It may be your eyes:
What Causes Double Vision That Comes and Goes?

What Causes Double Vision That Comes and Goes?

Double vision, medically known as diplopia, can be a concerning visual symptom that affects one's ability to see clearly. When it occurs intermittently, it can be particularly puzzling. Understanding the types, causes, and treatments of double vision that comes and goes is crucial for effective management.  Here's our comprehensive guide.

Types of Double Vision

asian businessman tired and hand on face in commu utc   Double vision, also known as diplopia, can present in different ways depending on the underlying cause and how it affects the eyes. Understanding the types of double vision is crucial for identifying and addressing the root issues effectively.

Monocular Double Vision

This type of double vision occurs when the problem originates within one eye. It can be caused by conditions such as astigmatism, where the cornea or lens of the eye is irregularly shaped, leading to distorted vision. Cataracts, which cause clouding of the eye's lens, can also result in monocular double vision. Other causes may include corneal abnormalities, such as scarring or irregularities, and certain retinal disorders that affect the way light is processed by the eye.

Binocular Double Vision

Binocular double vision involves both eyes and is often more complex. It occurs when the eyes are not properly aligned or when there are issues with the coordination of the eye muscles. This misalignment can be horizontal, vertical, or diagonal. Conditions such as strabismus, where one eye turns inward, outward, upward, or downward relative to the other eye, can result in binocular double vision. Neurological disorders affecting the nerves that control eye movements, such as cranial nerve palsies or disorders like multiple sclerosis, can also cause binocular double vision. Additionally, trauma to the eye muscles or the structures surrounding the eyes can disrupt their proper functioning, leading to diplopia.

Double Vision Causes

Diagnosing double vision can be challenging since the causes of double vision can vary. If you are seeing a double image, check through the disorders and situations below to gain some insight.

Neurological Causes

  1. Binocular Vision Dysfunction (BVD): BVD Is the umbrella term for all eye movement disorders that result in the two eyes not working together in a smooth and coordinated fashion causing visual symptoms and difficulties.
  2. Strabismus: Misalignment of the eyes due to weak or imbalanced eye muscles. The eye may look in slightly different directions.
  3. Multiple Sclerosis (MS): Neurological conditions like MS affect the central nervous system and can affect the nerves that control eye movement.
  4. Brain Tumor: Pressure on the nerves or brain structures involved in vision can lead to double vision.
  5. Stroke: Damage to the brain regions responsible for eye movement coordination.
  6. Myasthenia Gravis: A neuromuscular disorder causing muscle weakness, including those controlling eye movements.
  7. Concussion: Head injuries, such as concussions, can damage the brain or nerves related to eye movement control, resulting in permanent or temporary double vision.
  8. Aneurysm: An aneurysm, particularly if it affects blood vessels supplying the brain or optic nerve, affects eye muscles.

Eye and Systemic Causes

  1. Cataracts: Double vision caused by cataracts results in blurry vision and double vision, especially in one eye.
  2. Keratoconus: This progressive eye condition causes the cornea to thin and bulge outward, leading to distorted vision and potential double vision.
  3. Diabetes: Uncontrolled diabetes can damage blood vessels and nerves in the eyes, affecting vision and potentially causing double vision.
  4. Hyperthyroidism: Thyroid disorders, particularly hyperthyroidism, can impact eye muscles and their coordination, resulting in double vision.
  5. Cranial Nerve Palsy: Damage or dysfunction of cranial nerves responsible for eye movements can lead to double vision, such as in the case of sixth nerve palsy.
  6. Pterygium: An abnormal growth on the surface of the eye, such as a pterygium, can result in blurred vision and cause double vision in severe cases.
From binocular diplopia to monocular diplopia and from a stroke to a head injury—there are plenty of reasons you could be experiencing double vision. Treatment and management strategies will vary depending on the specific cause, emphasizing the need for professional and eye specialist diagnosis.

What is Binocular Vision Dysfunction?

Binocular vision dysfunction (BVD) is a condition that affects the ability of both eyes to work together effectively. In normal binocular vision, the brain merges the images received from each eye into a single, clear, and three-dimensional perception of the world. However, in individuals with binocular vision dysfunction, there is a disruption in this coordination, leading to some visual symptoms and challenges.

Symptoms of Binocular Vision Dysfunction

  1. Double Vision: One of the hallmark symptoms of BVD is double vision, where two images of the same object are perceived. This can occur horizontally, vertically, or diagonally, depending on the nature of the eye misalignment.
  2. Eye Strain and Fatigue: Individuals with BVD often experience eye strain, discomfort, and fatigue, particularly after prolonged visual tasks such as reading or using digital screens.
  3. Headaches: Persistent headaches, especially around the eyes or forehead, can be a common symptom of BVD. These headaches may worsen with visually demanding activities.
  4. Difficulty with Depth Perception: BVD can affect depth perception, making it challenging to judge distances accurately, especially in tasks like driving or sports activities.
  5. Sensitivity to Light: Some individuals with BVD may also experience increased sensitivity to light (photophobia) or glare, leading to discomfort in bright environments.

Causes of Binocular Vision Dysfunction

Binocular vision dysfunction can arise from various underlying causes, including:

Eye Muscle Imbalance

Weakness or imbalance in the muscles that control eye movements can lead to misalignment of the eyes, resulting in BVD.

Refractive Errors

Uncorrected refractive errors such as astigmatism, myopia (nearsightedness), or hyperopia (farsightedness) can contribute to binocular vision problems.

Neurological Conditions

Certain neurological conditions affecting the brain's ability to process visual information or control eye movements can lead to BVD. Examples include stroke, traumatic brain injury (TBI), or conditions like multiple sclerosis (MS).

Eye Disorders

Conditions affecting the structure or function of the eyes, such as cataracts, glaucoma, or retinal disorders, can impact binocular vision.

Diagnosis and Treatment

Diagnosing binocular vision dysfunction typically involves a comprehensive eye examination by an optometrist or ophthalmologist. This may include tests to assess eye alignment, eye movements, depth perception, and visual acuity. Treatment for BVD depends on the underlying cause and severity of the condition. It may include:
  • Prescription Glasses or Contact Lenses: Corrective lenses, such as prismatic lenses, may be prescribed to help align images properly for individuals with eye muscle imbalances or refractive errors.
  • Surgery: In some cases of severe eye misalignment or structural issues, surgical intervention may be recommended to correct the underlying problem.
Managing binocular vision dysfunction requires personalized care and may involve a multidisciplinary approach. Early diagnosis and intervention can significantly improve visual comfort, clarity, and quality of life for individuals with BVD.

Frequently Asked Questions

How do you know if you have neurological double vision?

Neurological double vision often presents with other neurological symptoms like weakness, numbness, or changes in coordination. A comprehensive eye exam by a specialist can help diagnose the underlying cause.

How can I fix double vision naturally?

While certain lifestyle changes like managing stress, getting adequate rest, and practicing good eye hygiene can support eye health, addressing the root cause of double vision typically requires professional evaluation and treatment.

Can stress and anxiety cause double vision?

Stress and anxiety can contribute to eye strain and fatigue, which may lead to temporary vision disturbances. However, persistent or recurring double vision should always be evaluated by an eye care specialist to rule out underlying medical conditions. Reach out to Vision Specialists of Michigan today for needed treatment and support.

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  • American Academy Optometry
  • American Optometric Association
  • Michigan Optometric Association
  • VEDA
  • Neuro Optometry Rehabilitation Association