Double vision is a troubling visual issue. It can be caused by a variety of neurological and physiological problems, particularly those affecting your eye muscles. For some, double vision may be caused by a difficult-to-identify condition called Binocular Vision Dysfunction (BVD).
In this article, NeuroVisual Medicine lays out what causes sudden, temporary double vision and how BVD may be a significant contributing factor.
What Is Double Vision (Diplopia)?
Types of Double Vision
Causes of Double Vision
Binocular Vision Dysfunction & Double Vision
Testing & Diagnosis for BVD
Double Vision & BVD FAQs
Double vision, clinically called diplopia, is a condition in which a person sees two distinct images of the same object. In most cases, one image appears blurrier or dimmer than the other, sometimes with such a slight difference that you may have double vision you don’t notice.
Visual specialists often identify different types of double vision based on where the second image appears relative to the first. It may shift horizontally, vertically, or diagonally.
They will also want to check whether double vision occurs in one eye (monocular diplopia) or in both eyes at the same time (binocular diplopia).
It’s also important to note how people experience double vision differently. Sometimes the onset is quick, which we identify as sudden double vision. Other times, it comes and goes unexpectedly, which is known as intermittent double vision.
Knowing these differences may help alleviate your anxiety with double vision. It also helps both you and your doctor determine the root cause of your visual issues and how to treat them.
Double vision often varies from one person to another. One way is that you may begin to experience double vision suddenly or temporarily. Below, we provide more details on their differences:
This type of diplopia appears within several minutes, often unexpectedly. Sudden double vision frequently results from less severe causes, including:
However, experiencing sudden double vision and dizziness, severe migraines, weakness, difficulty speaking, and loss of coordination are signs of a serious medical emergency. In those cases, it is vital to contact a doctor or go to an emergency room immediately.
This kind of diplopia often involves an irregular pattern, with double vision occurring on and off over the course of weeks or months. You may think this type isn’t as serious because it goes away on its own. However, the critical factor is that it keeps coming back, which may be a sign of other serious conditions.
Inconsistent, recurrent episodes of double vision can be caused by nervous system issues that flare up and resolve. They could also be due to chronic medical conditions associated with muscle fatigue.
In either case, consistently experiencing double vision means you should see a doctor for an immediate evaluation of your vision and overall health.
For those who aren’t certain if they have a clear case of diplopia, check out our online diplopia screening blog. For those who continue to experience diplopia symptoms despite receiving treatment, you may have double vision due to undiagnosed binocular vision dysfunction (BVD).
Find out if you have double vision due to BVD?
The conditions that cause double vision can also differ depending on whether they occur in one or both eyes.
When diplopia occurs in only one eye, it is known as monocular double vision. This form often results from structural issues in the eye itself. That is why monocular double vision often occurs alongside conditions such as astigmatism (when the cornea is more oval than round) or cataracts (clouding of the eye).
When double vision occurs in both eyes, it is called binocular double vision. You will see two images as long as both eyes are open, but the condition disappears when you shut one eye. Binocular double vision can be a sign of a more serious underlying condition in your nerves or muscles.
Clinicians may also determine the cause of a patient’s double vision by noting which direction the second image in their eye moves.
This is when the two images appear side by side. Horizontal diplopia often signals an issue with muscles that control inward and outward eye movement. It may also be an underlying symptom of multiple sclerosis (MS), stroke, or trauma.
Vertical double vision (vertical diplopia) occurs when one image appears to be sitting above the other. This may also result from stroke, multiple sclerosis (MS), and nerve and eye muscle issues due to trauma. Eye misalignment is another common cause, where one eye sits a little higher than the other. Many respond by tilting their heads to compensate for their vertical vision challenges.
Oblique diplopia is a combination of vertical and horizontal diplopia, where the second image appears diagonally above and away from the first. Because this condition is a combination of the two other types of double vision, the cause often involves a complex diagnosis.
If you’re struggling to get answers about what’s causing your double vision, an eye doctor from NeuroVisual Medicine’s network of BVD specialists may be able to help.
Discover whether your double vision is BVD-related.
Take this quick, free assessment and find out if your condition may be due to undiagnosed BVD. Let us help you find relief.
Double vision can be caused by many different physical and neurological symptoms. Here are some of the different conditions that can result in you experiencing diplopia:
Persistent double vision without other neurological symptoms or serious conditions may mean you have BVD, which can be hard to diagnose. Consider taking our free assessment to find out whether BVD may be partially or fully responsible for your visual disturbances and headaches.
BVD is the umbrella term for all forms of image misalignment. Large misalignments are called strabismus, where one eye drifts toward or away from the other almost entirely. On the other hand, phorias are very small, trace amounts of misalignments that are often very hard to detect.
Even individuals with BVD may have a tough time noticing the tiny difference in eye-to-eye position because their bodies naturally overcompensate to correct it
However, constantly correcting your vision, particularly during periods of deep focus, forces the eye muscles to strain and work overtime.
This causes double vision when you relax or switch to a different task. As a result, BVD is also often the reason for intermittent double vision. And since BVD is hard enough to diagnose as is, individuals are even less likely to find the right treatment for their symptoms.
The root cause of BVD, especially when it’s connected to your double vision symptoms, can be hard to diagnose. That is because it can be mistaken for (and even caused by) a wide range of conditions.
Two key causes of BVD, also known for triggering diplopia, are traumatic brain injuries and multiple sclerosis. Both involve damage to key nerve pathways, which can lead to eye misalignment and double vision.
In addition, there are more major causes of BVD that may be associated with diplopia:
Wondering if you have double vision due to BVD?
Take our BVD assessment and see if your symptoms are caused by eye misalignments.
While numerous eye doctors can diagnose a wide range of conditions through standard visual examinations, many aren’t equipped or experienced in diagnosing BVD.
On the other hand, BVD specialists trained by and affiliated with NeuroVisual Medicine can test and diagnose patients with Binocular Vision Dysfunction.
After a quick, initial assessment, you’ll schedule an appointment with a NeuroVisual Medicine-associated optometrist. Then, you’ll receive a NeuroVisual Medicine eye examination. This involves evaluating eye alignment, eye movements, depth perception, and visual clarity.
Based on the results of these exams, our specialists will provide an accurate diagnosis with an assessment of BVD symptoms and treatment.
BVD treatment plans may differ based on the underlying cause of your condition, as well as its severity. Generally, NeuroVisual Medicine’s BVD specialists will evaluate each patient’s needs, ensuring they receive treatment suited to their particular visual conditions.
Most often, this includes custom microprism lenses, which are suited specifically for individuals with BVD. These help align images properly while compensating for eye misalignments and refractive errors, reducing eye strain almost immediately.
Double vision can have many causes. Monocular double vision, double vision that remains when one eye is covered, is often related to an optical problem such as astigmatism, dry eye, corneal irregularity, or cataract.
Binocular double vision disappears when either eye is covered and occurs when the eyes are not working together in proper alignment.
Causes can include strabismus, cranial nerve problems, stroke, convergence disorders, decompensated phorias, neurological conditions, and Binocular Vision Dysfunction (BVD).
Determining the cause begins by identifying whether the double vision is coming from one eye or results from the way the two eyes are working together.
A comprehensive evaluation assesses your vision, eye movements, eye alignment, focusing ability, and how your eyes coordinate at different distances and positions of gaze.
When Binocular Vision Dysfunction (BVD) is suspected, a specialized NeuroVisual evaluation looks for small amounts of eye misalignment that may be difficult to detect during a routine eye examination.
Your symptoms, measurements of binocular alignment, and response to trial microprism are considered together to determine whether BVD is contributing to your double vision.
Whether double vision is constant or intermittent does not by itself determine how urgent the problem is. Sudden or newly developing double vision is more concerning, whether it is constant or comes and goes.
New double vision can occasionally be associated with neurological, vascular, muscular, or other medical emergencies and should be evaluated promptly.
Sudden double vision should be taken seriously, particularly when it is new and unexplained. Because it can sometimes be caused by a neurological or vascular problem, including a cranial nerve disorder or stroke, sudden double vision should be evaluated promptly by a medical professional.
If it occurs along with symptoms such as severe headache, weakness or numbness, difficulty speaking, facial drooping, difficulty walking, confusion, or other sudden neurological symptoms, emergency medical evaluation is appropriate.
Once urgent medical causes have been excluded, persistent or intermittent double vision may require further evaluation for eye alignment problems, including Binocular Vision Dysfunction.
A routine eye examination typically evaluates eyesight, refractive error, eye health, and may include basic testing of eye alignment.
A specialized NeuroVisual evaluation goes further by looking for small amounts of eye misalignment and difficulties coordinating the two eyes that may not be obvious during a routine examination.
The NeuroVisual evaluation considers the patient’s symptoms along with detailed measurements of eye alignment and binocular function.
Trial microprism may also be used to determine whether correcting a small misalignment improves the patient’s vision or symptoms. This can help identify binocular vision problems even in patients who have been told that their eyesight and eye health are normal.
NeuroVisual Medicine-associated practices have evaluated and treated tens of thousands of patients with Binocular Vision Dysfunction, many of whom experience symptoms such as blurred, shadowed, or double vision, dizziness, headaches, eye strain, and difficulty reading or driving.
Intermittent double vision is a symptom regularly encountered in patients evaluated for Binocular Vision Dysfunction, and NeuroVisual Medicine practitioners have extensive experience evaluating the subtle eye misalignments that can contribute to it.
