Diplopia

Key Takeaways

  • Double vision can make it difficult to do everyday tasks and undermine a child’s learning.
  • There are dozens of causes for double vision, including serious medical conditions, so you should see your doctor right away for a diagnosis.
  • Most of the time double vision can be corrected with eye glasses, prisms or other non-surgical therapies.

Overview

Many of us take for granted that we see a single image with our two eyes, a feat known as binocular vision. Sometimes clear binocular vision can be disrupted by an illness, muscular imbalance, or some other medical condition that causes us to see two images of the world, rather than one.

Double vision is not only frustrating and disorienting, it can make it difficult to read, balance, move and perform daily tasks. Also known as diplopia, double vision can result from a number of underlying causes, and therefore treatment can take a variety of forms.

Double vision Long Island

In cases of children, it is not always easy to diagnose double vision. This is especially true if your child isn’t old enough to communicate clearly. Parents who notice their child acting differently and suspect it is due to double vision should reach out to a respected pediatric eye doctor right away.

Helping our kids see the world in vivid detail makes them more comfortable and supports their academic and social development, which can be undermined by poor vision. What’s more, potentially serious underlying medical conditions that might be causing double vision should be addressed promptly to avoid lifelong vision or health problems.

Seeing Double: The Basics

Diplopia can strike one eye (monocular) or both eyes (binocular). Images may appear one over another, side by side, or as a combination of overlapping images.

When we see the world as we should – as a single coherent image – it is thanks to each eye creating its own image of the environment and sending these representations to the brain. The brain then morphs the two images into one clear picture we can understand.

Oftentimes children see double because each eye sends a different image to the brain and the brain cannot reconcile the conflicting images. This may be due to misaligned eyes, also known as strabismus.

The misaligned eyes can turn up, down, right or left. Regardless of the exact positioning, the eyes will have different points of focus and will send different images to the brain. This can create double vision.

Types of strabismus

Causes of Double Vision

Your child may be seeing double due to an ocular irregularity, or another health problem. Eye conditions that can trigger double vision include:

  • Strabismus: misaligned or crossed eyes send two conflicting images to the brain. As a result, the patient will see double, or the brain will ignore the image from the weaker eye, potentially causing lazy eye (amblyopia).
  • Convergence insufficiency: like strabismus, this is a condition where the eyes do not work together properly. This is usually due to the extraocular muscles lining up incorrectly.
  • Astigmatism: when the cornea is misshapen, the light bends more or less than it should as it comes through the eye (refractive error), making vision blurry or doubled.
  • Dry eye: this condition affects most of us at one time or another, making our eyes feel grainy and uncomfortable. It can lead to vision problems too, including inducing temporary double vision.
  • Keratoconus: is a degenerative eye condition whereby the cornea elongates into the shape of a cone, rather than having a sloping, rounded curvature.
  • Retina abnormality: among problems plaguing the light-sensitive portion of our eyes, macular degeneration is a serious, but rare one. In such cases, the central vision slowly disappears.
  • Lens abnormality: problems with the lens, such as cataracts, can cause the light to scatter in different directions in the eye, creating multiple images.

Other health problems that can cause your child to see double include:

  • Grave’s disease: this autoimmune disease affects thyroid gland function, which can cause visual irregularities like double vision.
  • Multiple sclerosis: this disease of the central nervous system can create a myriad of nerve-related symptoms, including along the optic nerves that control sight.
  • Myasthenia gravis: this is a chronic autoimmune neuromuscular disease that weakens the body’s voluntary muscles. It can undermine extraocular muscles that control the eyes.
  • Tumor: in rare cases, double vision can be due to a tumor that has grown large enough behind the eye to inhibit eye movement or harm the optic nerves.
  • Head trauma: an injury severe enough to damage the eye, muscles, nerves or brain can restrict eye movement, or the ability of the brain to processes images sent to it by the eyes.

Diagnosing Diplopia

With such a wide range of possible causes for double vision, zeroing in on the one affecting your child can be challenging. In most cases, patients will have something harmless, like dry eye, or a condition that is common and easily treatable, such as convergence insufficiency.

Eye doctors have to perform a thorough exam to rule out those unusual conditions that pose serious threat to sight and overall health – like an intracranial tumor. For this reason, an examination for double vision may take a little longer than you might anticipate.

Further complicating a diagnosis is that children may not be able to say what they are visually perceiving. Parents and doctors have to be vigilant for behavioral signs of double vision in kids.

Top 5 Signs: Does Your Child Have Vision Problems?

  • Viewing people or objects from the side, rather than facing their object of focus straight on
  • Turning their head to see things
  • Squinting
  • Covering an eye frequently or when trying to view an object
  • Flicking their eyes side to side when trying to focus on something

Warning signs that your child has a vision problem

Treating Double Vision

Treatment for double vision will entirely depend on its underlying cause. Some methods used to combat double vision are:

  • Wearing glasses
  • Wearing an opaque contact lens
  • Affixing prisms to glasses
  • Wearing an eye patch
  • Applying eye drops
  • Having surgery to realign eyes
  • Having surgery to correct retinal abnormalities
  • Having surgery to overcome lens abnormalities

More likely than not, your child can rely on non-surgical therapies to correct double vision. Surgical procedures are used to treat uncommon diseases like pediatric cataracts, or conditions that occur with greater frequency, like lazy eye, but when in advanced stages.

Simple, non-invasive therapies, like wearing eye glasses or a patch are typically enough to help your child see normally again.

Corrective Prisms

Corrective prisms worn in lenses are particularly efficient in encouraging the eyes to work in tandem and overcome diplopia.

Two triangular-shaped prisms will be attached to each lens, lined up in one of two ways. When the prisms meet base to base, it is called “plus.” When the prisms meet apex to apex, they are called “minus.” Regardless of their exact alignment, the prisms essentially work together to bend light to align multiple images into one.

In addition to being very effective, corrective prisms are extremely thin to the point that they are usually undetectable on the eyewear. This gives them good compliance rates, even among our tiny strong-willed patients.

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