Causes and risk factors
Cataract is a common cause of diplopia. Double vision can occur as a result of infection, scarring or drying of the cornea. Weakness of the extraocular muscles caused as a result of diseases such as Graves’ disease, Guillain-Barre syndrome, myasthenia gravis, multiple sclerosis, and diabetes. Strokes, brain tumors, aneurysms, trauma, anisometropia, strabismus; injury to the 3rd, 4th, or 6th cranial nerves; and migraine are other known causes.
Clinical presentation
Every object is perceived twice, both the images being in a horizontal, vertical, or diagonal alignment with each other. Double vision may be the only symptom or it may be associated with other symptoms depending upon the underlying cause. Strabismus (misaligned eyes) may be present. The patient may experience pain in or around the eyes, eyebrows, or temples. Other symptoms such as headache, nausea, or ptosis may be present.
Investigations
A complete ophthalmoscopic examination is carried out. Laboratory tests are carried out depending upon the suspected cause. This may be followed by a CT or MRI scan.
Treatment
Treatment for diplopia entails identifying and treating the underlying cause. Depending upon the cause, the patient requires medication or surgery. In patients with irreversible diplopia, patching of the eye or prism glasses are suggested in order to improve the vision.
When to contact a doctor
Contact a doctor as soon as you experience double vision.
Systems involved
Ophthalmic, nervous.
Organs involved
Eyes, nerves, brain.
