Diplopia, or double vision, is a serious disorder. Diplopia is caused by different diseases, among which harmless, but also severe clinical pictures can be found. If double vision persists for a long time, it is necessary to consult an ophthalmologist, who will investigate the cause of diplopia and refer the patient to an appropriate specialist, depending on the clinical picture.
What is double vision?
Seeing double images can have causes as innocuous as a squinting eye, which must be corrected by an ophthalmologist to allow correct spatial vision. Diplopia is the term used whenever double vision occurs in one or both eyes. In medicine, this is referred to as a disorder of binocular vision – the interaction of the right and left eyes. In this case, the brain does not combine the images seen by the right and left eyes into an overall spatial image, as is usual in a healthy person, but displays them as double images.
Causes
The causes of diplopia vary from patient to patient. Seeing double images can have causes as innocuous as a squinting eye that must be corrected by an ophthalmologist to allow proper spatial vision. But diplopia can also be caused by serious conditions such as a brain tumor. Other common causes include circulatory problems. Stroke patients also occasionally complain of seeing double images. Diplopia also occasionally occurs in some other diseases, such as multiple sclerosis.
Diseases with this symptom
- Circulatory disorders
- Squint
- Stroke
- Brain tumor
- Multiple sclerosis
- Migraine
Diagnosis and course
Affected persons should always go to the doctor if diplopia does not disappear on its own within a few hours and cannot be attributed to clear causes such as overtiredness or excessive consumption of alcohol. If there are other severe symptoms, such as pain in the left arm or severe headache, the emergency physician should be informed immediately, because time is of the essence if a stroke is suspected – the sooner a stroke is treated, the better the prognosis. All patients in whom diplopia is the only recognizable symptom should first consult the ophthalmologist, who can diagnose many of the causes of diplopia. He first performs a detailed eye examination with the help of various devices. This includes the so-called double vision test. During the course of this examination, the ophthalmologist tests the mobility of the eyes and performs various other tests of image vision using up and down tests. If paralysis of the eye muscles is suspected, an electromyography (EMG) is performed, which can detect or rule out paralysis of the eye muscles and can also be used to diagnose diseases of the optic nerve. If the cause of diplopia cannot be diagnosed, the physician also performs blood tests to diagnose any inflammation and uses imaging techniques.
Complications
There is usually a serious condition behind double vision. However, it can also be quite harmless, such as strabismus, for example. In this case, the ophthalmologist can correct the squinting eye and make normal vision possible. However, it can also be a brain tumor, in many cases there is an underlying disorder in the brain. Sometimes seeing double vision is quite harmless, but if there is no normal vision after a few hours, a doctor should be consulted. The ophthalmologist will make a correct diagnosis, he is the first contact person. Now, of course, the actual disease is treated, the double vision is a side effect. If, for example, a brain tumor is present, it must be surgically removed. However, complications can also occur during treatment; in certain cases, the operation first causes double vision. Double vision may well be visible for several months, but with successful treatment it disappears much sooner. A stroke also causes double vision, although there are other accompanying symptoms. Those affected complain of headaches, dizziness and pain in the right arm.In the event of a stroke, the patient must be taken to the hospital immediately; this greatly increases the chances of recovery. Double vision should always be taken seriously, but with medication this symptom also disappears very quickly. In any case, a neurologist can determine where the diplopia actually comes from and will fight the cause.
When should you go to the doctor?
Seeing double vision or double vision can have harmless as well as serious causes. Affected persons should therefore not hesitate for long and see a doctor immediately. The first point of contact in this case is the ophthalmologist. If the double vision is not based on ophthalmological findings, the ophthalmologist knows which specialists are best to consult for further diagnosis. In the case of diplopia, as seeing double images is called by the medical term, the brain does not combine the individual images recorded via the right and left eye respectively into a three-dimensional overall image, but leaves them as double images. This can be caused by an impairment of the eye, such as strabismus. Circulatory disorders and migraine can also temporarily trigger double images. More serious diseases such as multiple sclerosis or stroke can also cause double vision. A stroke can already announce itself with the first symptoms such as severe headaches or pain in the left arm plus double vision, which is why an emergency doctor must be called in case of this constellation of symptoms, as every minute counts already when a stroke is suspected. Another serious cause of diplopia is a possible brain tumor, which also requires immediate medical attention. In addition to the ophthalmologist and, if necessary, family doctor, the following specialists are also considered for treatment in the case of diplopia: internist, neurologist and oncologist.
Treatment and therapy
Treatment for diplopia is as varied as its underlying causes. If diplopia is caused by a squinting eye, treatment is by the ophthalmologist, who can correct the squint with the help of vision aids. If the double vision is caused by a brain tumor, the tumor must be surgically removed. In the case of malignant tumors, the treatment of the tumor is supplemented by radiation treatment and / or chemotherapy. Circulatory disorders causing diplopia are corrected by the neurologist, who initiates drug treatment. If a stroke is suspected, which is manifested not only by diplopia, but also, for example, by severe headaches, word-finding problems and / or pain in the left arm, the patient must go to the hospital immediately, because the sooner a stroke is treated, the better the chances of recovery. If diplopia is caused by other diseases such as multiple sclerosis or migraine, these are treated with special medications. Diplopia as a symptom of the disease disappears in the course of successful treatment along with the other symptoms.
Outlook and prognosis
Diplopia can occur for many different reasons and therefore must be treated individually in each case. In most cases, treatment of diplopia leads to success, so that the patient can see sharply again afterwards and has no further impairment of the eyes. The treatment is usually done with antibiotics, if it is an infection of the eye and head area. This infection can be treated relatively well and does not lead to further discomfort or complications. In the case of cancer (pressing on the brain) or injury to the head, surgical treatment is often performed to remove the diplopia. If diplopia is caused by a stroke or blood clot, immediate intervention by a doctor is necessary. If no treatment is performed, the patient will not be able to see sharply, which will greatly affect his daily life. The eye muscle has to be tensed more, which leads to further loss of vision. Therefore, diplopia should always be treated. It can also be compensated with prismatic glasses. Since diplopia is a non-reversible symptom, diplopia will not go away on its own.
Prevention
One prevention for possible diplopia is a generally healthy lifestyle, as many of the conditions that cause diplopia can be contributed to by obesity and poor diet.Temporary diplopia can be prevented by abstaining from excessive alcohol consumption. Adequate sleep also helps to avoid double vision.
What you can do yourself
Diplopia can occur due to very many different causes and usually cannot be cured by the patient alone without a doctor’s assistance. In this case, an ophthalmologist should be consulted in any case. In some cases, diplopia occurs only for a short time and disappears again after a few hours or after a few days. However, if diplopia persists for a longer period of time, it is imperative to consult a doctor. This condition can greatly reduce the quality of life and make everyday life difficult for the patient. Ordinary tasks and going to the workplace are in most cases no longer possible without further ado. In order to avoid depression and psychological problems here, a doctor must provide treatment. Often bacterial infections in the brain or in the area of the eyes are the triggers for diplopia. These can be treated relatively well with antibiotics and do not lead to further complications or discomfort. However, diplopia can also occur as a result of a stroke or be caused by tumors. In this case, urgent action must be taken, and surgical intervention is often necessary to eliminate diplopia. Therefore, early detection and treatment of the symptom by a doctor is very important. Self-help is not possible in this case.
