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Double Vision (cont.)

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What are the symptoms and signs of double vision?

Images may appear to overlap each other or may appear adjacent to each other. This can lead to other symptoms, such as blurred vision and dizziness. The double vision may be monocular (one or both eyes sees multiple images when tested individually) or binocular (double vision is seen only when both eyes are open, but each eye sees a single image when tested individually).

Double vision can be constant or variable. For example, double vision that varies with blinking is often related to irregularities of the eye's surface. Binocular diplopia may vary depending on the direction of gaze or with tilting or turning of the head. Fatigue may also contribute to variable double vision.

What tests do health care professionals use to diagnose the cause of double vision?

A thorough evaluation of double vision begins with a detailed history, including onset (gradual or sudden), duration, frequency (intermittent or constant), and variability with fatigue, head position, or direction of eye gaze, noting any associated symptoms (pain, headache, nausea, and weight loss among others) and other vision problems. A complete history of past and current medical conditions is reviewed. The physical examination to assess eye health includes measuring the vision (visual acuity) in each eye and assessing whether the diplopia is monocular or binocular. Careful examination of the eyes' alignment in various head positions is performed if the diplopia is binocular. A complete eye examination, which may include dilating the eyes, is performed to look for any ocular or orbital abnormalities. Particular attention is paid to the pupils and eyelid position if a neurologic cause is suspected. In some instances, specialized imaging (topography, CT, MRI, etc.) and other tests are needed to further investigate possible causes. When a life- or vision-threatening cause is suspected, time is of the essence.

Medically Reviewed by a Doctor on 10/9/2017


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