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Double Vision

Double vision doesn't have to part of your daily life.

When people see “Two for One” deals they are generally pretty excited or if you remember the 90's tv commercial for Double Mint Gum, “double your please, double your fun..” you remember the rest! However, double is not always better regardless of that catchy jingle. Diplopia, or double vision, can present in different ways, have varying etiologies, and can be associated with systemic manifestations that can be life-threatening. Double vision can occur with both eyes open but in some cases can occur with only one eye open, this is called polyplopia. Double vision can be intermittent, constant, distinct, or appear more like blurred vision. To be

Get your diplopia treated at Advanced Vision Therapy Center Boise Idaho

Eye-care providers who enjoy working with double vision are doctors who have done extensive training following their doctorate work. If someone has a complaint of double vision they should see a provider with residency training in binocular vision, neuro-optometry, or neuro-ophthalmology. It is important to work with someone with this specialized training to ensure the proper testing is done to determine not only etiology but also determine the best course of treatment.

What are some causes of double vision?

  1. Strabismus: A strabimus is an ocular deviation where the eyes don't focus on the same point. The eye can turn in-ward (esotropia – visit our blog on esotropia), outward (exotropia – visit our blog on exotropia), upward (hypertropia – visit our blog on hypertropia), and downward (hypotropia). So basically a strabismus can go in any direction, just like the Wonka-vator. Now a strabismus can occur intermittently and be a micro-strabismus, which means not cosmetically noticeable. A strabismus can be congenital, secondary to a systemic event such as an aneurysm, secondary to a traumatic event, secondary to an uncorrected refractive error, etc.

  1. Convergence Insufficiency: A convergence insufficiency is a decreased ability for the eyes to turn in-ward together as a team and keep a near object single and in-focus. To look at a near target the eyes must converge together and sustain this inward posture. If the eyes are unable to hold this posture or even converge to the appropriate distance the patient's vision will fluctuate and even double at near. Some symptoms that will accompany can be headaches, eyestrain, and blurred vision. This double vision presents horizontally.

  2. Ocular Surface Disease/Corneal Irregularity: Corneal surface disease or corneal irregularity can cause a monocular diplopia (double vision with one eye). This can occur because when light enters our eye the first layer that the light hits is the tear film and then the cornea, if this surface is not smooth the light will refract in different directions. This refraction can cause distorted images and doubling.

  3. Cataracts: Just like corneal irregularities, cataracts can cause diplopia because of an improper refraction of light secondary to the opacity. This double vision can also be monocular. In certain circumstances if a patient has had cataract surgery and is utilizing a multi-focal intra-ocular lens implant they may have diplopia depending on the lens design and the patient's pupil size.

Are there certain systemic conditions where diplopia is more common?

  1. Diabetes: Diabetes can have some serious implications throughout the body as well as the eyes (visit our blog on diabetes). Poorly controlled diabetes can cause a third cranial nerve palsy. This is where the eye turns outward and the lid can droop. The third-nerve innervates some muscles responsible for eye movement as well as the upper eye lid.

  2. Myasthenia Gravis: Myasthenia gravis is a chronic autoimmune neuromuscular disease. These patients have muscle weakness that can fluctuate. These patients may see double intermittently as well as have droopy eyelids (ptosis) intermittently.

  3. Traumatic Brain Injury: Traumatic brain injuries can cause diplopia because they can induce a convergence insufficiency and/or a cranial nerve palsy.

  4. Neuro-degenerative Conditions: Similar to a myasthenia gravis neurodegenerative conditions can have intermittent blurred vision and diplopia secondary to fluctuations in muscle responsiveness.

As mentioned before there are a lot of treatment options for diplopia. Regardless of the cause of diplopia a thorough examination is indicated with a residency trained neuro-optometrist or neuro-ophthalmologist to determine the cause and best treatment options. Two is not always better than one!

Have your double vision treated with prism at Advanced Vision Therapy Center Boise Idaho

Posted by Advanced Vision Therapy Center at 11/23/2016 12:26:00 AM
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Improvement Starts Here

With over 25 years of proven success, you can trust Advanced Vision Therapy Center to provide the care you need.

Our Clinical Director is Idaho's only residency trained optometrist in vision therapy and neuro-optometry and is a Fellow of the American Academy of Optometry.  His residency at University of California, Berkeley means he has the expertise and experience to treat even the most complex cases.

Read what our patients have to say.

  Vision therapy can be a bit unfamiliar to some people. We are going to begin this blog by discussing briefly when vision therapy is used. Many visual conditions can be effectively treated and managed with prescription glasses or contact lenses. However, for other visual conditions (convergence insufficiency, binocular vision dysfunction, etc) prescription glasses or contact lenses cannot correct the vision problem. It is in these cases that vision therapy may be prescribed.   ... Read More
  Many people are unaware of the differences between an optometrist, a neuro-optometrist, and a behavioral or developmental optometrist. Sure, they sound alike but the services they provide are quite different. And if you, or someone you know, has a vision problem that cannot be corrected with glasses or contact lenses this blog is for you.   ... Read More
  At Advanced Vision Therapy Center our results speak for themselves. Jonah, however, wanted to share his story with you. We invite you to watch this short video to learn more about Jonah's experience and success.   ... Read More
  It's a dangerous world we live in today! With October upon us, people are thinking about spooky, creepy crawly things, and of course things that go bump in the night. Most ghoul hunters know that to protect themselves from the evil lurking in the shadows this time of year, they need the necessities such as garlic, silver bullets, a know, for protection.     ... Read More
  Traumatic Brain Injury (TBI) is a term used within the medical community to describe an injury to the brain which is not hereditary, congenital or degenerative. Traumatic Brain Injury can be result from a blow to the head, whiplash, seizure disorders, tumors, stroke, toxic exposure, or infectious diseases to name a few. The incidence of prevalence of brain injury outnumbers breast cancer, spinal cord injury, multiple sclerosis and HIV/AIDs combined.   ... Read More
  Many people have heard of vision therapy, but don't know a lot about it. As with any type of therapy, the effectiveness of the program is dependent upon several factors. It is advisable to ask questions and do your homework. Vision therapy programs vary greatly from provider to provider.   ... Read More
  Everyday in our schools students are presented with information that they are required to look at, interpret, and process that information. For years it was believed that the eyes had nothing to do with learning. That is definitely not the case. Did you know it is estimated that 80% of what we learn is through visual information?     ... Read More
  Convergence Insufficiency (CI) is a common eye-teaming problem which occurs when the eyes are unable to maintain the ocular posture necessary for reading or near tasks. Convergence Insufficiency results from misalignment of the eyes when focusing on up close, such as when reading. The eyes have a strong tendency to drift outward when reading or doing close up work. The exact cause is unknown.    ... Read More
  After this abnormally tedious Boise winter, we are all ready to get outside and play in the sun! Hold on though, before you rush outside, have you taken the necessary precautions to protect yourself for ultraviolet rays? There are three types of ultraviolet rays, these wavelengths are not visible to the human eye and are shorter than violet wavelengths of light.    ... Read More
  Whether you are playing sports as a hobby or competitively there is a lot to consider. Are you using proper form? Is your equipment up to date? Are you warmed up? Are you wearing the appropriate safety gear? Is your opponent looking bigger and stronger than last time? Seriously, did he grow six inches? Whatever your thought process or preparation is you may be missing a key step. Are you wearing your protective eye-wear?   ... Read More
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7960 W. Rifleman Street, #155
Boise , Idaho , 83704 USA
Phone:  208-377-1310
Fax:  208-321-1952