Double vision occurs when a person sees a double picture in which only one should be present. The two pictures may be next to each other, on top of each other or both.
The condition can affect ability to balance, move, and read.
When double vision only affects one eye, this is monocular. When both eyes are affected, then it is binocular. Treatments depend on the cause and form, but eye exercises, specially made lenses, and surgery are included.
The article would look at the causes of double vision, diagnosis and treatment.
Fast facts on double vision
Here are some key points about double vision. More detail is in the main article.
- Double vision, or diplopia, can result from a range of underlying conditions.
- Diplopia can affect just one eye or both.
- A childhood squint, or eye turn, can sometimes recur and cause double vision.
- Temporary double vision can be caused by alcohol or other recreational drugs.
- Treatments can include surgery, eye exercises, or corrective lenses.
Double vision can be cause by nerve or muscle damage in the eye.
Every eye produces its own surrounding image. The brain integrates and perceives the representations from each eye as one unified image.
A double image can be produced by damage to the muscles that move the eyes or the nerves that regulate eye movement.
To establish depth of field the eyes need to work together.
Some diseases can weaken the muscles that move the eyes, and cause double vision.
Causes of binocular double vision
A common cause of double vision of the binoculars is squint or strabism.
It happens when eyes aren’t matched properly. Strabism is relatively common in adolescents. The disorder does not always lead to double vision though.
Strabism causes the eyes to have a subtly different appearance. It may be because the muscles of the affected eye have the following problems:
- They are paralyzed or weak.
- They have restricted movement.
- They are too strong or overactive.
- The nerves controlling the eyes muscles have abnormalities.
Sometimes, people who have a squint as a child will restore a squint later in life. In certain cases, treating a squint can in fact cause double vision, even if the individual’s vision is fine until the squint is treated.
This is because the brain in an effort to preserve normal vision had blocked the signals from one of the eyes.
Other conditions can lead to double vision including:
- Thyroid dysfunction: The thyroid gland is in the neck and produces a hormone called thyroxine. Changes in thyroid function can affect the external muscles that control the eye. This includes Grave’s ophthalmopathy, in which the eyes can appear to protrude because fat and tissue build up behind the eye.
- Stroke or transient ischemic attack (TIA): In a stroke, blood fails to reach the brain due to an obstruction in the blood vessels. This can affect the blood vessels supplying the brain or nerves controlling the eye muscles and cause double vision.
- Aneurysm: An aneurysm is a bulge in a blood vessel. This can press on the nerve of the eye muscle.
- Convergence insufficiency: In this condition, the eyes do not work together correctly. The cause is unknown, but it is thought to be due to the muscles that control the eye not lining up correctly.
- Diabetes: This can affect the blood vessels that supply the retina at the back of the eye. It can also affect the nerves that control eye muscle movements.
- Myasthenia gravis: This can cause weakness in the muscles, including those that control the eyes.
- Brain tumors and cancers: A tumor or growth behind the eye can interfere with free movement or damage the optic nerve.
- Multiple sclerosis: MS is a disease that affects the central nervous system, including the nerves in the eyes.
- Black eye: An injury can cause blood and fluid to collect around the eye. This can put pressure on the eye itself or the muscles and nerves around it.
- Head injury: Physical damage to the brain, nerves, muscles, or eye socket can restrict the movement of the eye and its muscles.
Causes of monocular double vision
If one eye is shielded but not the other, double vision is observed, this is called monocular double vision.
Single vision monocular is less common than double vision binocular. The following conditions may cause monocular double vision and may be caused by:
- Astigmatism: The cornea, or the transparent layer at the front of the eye, is irregularly shaped. With astigmatism, the cornea has two curves on the surface similar to a football instead of being perfectly round like a basketball.
- Dry eye: The eye does not produce enough tears, or it dries out too quickly.
- Keratoconus: This is a degenerative condition of the eye that causes the cornea to become thin and cone-shaped.
- Retinal abnormalities: In macular degeneration, for example, the center of an individual’s field of vision slowly disappears, and sometimes there is swelling which can cause double vision in one eye.
- Cataracts: Cataracts occur in more than half of all people in the United States over the age of 80 years and can sometimes cause double vision in one eye.
Temporary double vision
Often double vision may be temporary. It is commonly caused by drug intoxication, benzodiazepines, opioids, or other anxiety and epilepsy drugs. Head injuries can also cause temporary double vision, such as concussions.
Being particularly exhausted or getting eyes strained can offer temporary double vision. If normal vision does not return soon, seek medical attention at the earliest possible opportunity.
To an eye doctor, diagnosing double vision may be difficult, as there are so many potential causes.
An article from the American Academy of Ophthalmology website states:
“The patient who complains of double vision can have something as benign as dry eye or as life-threatening as an intracranial tumor. The cause may be as rare as Wernicke encephalopathy or as common as convergence insufficiency.”
The specialist will begin by asking if the double vision is either monocular or binocular.
When the dual vision is monocular, this means the problem is more likely to be in the eye than in the nerves. This would certainly be less serious.
Diagnosis in children
Children cannot always express what they see, and this can make diagnosis difficult.
Physical signs of double vision include:
- squinting or narrowing the eyes to see
- covering one eye with their hand
- turning their head in an unusual way
- looking at objects from the side rather than facing forward
- flicking eyes side to side, between images
This will depend on the underlying cause.
Treatment for monocular double vision
Treatment will depend on the cause.
Astigmatism: An abnormally shaped cornea is referred to here. The curvature can also be counteracted by protective glasses or contact lenses and the passage of incoming light through the eye.
Other choice is Laser surgery. This procedure is for the cornea to be reshaped with a laser.
Cataracts: The safest treatment is usually surgery. The procedure removes the clouding and the double vision trigger. Complications include illness, pain, and likely persistent blurred or double vision, but these may usually be overcome by timely care.
Dry eye: When the eyes don’t get enough tears or dry out too quickly, they can get inflamed and sore. That can lead to double vision. Tear replacement eye drops are also used to alleviate symptoms.
Treatments for binocular double vision
Depending on the cause, the treatments for binocular vision vary, but they include:
- wearing glasses
- eye exercises
- wearing an opaque contact lens
- botulinum toxin (Botox) injections into the eye muscles, causing them to remain relaxed
- wearing an eye patch
- surgery on the muscles of the eye to correct their positioning
A stick-on prism, positioned at the center of the spectacle frame between the eyes, may also allow the images from each eye to realign.
Exercises are unable to treat many of the conditions which cause double vision. However, some exercises can help with the insufficiency of convergence.
- Focus on a detailed target, perhaps a thin stick or small text in a magazine.
- Hold this at eye-level, an arm’s length away from you.
- Aim for the image to remain as a single image for as long as possible.
- Move the target towards the nose in a slow, steady fashion.
- When the single image becomes two images, your eyes have stopped collaborating. Focus intensely on bringing these images back together. Once they join, bring the target closer to the nose.
- Once you become unable to rejoin the images, move your hand back to its original position and start the exercise again.
- The normal convergence range is 10 centimeters (cm) away from the nose. Aim to keep the image as a single image up to the 10cm mark.
- An orthoptist may provide a tool known as a Dot Card to assist these steps.
- Choose a similar target to that in the smooth convergence exercise.
- Start the target at a 20 cm distance from the nose.
- Fix your gaze on the target for between 5 and 6 seconds.
- Switch to looking at a fixed object around 3 meters (m) away for around 2 to 3 seconds.
- Switch your vision back at the nearer target.
- Repeat this, gradually moving the target closer, until you can focus on the object when it is 10 cm away without double vision.
The usefulness of these activities is largely limited to resolving the insufficiency of convergence.
When symptoms do not change, undergo further examination with a doctor.
Allergic conjunctivitis: What to know
When a person’s eyes come into touch with an allergen, a chemical that causes the body’s immune system to respond, allergic conjunctivitis develops.
The eye gets inflamed and painful. The overactive immune system causes the body to produce histamine and other active compounds through mast cells, resulting in symptoms. The nerve terminals are irritated when blood vessels dilate or expand. As a result, the amount of tears secreted increases.
Infectious conjunctivitis differs from allergic conjunctivitis. The causes are not the same.
When the immune system overreacts to a substance, an allergic response occurs. The majority of people do not react to dust, pollen, or other substances in this way, but other people are more sensitive.
Allergens that typically cause allergic conjunctivitis include:
- eye drops
- pollen, as in hay fever
- animal fur
- dust mites.
There are different types of allergic conjunctivitis.
1) Seasonal allergic conjunctivitis or allergic rhinoconjunctivitis
In regions with cold winters, pollen is the most prevalent allergen that causes conjunctivitis.
Other symptoms of pollen-induced conjunctivitis include sneezing, an itchy, clogged, or runny nose, and itchy, watery eyes.
Hay fever is also known as seasonal allergic conjunctivitis or allergic rhinoconjunctivitis.
It generally takes place in the spring and summer. Plants, particularly grass, trees, and flowers, are in pollen during this time. Some people get symptoms in the early autumn.
2) Contact conjunctivitis
Cosmetics, eyedrops, or other chemicals that irritate the conjunctiva in people who are vulnerable induce symptoms known as contact dermatoconjunctivitis. An allergic reaction occurs when these compounds come into contact with the body. Some people are hypersensitive to certain chemicals.
After the substance comes into contact with the eyes, symptoms generally appear 2 to 4 days later.
3) Papillary conjunctivitis (giant papillary conjunctivitis)
This is a common side effect of wearing contact lenses. Contact lenses can be uncomfortable for some people. This might grow worse and more unpleasant with time, causing the eyes to become red.
When a person wears hard contact lenses following eye surgery, giant papillary conjunctivitis (GPC) can develop.
Infections of the eye can be caused by poor hygiene when handling contact lenses, solutions, and cases.
4) Perennial conjunctivitis
Perennial conjunctivitis is a kind of conjunctivitis that lasts all year. It is mostly caused by an allergy to home dust mites. These tiny insect-like critters like to reside in bedding, upholstered furniture, and carpets.
Dust mites feed on human skin cells and like warm, damp people.
An allergic reaction to a particular dust mite protein is known as dust-mite allergy. Conjunctivitis, a clogged or runny nose, sneezing, and airway tightness, as seen in asthma, are all symptoms of this.
Animal dander, minute scales from animal skins or hair, and bird feathers are among the other causes. Some people may experience an allergic response to them.
The following suggestions may help:
- Cold compresses: The eyes can be soothed by placing a wad of cotton wool soaked in cold water on the eyelid.
- Avoiding the allergen: Staying indoors while the pollen count is high, keeping the house clean, and limiting soft furnishings can all help.
- Contact lenses should be avoided at all costs: These should not be used until all symptoms have vanished. After using any eye medicine, wait at least 24 hours before putting contact lenses back on.
- Artificial tears: These eye drops dilute the allergen and help remove it.
- Refraining from rubbing the eyes: Rubbing might aggravate the irritation. It’s tempting to touch inflamed eyes, so this might be challenging.
Antihistamines, mast cell stabilizers, and corticosteroids are used to treat the condition.
Antihistamines, taken orally or as eye drops, may provide quick relief from symptoms. Histamines are blocked by antihistamines. When the immune system responds to a foreign substance, histamines are produced.
Cetirizine, fexofenadine, and loratadine are oral antihistamines used to treat allergic conjunctivitis. Once a day is generally plenty. Alaway and Zaditor are antihistamine eye drops. The eye drops will aid with eye problems, but the oral dose will help with a runny nose and other symptoms as well.
Azelastine, emedastine, and ketotifen are the most regularly prescribed antihistamine eye drops. They’re used twice or three times a day on the eyes.
Some antihistamines might make you sleepy. People who are taking them for the first time should avoid driving or using heavy machinery until they know how they will react to the drug.
Mast cell stabilizers
Mast cell stabilizers take longer to operate than antihistamines, but their effects stay longer once they do.
Lodoxamide and nedocromil are the most often used mast cell stabilizers. They are available as eye drops.
Antihistamines and mast cell stabilizers are used by certain patients. Before the mast cell stabilizers start acting, the antihistamines give some relief from symptoms.
These are only used in extreme cases and are rarely prescribed. The adrenal cortex produces corticoid, a steroid hormone. Synthetic corticosteroids are a type of drug that can reduce swelling and suppress the immune system.
Corticosteroids are effective, but they should be taken with caution and only for a short period of time due to the risk of adverse effects.
The majority of people who suffer from allergic conjunctivitis have issues with both eyes.
Symptoms may occur rapidly after coming into touch with the allergen in the eyes. Symptoms may develop after 2 to 4 days in other circumstances, such as when eye drops cause a response.
The following are some of the signs and symptoms of allergic conjunctivitis:
- Eyelids swollen: When the conjunctiva becomes inflamed or if the person rubs their eyes a lot, the eyelids may puff up.
- Soreness: The inflammation may cause pain and tenderness throughout the affected area. Some people describe the pain as burning.
- Red or pink eyes: As the capillaries, or small blood vessels, in the conjunctiva widen, the eyes become irritated.
- Pain: One or both eyes may be affected. If a person has painful, red eyes, is light sensitive, or has vision problems, they should see a doctor right away.
- Itchiness: Itching may occur as the eyes become irritated. Rubbing can aggravate the itching.
Seasonal allergic conjunctivitis affects people at specific seasons of the year, generally from early spring to summer and occasionally into fall.
Perennial allergic conjunctivitis patients are vulnerable at any time of year. They could notice that their symptoms are more severe at some times of the day than at others.
Contact conjunctivitis can be identified by red, cracked, or dry eyelids. The symptoms of contact conjunctivitis and giant papillary conjunctivitis are not seasonal, and they can appear at any time of year.
A doctor will examine the patient and inquire about signs and symptoms such as sneezing and a runny nose to diagnose allergic conjunctivitis.
Other conditions with comparable symptoms may need to be ruled out as well.
Anyone experiencing the following symptoms should contact a doctor right once, since they might be signs of a more serious problem:
- vision problems
- very red eyes
- painful eyes
- sensitivity to light, or photophobia
Aside from allergic conjunctivitis, the following disorders can cause redness in the eyes:
- Keratitis: The cornea gets irritated and ulcerated on occasion. It can sometimes lead to corneal scarring, resulting in irreversible vision loss.
- Iritis: Iris inflammation is a condition in which the iris becomes inflamed. The iris may cling to the lens if left untreated, limiting critical fluid outflow from the pupil. It’s possible that irreparable eye damage will develop.
- Infective conjunctivitis: This is caused by bacteria or virus. It’s possible that it’s caused by the herpes virus, and it might signify a sexually transmitted infection (STI).
- Acute glaucoma: In the eye, pressure builds up. Symptoms might emerge quickly. Acute glaucoma, if left untreated, can result in irreversible visual loss.
The doctor will also look to see if the discomfort is caused by an item or substance, such as an eyelash.
If the patient’s symptoms are severe or worsening, the doctor may recommend them to an ophthalmologist, or eye specialist.
After recent eye surgery, anyone who gets papillary conjunctivitis will be sent to an ophthalmologist. To ensure that therapy is effective, the eye or eyes must be closely monitored.
Complications of allergic conjunctivitis, whether chronic or seasonal, are uncommon.
Allergic conjunctivitis can have a negative influence on a person’s quality of life, although it seldom has a long-term effect on health.
Dermatoconjunctivitis and large papillary conjunctivitis can also cause complications.
It’s possible that the cornea will get inflamed. Keratitis is a condition that causes ulcers to grow on the cornea. This raises the danger of scarring and the chance of vision loss for the rest of one’s life.
Keratitis symptoms include:
- blurred vision
- a feeling that there is something in the eye
- watery eyes
- intense pain in the eye
- sensitivity to light
If any of these symptoms appear, the person should seek medical attention.
Finding out what causes allergic rhinitis and avoiding the allergen is the best method to prevent it.
Pet fur and pollen are two common allergies.
If your pet is the source of your allergy, try the following:
- wash their bedding regularly
- brush them regularly and wash them every 2 weeks
- keep pets out of the bedroom
If you’re going to a residence with a pet, taking an antihistamine one hour ahead of time may help alleviate symptoms.
If pollen causes an allergic response, do the following:
- use wraparound sunglasses to protect your eyes
- bathe and change your clothes after being outside
- try to get someone else to cut the lawn for you
- stay inside and keep doors and windows closed when the pollen count is high
- avoid areas with a lot of grass, flowers, or trees
Pollen counts are greatest in the mid-morning and early-evening hours.
If you have an allergic reaction to home dust mites, you should:
- choose anti-allergenic matresses and bedding
- vacuum often, and dust with a clean, damp cloth
- avoid soft furnishings, such as carpets and drapes
- use a vacuum cleaner with a HEPA filter
What you need to know about blepharitis
Blepharitis is a condition that affects the upper and lower eyelids. Around the eyelashes, it can cause clumping and stickiness.
Inflammation near the base of the eyelashes causes it. There are a variety of therapies available, including home remedies, that can help to alleviate symptoms.
We’ll go over what causes blepharitis, how to remedy it, and how to avoid it in this post.
Blepharitis can affect people of all ages and can be acute or chronic in nature; chronic adult blepharitis is the most frequent kind. Blepharitis is a term that refers to a persistent inflammation of the eyelids.
The symptoms of blepharitis are depicted in the images below.
Blepharitis can be caused by a variety of causes.
They are as follows:
- parasites: Demodex eyelash mites
- infection with the herpes simplex virus (HSV)
- an inflammatory reaction to bacteria that normally live on eyelids
- seborrhoeic dermatitis or rosacea
Blepharitis is more common in people who have dandruff. Controlling the dandruff might assist to ease the symptoms.
Dysfunction of the Meibomian glands on the rim of the eyelids is another probable reason. These glands secrete an oily material that keeps the tear film from evaporating in the eye.
Some clinicians feel that blepharitis is a prelude to Meibomian gland malfunction rather than blepharitis being caused by gland dysfunction.
Blepharitis can be anterior or posterior.
Anterior: This affects the eyelid’s front edge, where the eyelashes contact it.
Posterior: This affects the inner edge of the eyelid, where it meets the eyeball.
The following are the key signs and symptoms:
- burning or stinging eyes.
- oversensitivity to light (photophobia).
- gritty feeling in eyes and the sensation of having something in the eye.
- itchy eyelids.
- red eyes.
- irritated and watery eyes.
- flaking and crusting at the base of the eyelashes, similar to dandruff.
Symptoms are usually more noticeable in the mornings.
Although blepharitis is not a sight-threatening condition, it can cause temporary vision loss.
Chronic blepharitis symptoms come and go, with periods of remission (a break in the symptoms) followed by exacerbations (a flare-up). It frequently affects both eyes at the same time.
Blepharitis is usually treated with a combination of medical and home remedies.
A doctor will likely prescribe home therapy, such as the ones listed below, but they can also do the following process:
Electrochemical lid margin debridement (BlephEx): This clears the eyelids of any mites, bacteria, and the biofilm that they produce. Any congested Meibomian glands are also opened.
Thermal pulsation treatment (Lipiflow): This dissolves any clogging debris in the Meibomian glands.
Intense pulse light therapy (IPL): This helps to unclog congested eyelid glands.
Severe instances of blepharitis may necessitate the use of antibiotics, either topical or oral.
In order to treat both forms of blepharitis, it’s important to keep your eyelids clean. Even if your symptoms have improved, you should keep doing it.
The most important aspect of therapy is self-care. Blepharitis symptoms might reappear if self-care is not maintained.
Although blepharitis cannot be cured, it can be effectively managed with medication.
People with eyelid inflammation should avoid wearing cosmetics around their eyes, such as eyeliner, mascara, and other eye makeup, in addition to home therapy.
Blepharitis treatment entails:
- massage, to express the small oil glands of the eyelids
- lid cleansing, to remove crusts
- warm compresses, to loosen crusts
What is the best way to apply a warm compress?
Placing a warm compress over closed eyelids, warming the compress with warm water when it cools, and reapplying for up to 10 minutes is all it takes to use a warm compress.
The following are some suggestions:
- Using a soft cloth only: Scrubbing too vigorously or using a rough cloth can damage the skin and eyes.
- Dipping the cloth in warm water: Some patients have suffered facial burns by using a microwave to heat up the wet cloth.
Cleanse the eyelids after using a warm compress for up to 10 minutes.
Warming eye masks: These may have the same effect as warm cloth compresses while being more convenient. There are additional eyelid cleansers (Ocusoft, Thera Tears Sterilid) that can be used instead of dilute baby shampoo.
How do you clean your eyelids?
To do so, use a cotton swab soaked in a mild solution of baby shampoo to gently rub the eyelid margin—at the base of the eyelashes and where the glands are located. In roughly half a cup of warm water, drop 2 to 3 drops.
This lid hygiene must be done twice a day, every day as a self-care routine. This is a significant lifelong commitment, but without it, the symptoms will return.
How do you massage your eyes?
Massaging helps express the oily contents of the glands after applying the heated compress to release the sebum.
Massage the eyelid margin, where the eyelashes and glands are, with a finger or a cotton-tipped applicator or swab in tiny circular strokes.
These non-prescription eye drops will assist to alleviate the dryness of the eyes caused by blepharitis during the day. Artificial tears that are free of preservatives are the finest to use.
Artificial tears may be purchased over the counter, but you should first consult your doctor to ensure that they are appropriate.
Symptoms will be discussed, a medical history will be taken, and the patient’s eyelids and eyes will be examined.
The doctor will search for indicators that will help them figure out which sort of blepharitis you have. A slit lamp may be used.
This is a low-power microscope with an intense thin-beam light source that has been particularly constructed.
The doctor may examine the exterior of the eyes and the eyelids with the lamp while the patient’s head is held still by the chin and forehead resting on supports.
The doctor will next provide a therapy recommendation. This may or may not be the case, depending on the cause. A acceptable alternative will be picked if blepharitis looks to be caused by a skin condition, such as rosacea, or if it is caused by mites.
A novel laser treatment for macular degeneration may be effective
A novel form of laser treatment has the potential to reduce the course of age-related macular degeneration (AMD), a leading cause of visual loss, without causing retinal damage.
This was the finding of a research published in The FASEB Journal by the University of Melbourne in Australia.
The effectiveness of a new low-impact, low-energy laser therapy for individuals with early age-related macular degeneration (AMD) was investigated by Erica Fletcher, an associate professor at Melbourne’s Department of Anatomy and Neuroscience, and colleagues.
They discovered that, unlike previous laser therapies, the “nanosecond laser” they examined did not harm the retina, which is the light-detecting tissue at the back of the eye.
Prof. Fletcher claims that theirs is the first study to show how the novel laser treatment can help people with AMD improve their eye health.
AMD is a painless eye condition that causes central vision loss over time. It is the main cause of irreversible impairment of fine or close-up vision – such as that required for reading – among people aged 65 and older, according to the Centers for Disease Control and Prevention (CDC) (resource no longer accessible at www.cdc.gov).
According to estimates, roughly 1.8 million Americans aged 40 and over have AMD, with another 7.3 million at risk.
AMD is responsible for 48 percent of severe vision loss in Australia, where the study took conducted, with an estimated 17,700 new cases per year.
New laser treatment reduced drusen and thickness of Bruch’s membrane
In the early stages of AMD, examination of the back of the eye reveals the development of microscopic fatty deposits known as drusen, as well as a thickening of a thin layer of tissue known as Bruch’s membrane. As these symptoms increase, the core section of the retina is slowly destroyed.
According to the findings, the nanosecond laser can diminish drusen and thin the Bruch’s membrane without causing damage to the retina’s structure.
The researchers conducted a number of tests and experiments as part of the study. One study included 50 AMD patients who had a single session of nanosecond laser therapy and were followed up on two years later. Their drusen burden was lowered in comparison to a similar group of untreated individuals, according to eye tests.
The membrane was thinner three months after treatment in mice with thicker Bruch’s membrane who underwent the laser therapy.
New laser treatment did not damage the retina
The researchers used human and animal eyes to assess the new laser’s effect on the retina, for example, using a procedure called “immunohistochemistry,” which can detect minute changes in tissue structure.
The researchers state this about their research:
“Nanosecond laser resolved drusen independent of retinal damage and improved BM [Bruch’s membrane] structure, suggesting this treatment has the potential to reduce AMD progression.”
The findings “indicate that treating people with AMD with our new nanosecond laser lowers indications of the disease,” according to Prof. Fletcher.
“Most importantly,” she continues, “the nanosecond laser does not cause harm to the delicate retina, unlike other lasers now used to treat eye disease.”
The researchers also discovered evidence that using the nanosecond laser to treat one eye can have beneficial benefits on the other eye, raising the prospect that one therapy could be enough to correct disease in both eyes.
Glaucoma, in which fluid builds up in the eye and puts pressure on the optic nerve, is another main cause of blindness. The condition is treatable, but there is no treatment at this time.