the myelin sheath.
This is the fatty sheath that surrounds all the different nerves in your body it’s basically kind of like the rubber wiring around other wires that you see for electronics it actually helps the propagation of electrical signals down those nerves so this can affect many different motor abilities in your body and can be very frustrating and specifically in eye care multiple sclerosis can present in several different ways.
In fact it’s one of the big things that doctors look for specifically when a patients coming in with kind of any sort of vision loss or some sort of visual obscurations they’re seeing things a little bit differently and when we examine the eye everything looks normal this is because ms can actually cause something called an optic neuritis.
And this is where there’s swelling and the back of the nerve behind the eye and because it’s behind the eye the doctor really can’t see it but we know that with swelling with the nerve there’s these kind of typical symptoms that people will develop people usually experience some type of blurred vision maybe dimming of lights loss of color vision they could actually be experiencing pain with eye movements.
So when we ask a patient if they’re looking left look right are they experiencing a sharp pain that could be that the optic nerve is swollen and then when you turning your eye it’s pulling on that nerve and you can actually feel it usually in these cases we order our brain MRI to really identify that it is MS and it’s really important that we do so because the earlier.
We catch it really the better the outcomes and treatments are for those patients but since MS can affect all of your muscles it can actually affect the eye muscles quite in an extreme manner and just like with other conditions it can be quite variable and pretty straighting.
So I doctors like myself can prescribe glasses with prism in there to help orient kind of how the eye is seeing and that can sometimes negate the double vision so the person could be seeing double and then we’ll prescribe the prism glasses and it’ll shift the images together.
So they’re seeing single again however if it’s highly variable and one day they’re having a better day then the prism glasses we prescribed when they’re having a bad day are no longer gonna work they’re gonna almost over prescribe so it could actually cause double vision so sometimes these patients will have multiple sets of glasses depending on how good or bad of a day.
They’re having there’s also some prisms that can be kind of stuck on to glasses lenses kind of like a sticker those ones are pretty nice because you can just remove them and put them back on depending on really how severe the double vision is affecting you that day of course for some people.
The easy solution is actually just patching over one eye because when you’re having double vision due to two eyes and you patch one eye then all of a sudden you’re just monocular using one eye ultimately MS can be very frustrating not only just for the doctor again but absolutely for the patient and I do not wish that disease on anybody and number five that is a brain tumor or mass lesion.
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I do not like to mention anything like brain tumor to patients actually in the clinic because it can cause a lot of fear and anxiety but the reality in medicine and in life these things do happen and an eye exam is very much a neurological exam in many ways basically because we’re testing so many cranial nerves all at once your cranial nerve three involves a lot of the eye muscles in q including.
How the pupil works Journal of six controls eye muscle screen of four controls your eye muscles cranial nerve two is your optic nerve and because all of these cranial nerves originate in deeper parts of the brain they actually have long extensions that go to the eye so if a tumor or a lesion in your brain is occurring anywhere along these nerves.
It can affect to the eye muscles actually not too long ago I did have a case where a woman came in she had double vision whenever she was looking off to her left side and just a couple of weeks before that I had seen it for another reason and everything was normal so I kind of had this deep sinking feeling that something bad was going on basically after seeing all that all the different tests and checking her.
I’m suls I was able to narrow down that it was criminal of six on her left side that was affecting her ordered a brain MRI and basically it came back that she did have really severe hemangioma ultimately at that time things were starting to turn out for her I honestly haven’t kept up with her for a couple of years.
So I don’t know where she’s at I’m really hoping though that things turned out well for her I think it’s important that if you’re ever experiencing any sort of new onset double vision and you haven’t had it address before by your doctor please make an eye examination with your local eye care physician.
So that you can get things checked out and make sure that everything’s okay again thankfully with many cases of double vision we can narrow down the cause we can get correct treatment if needed we can actually prescribe glasses or have special prisms put into the glasses to basically bring things back into alignment.
However if you are being prescribed prism understand that it can be very difficult and pretty variable depending on how you’re doing that day during testing and how the glasses are made and fit again if you are having issues with double vision whether you are being treated by a neck your professional or just experiencing now make sure you talk with your doctor and see.
If they can help you out hey thanks for watching if you got something on this video hit that like button for me share it with a friend or family otherwise keep an eye on it we’ll talk to you soon.
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