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Schnall Pediatric Ophthalmology

Diplopia (Double Vision)

What is diplopia?

Diplopia is a medical term, which means double vision. It usually occurs as a consequence of the eyes being misaligned. Diplopia is not normal and is often a sign of serious eye or neurological disease. Children with crossed eyes do not have diplopia. Their brains "turn off" or suppress the information from an eye which is misaligned so they do not see double. Adults have no such protective mechanism and cannot suppress the double image.

What might a patient with diplopia notice?

Someone with double vision will see two separate images at varying proximities. They may be very close, like ghost images of one another, or so far apart that the second image is ignored. They may be horizontally or vertically separated, or both. The separation of the double images depends on where a person is looking. For instance, they may be closer together when looking to the right and farther apart when looking to the left. Because of this, adopting a particular head position may make the images single again.

The person with diplopia may experience dizziness of feel disoriented. Covering one eye may help with walking or driving.

What are some of the other details about Diplopia?

Diplopia usually occurs as a symptom when the eyes become misaligned for the first time in childhood. It may occur in younger children, but usually after an injury, infection, or accident, and may disappear without the underlying problem being cured. Double vision disappears with one eye closed. If double vision occurs, an ophthalmologist should be consulted as soon as possible. It can be a sign of a serious problem. Eye muscle weakness due to conditions affecting the nerves to the eye muscles or the muscles themselves can lead to misalignment of the eyes and double vision.

How is Diplopia Treated?

Once the actual cause underlying the diplopia has been determined and treated, the diplopia may spontaneously disappear. If not, it may be treated by applying prisms to the patient's glasses. Under certain circumstances, diplopia can be corrected with eye exercises (orthoptics), often in combination with glasses and/or prisms.

Due to some common medical causes of diplopia are diabetes and thyroid conditions, it is very important to see an ophthalmologist as soon as possible after diplopia occurs. Ophthalmologists are medical doctors who can diagnose the underlying condition and treat or refer the patient to the proper specialist for treatment.

If the diplopia is caused by an injury or does not disappear after medical or orthoptic treatment, surgery is often the best treatment. With eye muscle surgery, the muscles are adjusted to straighten the eyes and the diplopia may be cured.

In a few patients with diplopia, an alternative to surgery may involve injecting one of the eye muscles with a drug called Botulinum to straighten the eyes. This medicine causes a temporal weakness in one of the muscles, which may lead to realignment, and relief of the diplopia.

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