Diplopia aka "Double Vision"

We get a few patients/referrals a month complaining of "double vision". Things that cause double vision and their solutions are not easily understood by even medical professionals.

Far and away the most common cause of "double vision" is ASTIGMATISM. Uncorrected astigmatism (or any corneal distortion) causes what I call "ghosting', which is 2 images nearly superimposed, but slightly displaced. I consider it a form of blur, not TRUE "double vision" or diplopia". This is an easy fix - glasses/contacts/lasik. If the corneal distortion is from keratoconus or trauma, obviously a special contact lens or possibly even a surgical procedure may be indicated. But *most* people who complain about seeing "two of everything"...they're not talking about true diplopia. They're talking about ghosting. They just don't know what to call it.

True diplopia is: one eye sees one image, the other eye sees a totally different image at a different point in space. You must have 2 working/non-suppressed eyes to experience true diplopia, that's why when anyone asks me about double vision or tells me they think they might have double vision, I ask them "one eye or both eyes?" If you shut one eye and the double vision is still present, that's not diplopia. That's "monocular diplopia", or GHOSTING from astigmatism or corneal distortion (or rarely retinal distortion or "metamorphopsia" like in macular degeneration).

I had a patient tell me they only "see double" when they look closely in a mirror. That's not diplopia...that's not any eye problem at all. That patient just noted (correctly) that there are 2 reflected images from a mirror- one from the mirrored back side of the glass, and another, fainter reflection from the ANTERIOR surface.

I also have parents of strabismus children worried about their children seeing double. That almost never happens. The brain greatly dislikes diplopia (because its fairly disconcerting) and children with "crossed" eyes instead experience SUPPRESSION, not double vision. Suppression is when the brain "ignores" one of the images in order to avoid diplopia. Suppression is a big problem because it usually leads to permanent vision loss in children (amblyopia).

True diplopia usually occurs in adults with a new-onset eye or brain condition. That's why its so interesting in medicine. True double vision implies a new problem that needs to be investigated. Cranial nerve palsies & trauma are the most common causes of true diplopia, and both require a neurological work-up. It's not really usually from any "eye" problem - the eyes themselves are usually fine. Its the muscles/nerves that control them (or not) that are the problem.

The treatment for true diplopia is treatment of the underlying cause of the diplopia - many nerve palsies are self-resolving, but obviously must be monitored by a neurologist or neuro-ophthalmologist. If there is trauma and muscle-entrapment, surgery is indicated to correct that. Some patients can end up with permanent diplopia because their traumatic condition or nerve palsy never really resolves. For those patients we can usually prescribe glasses with PRISM in them to account for the eye/eyes that don't track/move/aim properly. The prism doesn't treat the diplopia, it just accounts for it by bending light to "aim" it in a way where the patient doesn't see double.

A quick note about prism: I could blog all day about it because there are so many misconceptions, but prisms do not "move" your EYE. A prism moves the IMAGE. Even some eye care professionals are confused on this point. I've heard eye care professionals tell patients that the prism glasses "move the eyes so they're aligned" - no, that's absolutely incorrect. Prism glasses move the IMAGE to account for an eye pointing the wrong way. Prism doesn't "treat" diplopia, it just accounts for it.

In short & the main message of this blog post is: MOST people who think they have "double vision", don't. They have ghosting from a corneal problem. Maybe if someone is Googling "double vision" they'll find this post and be a little less anxious about it! It still warrants a visit to an eye doc, tho ;)

Edit: a fellow O.D. emailed me and brought up the topic of binocular vision & vision therapy. While I do not discount the existence of convergence insufficiency (my wife is CI) nor the validity of vision therapy, I do not consider it a "common" cause of diplopia. A "common" cause of headaches, eyestrain, asthenopia - YES. But not diplopia...IMO, anyway. Maybe I'm wrong. But he's right in one aspect - it does deserve a mention in this post.

I'm admittedly a little biased against VT and binocular vision disorders. Here goes my feather-ruffling, but hey! It's my blog! :D I attended SUNY College of Optometry where I received an excellent education. Top notch ocular disease & contact lens training especially. However IMO we spent way, way too much time diagnosing and treating vision therapy problems. My "pediatrics" internship was quite literally all VT. I was...uh...not happy. This was after I had already completed a separate entire VT internship that was all VT. Then I went & did an externship at a VA hospital where I saw a lot of eye disease and learned a lot...but also did a lot of VT. No joke. SUNY was a little bit VT-overboard IMO. Maybe its changed now, I don't know. I haven't been back in 10 years. But they burned me out on VT. I don't practice VT, and I don't diagnose a lot of binocular vision disorders like CI. I do *some*, but its a minute part of our practice. Maybe if I was more interested in it...?

But again, IMO binocular vision problems are probably not a major cause of diplopia.

Comments

  1. Ray LeBlanc, OpticianNovember 27, 2011 at 11:42 AM

    Very interesting article.

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  2. i have this problem ..i consults many doctors they giving many lenses but not suitable (i didn't get clear vision)..finally i wearing one glass for 6 months but i can't see clearly (i asked the doctor again that i can't see clearly i hav seeing doubly ..he told that u should wear this for 1 year ) can this problem be treated or not ??

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  3. it will be cure by laser treatment ??

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  4. don't know if that can be treated or not. not a lot of information htere...sorry! it is doubtful that laser is indicated

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  5. Well you hit the nail on the head. I seem to have diplopia. If I cover either eye I see fine. If both uncovered I see double side by side vision. Head MRI clear. I am a type 2 diabetic but eyes are totally clear. It's been 3 weeks and I have to wear a patch over the right eye to function. I have been keeping my blood sugar in check since the incident. Question 1, will it correct inself in time and if yes, how long. Question 2, does it hurt or help wearing a patch all the time. Thanks

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  6. That's likely a cranial nerve palsy. 3rd nerve or 4th nerve or 6th nerve etc. Will it go away? They usually do, yes. As long ad the underlying cause is being treated

    No it will not hurt to wear a patch all the time

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    1. Thanks for this info. I have intermittent 6th nerve palsy and while it is getting better sometimes it is really annoying. Other than taking Vit. D and getting another MRI in three months the neurologist and neuro opthamologist have me in a holding pattern and I didn't think to ask if a patch is o.k. but I have been wearing on some to avert eyestrain headaches. They are trying to rule out demyelinating processes while I suspect it is just an infection (with MRI issues from prior trauma or prior migraines). Using the patch when it is bad enables me to assure I don't get headaches from the vision disturbance. Thanks!

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  7. Hi - I'm after some advice. My son (12 years old) started with double vision two years ago. He's had numerous tests to find underlying causes - MRI, rods and cones tested using the sensors on eyes and head etc. Everything came back clear. At the time he also had serious reading issues and needed magnification and things like fine lines disappeared. These issues resolved about 12 months ago but he still has constant double vision. If he closes one eye he can see fine. However his latest eye test shows the double vision has worsened. The optician is keeping an eye on him and will refer him back to the specialist if it continues to get worse but I was hoping you might have some idea what could be causing it. He lives with it and complains very little but it is getting him down now so it would be great to get it sorted. If he was to have prisms they would be really thick and heavy. Thanks for any help you can offer.

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  8. no, unfortunately I have no new news for you. if he's already been worked up and nothing was found...that's all you can do really. good luck!

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  9. Ok, thanks for your help.

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  10. I had eye muscle surgery (I'm 14) and I have been seeing double for months,,, The doctor said he 'cut' an eye muscle, and without glasses, I don't see double but with them I do, and if i have glasses on and cover one eye i see fine. I don't see two overlaped images, I actually see 2 channels, with the same image (different perspectives). I just changed my glasses and lenses, etc... and I thought I'd stop seeing double but it's still there and I'm getting worried. Will I stay like this for the rest of my life or what? I used to have my eyes crossed, one fine and the other pointing towards my nose.

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  11. Yes it sounds like you are experiencing/describing true diplopia, brought on (not surprisingly) by your recent strabismus procedure. It is doubtful that you will be permanently double. You're only 14, which is old for strab surgery but still young enough to recover most likely. You're just experiencing a recovery/adaptation time.

    The probable reason you don't see double with your glasses on is...suppression.

    Your best bet is to do what your doc says wear the glasses if they say you should. Stick it out. You'll adapt. Good luck!

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  12. Actually, thanks for the answer, with my glasses on I do see double, with them off, I don't :)

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  13. oops sorry I MEANT to type "The probable reason you don't see double with your glasses *OFF* is...suppression."

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    1. Similar experience to this contributor, except I am 56 - surgery for esophoria in June, good post-operative result but diplopia has now returned. Very small suppression area (not sure what this means). Further surgery? Prognosis?

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    2. Impossible to speculate, sorry. I really have no idea and neither does your surgeon

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  14. Hi there! I went to my eye doctor yesterday because I've experienced seeing double for a while.. I've been going through health anxiety after I gave birth almost a year ago. Anyways I've been seeing floaters since I was pregnant but got that issue looked at. I don't know how long I started to see double but I went in because I was focused on that. I am nearsighted and have astigmatism. I only see double without glasses and contacts. I don't see double with them on. The doctor diagnosed me with exotropia but very mild. I don't even look like I have lazy eyes, cross-eyes, or eyes that goes outward. She did some testing on me with her tools and diagnosed me with that. I think she used a prism the long clear ruler. I'm having a hard time with this diagnosis because I'm constantly thinking something is wrong with my brain like if there's something bad inside my brain. I called my dr. again today to see what she thinks and she thinks it's muscle-related but if it would give me assurance I can go see a neuro. I'm scared. I also want lasik ASAP but scared they won't be able to do it. I have a consultation this coming Saturday for the Lasik. I only see double without my contacts and glasses when I look at faraway object like the letters on the tv or digital clocks, word on posters. The double I see is up and down and sometimes I have to sqiuint hard to make them go back into one object. Please give me your opinion/ advice. Thank you.

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  15. This does not sound like "diplopia" to me. Double vision "only with your glasses off" is not double vision.

    Consequently it does not sound to me like you need a neuro referral.

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  16. What does it sound like to you?? She said I have exotropia. The double vision I have is up and down. OR.. Like a reflection under the object.. I'm so scared of it being something life threatening or a serious illness like Graves disease or MS.

    I really want lasik. What is your opinion on me getting lasik with my condition?

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  17. It sounds like blur from refractive error. It sounds nothing like graves or ms.

    LASIK probably fine for you.

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  18. My friend who is a medical student said vertical double vision is not a good sign. Is this true? Does it sound like i have that?

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  19. You (and your med student friend?) are over thinking this.

    What you see with your glasses OFF does not mean anything. Do you have "vertical diplopia" with your glasses ON? if not...no worries!

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  20. I had my Lasik consultation today and they said that I'm a good candidate for Lasik so I went ahead and scheduled the appt. The doctor that examined me didn't really ask about my so called "double vision". I just want to know if you think it's double vision if I describe it to you like this.. Without my contacts or glasses on I see like a light/ almost faint reflection of the object or words... Also when I have my glasses on it's not as bad.. my glasses is a year old but I see just the reflection of the bottom part of the words so it's not really double when I have glasses on just some reflection of the very bottom part of words on TV like when I'm reading captions or when I look at a litted billboard/ sign while driving at night. Please tell me.. Does that sound like double vision??

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  21. I feel like you're not reading my previous responses...?

    whatever you see (double, etc) with your glasses *OFF* means NOTHING. so...NO that still does not sound like double vision. it still sounds like refractive error.

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  22. This all sounds normal. Not a "bad brain" but rather a little on the "picky" side vision-wise.

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  23. Picky? So it's normal? Is it just adjusting?

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  24. My mom (she's 70) had her second eye cataract surgery last Thursday. Ever since she's been having double vision. She's fine looking at things up close. But the double vision would get worse and worse when she sees things far away. Reading close there's no double image. When her eyes moves away, she would see "ghosting" and then if she sees a red light far away, she actually sees two side by side red light. Also she has double vision in both eyes, with one worse than the other. The doctor said everything looks surgically perfect to her and doesn't seem my mom has any eye muscle problems. She said the double vision may be caused by her astigmatism (very light in the other eye that had surgery first and no problems from the surgery). But I thought the refined lens that we paid extra are supposed to help her astigmatism. The doctor said that my mom may have to wear prism glasses. But she did not have to wear glasses all the time for far distance before surgery. It's very disappointing at this moment. Will cataract surgery cause double vision? Why her astigmatism wasn't improved by the refined lense but giving her double vision that she never had before if that's what I understood from her doctor? Will she have to wear prism glasses forever? Thanks so much for your help.

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  25. cataract surgery itself does not generally cause diplopia.

    this is only 1 week out from surgery. a lot of these complaints will go away after 4-6 weeks when the refractive status stabilizes. I tell patients never to "judge" their vision or the result of the cataract surgery in the 1st month.

    too early to tell if she will need prism glasses or if the toric implant worked as desired, etc etc etc. just wait and see what happens. good luck!

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  26. Thanks a lot for the answer! It's very helpful.

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  27. I am 42. Male. No health problems aside from hip replacement surgery 3 years ago, metal on metal hip resurfacing implant restored normal hip functioning.

    My diplopia came on in the past 6-12 months. It is binocular. Closing one eye makes it completely go away - it is only there when I have both eyes open. The images I see are side by side. The image on the left may be slightly higher than the one on the right, but ofr the most part the images split sideways.

    If I blink my eyes and refocus on the object, they will go back together. As I stare at it, the object splits / pops back into two images. If I really try to focus hard and concentate I can soewhat prevent it from happening..but eventually it will do it.

    At first I noticed the problem only at night if I drank alcohol. After a glass of wine or two I noticed I would see double and would often close one eye to see clearly. My wife noticed that one eye was "off" when she would look at me.

    More recently, it seems worse and during the day or early evening, I will have episodes of double vision that comes on - no alcohol in my system. If I then drink alcohol, it gets worse. At first I thought alcohol was causing it, so I stopped drinking any alcohol, which may have decreased how often or how bad it would come on, but it did not stop it. for the past month or two, I usually get the double vision more at night when I am tired, but I do also notice it during the day sometimes.

    I have a desk job, I do mostly reading and computer work. I wear contact lenses all day, and switch to glasses at night. My presecription is about 5.25 in my left eye and 5.0 in my right eye.

    I went to the doctor a few months ago and she referred me to an opthamology office, where I was treated by an OD who works there. he prescribed various tests.
    I have had an MRI of my brain and oribtals and was told everything was normal. I have had blood work for thyroid, diabetes, MG, and told all that was normal. the OD had me do an eye exam and fitted me with test glasss that had slight prism in them.. I think 2 degrees in each eye.. and when I wore those around his office and looked at objects.. the double vision was gone. I took them offf and put on my old glasses and it was back.. .put the prsims back on and it was gone.

    I understand the prisms don't fix the diplopia they just mask it so I don't see it...

    I only see double for objects farther away. there have been a few times when I felt like I saw double looking at my compute screen..but most of the time..99% of the time, I only have double vision looking at far away objects. if it's bad, it might be something 10-15' away..but if i look off at somethign in the distance, it's more prevalent. tonight i was at my sons peewee football game and watchign the game was annoying b/c it was constantly splitting into two imags... i would stare/blink/refocus and it woudl go away, but immedatley come back...

    i dont' get eye pain. or headaches. if the double vision is happening a lot it may make my eyes feel tired... and i just want to clsoe them... i cant' say resting them or taking a break helps... i do notice if I look around.. left/right/far/close i don't notice it as much as opposed to when I look at something and focus on it... it's like i stare at it and it happens.

    i have considered askng my doctor for another referral to another opthamologist that specializes in nuerological stuff...since my probelm is probably not my eyes as much as it is something in my head.

    any suggestions? i apprciate anything you might have to offer as guidance or suggestions!

    -SP

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    1. Hi, I know it has been a while since this post but did you manage to get a diagnosis for your double vision? I have experienced the exact same symptoms as you and have had the same tests done that all came back fine but in the end the DRs diagnosed early onset MG even though the tests came back negative for MG. I do t think this is correct. If you have any other input I would really appreciate you sending it on to me. Thank you so much.

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    2. i know it has been a while since you
      Posted this but did you get any clarity on your diagnosis for the double vision? I have the exact same symptoms as you. I had the same tests done all came back negative. Let me know how it went with you. Much appreciated. Cherie'

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    3. My problem is identical. Any headway?

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    4. I have the exact same problems...going on about a month now.

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  28. Sir i have this double image when i am talking withj people on the other side of the road or people who are far away from...its like i am not able to concentrate into their eyes...at that time my friends too ask if i have squint??..can you give me some solution of what type of glasses i should use..i already have a myopia of -7 in my both eyes

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  29. need an eye exam and maybe a new Rx

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  30. i think i might have this problem...i'll have to get it checked out

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  31. I've been having <10 second episodes of double vision around 5 times per day for 3 weeks. One clear image directly above the other. It took me a while to realize it because it's only when I look down. It goes away when I look up, and comes back when I look down again. Each eye sees fine on their own. My eye will feel kind of stuck during an episode and they mostly happen at night. I've have no injuries, am active and healthy. I have a history of migraine with aura but this is very different and no pain. Neurologist and opthomologist said everything looks normal. I have a neuro-optho appointment 3 months from now. I've becoming a little preoccupied but it's probably good that I wait and see how things do or don't develop.

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    1. Hello, It looks like there are a few of us on here that have the same issue but we have not received any response. Just wondering if you are still having the problem or if you have found any answers?

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    2. Thankfully after many weeks my double vision sticky eye problem slowed quickly then stopped. However it was replaced with short dizzy spells that I'm still experiencing. My eyes sometimes feel weird but nothing like before. One possibility I read about online is microcranial nerve palsy which resolves on its own and migraine is a risk factor. In any event, an explanation would be great but I'm just happy it's mostly gone.

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  32. Hello I am 40 years old. I notice seeing like double images above each other after working or staring at computer for longer period. When driving home from work is also horrible for me because every images like cars passing, lights etc will have an overlapping imaged. But what I notice is that when I take a nap or after waking up in the morning preparing for work, my vision is very clear no double image or Ghost image.
    Now what I do notice is that when driving to work in the morning from 6am, after too many reflection of lights I will starting having problems seeing double images again so most times I drive with a sunglass/ dark glass in the morning to avoid this light reflections. I went to see an eye doc. who recommended different glasses to me that I should be wearing them while working on the computer but yet with these glasses on while working on the computer, I still keep on seeing this double visions.
    But during weekends at home , am always fine with my eyes because am away from work . Please what recommendation can you give me about my eye problem?

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    1. well that does not sound very alarming. that sounds like blur and/or presbyopia onset, especially if the other doc didn't find anything. could also be a "dissociated phoria" or something like that, but you would need further testing. not an obvious answer I can give you on the internet, you know? good luck!

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  33. I share the same symptoms as Anonymous posted on October 24, 2014 and also Py on August 7, 2015. Seems like we all have the same problem.

    I can't say alcohol makes it better or worse and yes when it happens, my eye feels stuck, although hard to tell which eye it is. It is definitely worse in the morning and most days by 2 or 3 o'clock it's like my eyes feel better and the problem goes away. Occasionally the episodes will continue after that but not much. Sunglasses help.

    I did not wear glasses until this started happening on June 9th. This caused me to get an eye exam and he said everything looked good, yet prescribed glasses for me. Glasses really don't make a difference with this problem.

    I saw an Ophthalmologist and he said it was muscular and basically due to age. I am 47 year old male, no health problems. He gave me some Refresh eye drops which doesn't get rid of the problem. Hard to say if it really helps in any way.

    I went to a neuro ophthalmologist and she basically said the same thing although she said my right eye had a slight tendency to point inward. She saw no neuro issues and said it was a muscular issue.

    I had a CT, MRI, all the bloodwork for MG, Thyroid etc and everything was fine. I have no pain or headaches. When I'm stressed, it does seem to get a little worse.

    It mostly happens after looking left and focusing on something (like a drive up window or even across the street) and also when looking at a mirror especially shaving and looking at my left cheek. It doesn't just "happen" it's always after an intent focus on something then looking at something close and usually downward - like my phone, or paper on the desk. I do find myself squinting a lot more to try to prevent it from happening.

    When it first started happening it was happening a lot, It has gotten better and less frequent, although I don't know if I have just "adapted" to trying to prevent it from happening.

    Really hoping you can respond with some thoughts or insight. It's stressful not knowing what is going on and not really getting any answers anywhere.

    Thank you for your time. Look forward to hearing from you!

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    1. I also face similar symptoms...let me know if you got some solution

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  34. I had eye surgery when I was a little over 1 and another one in 6th grade and now I think I'm seeing double vision I'm not really sure. I haven't been able to see 3d my whole life because I have a lazy eye. It was claimed to be fixed in 6th grade but it drifts off every now and then I'm now 14 and I need some answers the double vision thing just started a week or so ago. I only saw it on my forgot all clock/cable box, my tv, and a design on my pillow. I wonder if this could be my brain trying to grasp at 3d? Please help!!!!

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  35. yeah strabismus surgery. these are never fun. I may have made this comment elsewhere on this blog but...

    here's what stabismus surgery does: it makes people with an eye that's nowhere close to straight be somewhere close to straight. that's it. it DOES NOT make any eye "perfectly" straight, or at least that's rare. almost all former strab surgery cases see double SOMETIMES. it's pretty much unavoidable. so here's what I say to these cases: if you only see double "sometimes" in certain situations, you are probably mostly ok. if you are seeing double constantly or at least over 50% of the time, then you might need further surgery or prism glasses or something.

    it is definitely not alarming nor emergent for a person who has had strabismus surgery in the past to sometimes see double. in fact, it's expected.

    unfortunately you will likely never see "3D". whomever told you that the 2nd surgery in 6th grade would make you see 3D should have never told you that, b/c that would be super rare to "fix" someone's 3D perception. it wasn't fixed with that surgery and it will not be fixed with further surgeries, or at least it's really unlikely.

    don't worry about it too much. if it becomes a BIG PROBLEM (seeing double all or most of the time) then you may need to have something done about it. but if it's just "sometimes", that's totally expected in a person who has had multiple strab procedures.

    when you say "I'm not really sure" it makes me think you're not seeing double all that often. good luck! try not to worry!

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  36. I recently got diagnosed with binocular vision dysfunction in my left eye and told the treatment is prismatic glasses. I had a skull fracture 2.5 years ago and have had symptoms for about the past year or so (that I've noticed). Symptoms include random bouts of dizziness,stumbling or taking an extra step to the right sometimes, my right eye lid twitches after reading too much, blurred vision towards the end of the night, headaches centered around eyes, and when reading sometimes my eye seems to shift quickly which sometimes causes me to lose my place. My eyesight was tested to be 20/20 and I have always had perfect eyesight so I am very upset by this diagnosis. Will I have to wear prismatic glasses forever? Will they help to retrain my eye muscles so I no longer experience the exophoria and thus will not need glasses forever? How thick will the glasses be if I do not need corrective lenses for my eyesight? Are there exercises I could do in lieu of glasses or in addition to the glasses that could help correct the problem? Any advice would be greatly appreciated! I am feeling a little blown away by this news. And I should add that I had an mri following the head injury and it was clear.

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  37. yes head injuries and associated vision problems are not very fun, so I feel for you! I'll try to answer your questions to the best of my ability!

    "Will I have to wear prismatic glasses forever?"
    no one knows what the future holds! however...most of the time for most people, once you start down the road of wearing prism, it's very, very difficult to get off of it. MOST of the time when a person gets prescribed actual ground-in prism (not temporary "Fresnel" prism), it's forever.

    "Will they help to retrain my eye muscles so I no longer experience the exophoria and thus will not need glasses forever?"
    NO. this is a common misconception about prism. prism is not magic. prism will not do anything to your eyes. it will not "retrain" your eye muscles or anything like that. prism moves the IMAGE. that's it. so if a person is seeing double, we measure the direction and amount of the double vision and then we move the image with prism in a way that matches that so you don't see double anymore. prism DOES NOT move your EYE, or retrain your eyes or eye muscles...NONE of that. it ONLY moves the image to account for the double vision. that's it.

    "How thick will the glasses be if I do not need corrective lenses for my eyesight?"
    ground prism is famously thick. it's unavoidable. HOW thick depends on HOW much prism. the more prism, the thicker the lens. but all ground prism, even in cases of not-very-much prism, are thick

    "Are there exercises I could do in lieu of glasses or in addition to the glasses that could help correct the problem?"
    debated in the profession. and some of this depends on the exact type and direction of the double vision. if the double vision is VERTICAL, well there is not going to be much you can do about it. if the double vision is HORIZONTAL, well then the vision therapy gurus will tell you that yes, eye exercises will help. vision therapy is a long road, just like physical therapy. it can work, but it takes *A LOT* of dedication and the knowledge that the improvements will be slow and incremental. if you have *A LOT* of double vision (images very, very far apart) then VT probably is not going to eliminate it. if you have "a little" double vision (images almost superimposed but not quite) well then there's more hope.

    good luck! hope that helped!

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  38. Thanks so much for your input!! I'm pretty sure it is a horizontal issue and the double vision is at a minimum. In fact it it only late at night when I'm exhausted from the day that I even notice it. I am NOT ok with having to wear thick glasses!! This is all so confusing and upsetting to me and it's hard to believe I will have to wear these glasses forever when my eyesight is still so good and my symptoms are minimal. The symptoms are there unfortunately but not severe. The eye twitch is what sent me in to get an exam as it was making me crazy! Should I seek a second opinion regarding the exercises?

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  39. I mean of course it's up to you whether you seek a 2nd opinion or not. it's almost never a bad idea, butinsurances famously will not cover the visits for 2nd opinions, so it would be out of pocket.

    sounds like you don't experience double vision very often. prism is usually ONLY prescribed when a patient is CONSTANTLY or at least most of the time experiencing double vision. prism is usually NOT prescribed in cases where the patient only experiences double vision "sometimes" or in extreme/rare circumstances (like "exhausted at the end of the day").

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  40. Hmmm so it sounds like perhaps the exercises could be beneficial to me rather than wearing coke bottle glasses... Your input is GREATLY appreciated!!!

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  41. I am a 50 year old healthy white female. Several years ago I had a sudden corneal erosion and was diagnosed with Map Dot Fingerprint in both eyes. Since then I have developed monocular diplopia is both eyes, with the left eye significantly worse.

    In September 2015 I had PTK performed in the left eye. Surgery went well; the cornea regenerated as expected and the surface is smooth, but I still have monocular diplopia in the surgeried eye!

    My opthamologist is not sure what to do and says I have very early stages of a cataract, so perhaps that is a cause. I'm reluctant to have another eye surgery as a "guess".

    Is there a way to definitely diagnose the source of the monocular diplopia?

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    1. there definitely is NOT a way to difinitively diagnose any diplopia, monocular or binocular. it's going to be a big guessing game, unfortunately. sorry!

      Delete
    2. You say in your article that monocular diplopia (or GHOSTING) is from 1) astigmatism or 2) corneal distortion or 3) rarely retinal distortion or "metamorphopsia" like in macular degeneration.

      My corneal distortion (bumps) has been repaired, so theoretically that has now been eliminated as a contributing factor.

      How does one determine if astigmatism is the cause? (I do have astigmatism.) Can a special contact lens be placed on the eye to test if that eliminates the distortion?

      Here is something I noted related to the surgery: as is standard of care, I had a bandage contact lens placed in my eye directly after the surgery, and a protective patch placed over the eye socket. About 12 hours (or so) after the surgery I peeked out from under the patch and I distinctly recall noting I had excellent, non-duplicated vision!! (But admittedly I was still on pain-killers and fairly out-of-it.)

      In the next 12 hours though, I began to have complications seemingly related to the contact lens - stabbing pain and excessive tearing. Upon examination, my opthamologist felt the contact was too small for my eye and switched it for a larger one. By this time my eye was in a highly irritated and high pain state and I only tolerated the new contact for about 24 more hours before I took it out. My vision in the eye has had diplopia since then.

      Could the initial bandage contact lens have been unintentionally correcting astigmatism that is also causing the diplopia?

      Delete
    3. "Can a special contact lens be placed on the eye to test if that eliminates the distortion?"

      no, not really. many practitioners advocate trying a gas perm lens to see if it helps, but that does't differentiate between corneal distortion or astigmatism. there's no easy solution here.

      "Here is something I noted related to the surgery: as is standard of care, I had a bandage contact lens placed in my eye directly after the surgery, and a protective patch placed over the eye socket. About 12 hours (or so) after the surgery I peeked out from under the patch and I distinctly recall noting I had excellent, non-duplicated vision!! (But admittedly I was still on pain-killers and fairly out-of-it.)

      In the next 12 hours though, I began to have complications seemingly related to the contact lens - stabbing pain and excessive tearing. Upon examination, my opthamologist felt the contact was too small for my eye and switched it for a larger one. By this time my eye was in a highly irritated and high pain state and I only tolerated the new contact for about 24 more hours before I took it out. My vision in the eye has had diplopia since then.

      Could the initial bandage contact lens have been unintentionally correcting astigmatism that is also causing the diplopia?"

      that is kind of anecdotal/academic and doesn't tell me much about the cause of your problem, nor does it help figure out what to do with you. again, there is not going to be some easy answer here. this is a typical story of most people who have PTK. they assume it's going to fix their vision but often times it causes as many problems as it solves

      Delete
    4. I mentioned to my doctor that immediately after surgery I had clear vision and as I healed (and the bandage/contact came out) my vision seemed to get worse. At my request, and an experiment, he prescribed me a contact lenses and in my surgeried eye, my diplopia vanished.

      It seems the SPK he performed for my map-dot-fingerprint did not make the surface smooth enough. The topo map of the eye surface shows it to be smoother, but not all smooth; there are still height differences.

      The plan is to perform PTK on my other unsurgeried eye. I'm hoping the PTK is more accurate than his SPK was. Do you have any thoughts?

      Delete
  42. I never had any glasses before and then was prescribed some. I have astigmatism in my left eye. About a week later, I noticed I could see a shadow image a little above the objects. I took off my glasses thinking it was due to being new to them. However, this ghosting or shadowing still occurs. It's there with glasses on or off and if I close one eye it's there and the other closed its there. Went to neuro brain mri clear, no thyroid issues, or mg. Ophthalmologist said my eyes looked fine and thinks it has to do with another symptom of my body I'm having, which is tremors. It's really frustrating. The ghosting or whatever we want to call it is most noticeable looking at digital clocks, tv, street signs at night, but I see it with other objects as well. Do you have any suggestions? Thank you.

    ReplyDelete
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    1. I'm actually glad you brought this up because it's really common. You have apparently learned to notice that human vision is not perfect. Almost everyone has some ghosting when looking at a digital display like an alarm clock. I'm serious. The people who say they don't see that ghosting just haven't noticed it. Tt's *NOT* that they don't have it. Tt's that they don't notice. This is actually quite normal. I don't have any suggestions b/c it is highly likely that nothing can be done about this problem. Tt's not really even a problem. It's completely normal.

      Delete
  43. Hi there! For the past couple days I have woke with vertical double vision (not ghosting). When I cover either eye it goes away. I do not have any pain or headaches associated with this and the double vision does go away within an hour or two. I do have a mild astigmatism and wear glasses. The problem persists whether I have my glasses on or not. Though the double vision goes away my eyes feel tired the rest of the day and it feels strange when looking peripherally. Any suggestions as to what this could be? Thank you!

    ReplyDelete
    Replies
    1. in the case of non-ghosting diplopia, you definitely need an eye exam. it "could be" a lot of things, some benign (dissociated phoria, etc) some more serious (cranial nerve palsy etc). please get an exam!

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  44. Hello! I am hoping you can provide any insight into my current situation. I had a baby 7 months ago and since a week or so after he was born have been experiencing true vertical double vision. I wear contacts daily and have mild astigmatism in one eye. While in my third trimester I experience some "episodes" of double vision usually when my eyes were tired but I could just blink and refocus and be fine. I went to my eye doctor and he said my eye muscles are turning inwards. Not enough for regular people to notice but he said he can see my eyes turn in and out as they are trying to focus. I am still nursing my son so my hormones continue to be out of wack and I am as tired as I've ever been. Do you think there is something more serious going on or could this all be pregnancy/breastfeeding/hormone related? Other than this issue I am a very healthy and health conscious 32 year old. Many thanks for any advice or insight.

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    1. that does not aound particulary serious or alarming, and it sounds like someone has already made the diagnosis: esotropia...probably accommodative esotropia. maybe your Rx has changed, which is VERY COMMON in pregnant and nursing mothers...so it is very possible/probable that this is pregnancy/breastfeeding/hormone related

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  45. Thank you for your response. Can the esotropia be slight enough that it is not noticeable excel or to a professional during an examination because myself and my friends and family have not noticed any physical changes when looking at my eyes. I am going for a second opinion tomorrow as I have started to notice that wig my contacts (these have the strongest prescription) the double vision is worse. With my glasses (little less of a prescription) the double vision seems mildly better and although with no glasses or contacts everything is generally blurry I don't believe double vision is a problem. Now wondering if my original prescription is too strong and therefore my eye muscles are having to work harder to "straighten out". Would that be a probable cause? I have absolutely no other symptoms or concerns regarding my health so I don't believe it could be neurological issue. Thanks!

    ReplyDelete
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    1. "Can the esotropia be slight enough that it is not noticeable excel or to a professional during an examination" YES

      "because myself and my friends and family have not noticed any physical changes when looking at my eyes"

      it would have to be EXTREME for a non-professional to notice it

      "
      Now wondering if my original prescription is too strong and therefore my eye muscles are having to work harder to "straighten out". Would that be a probable cause?"

      YES very, very possible

      "so I don't believe it could be neurological issue"

      I don't, either

      Delete
  46. I am 53, and had a detached retina in Dec and had surgery for it. A buckle was used. I immediately noticed the vision was bad, but figured it was from the gas bubble and swelling and that it was normal. Well, almost 5 months later and bouncing between the specialist and my surgeon, I still have double vision. I had a second surgery in March to remove the buckle, as they thought that would help because it did affect my movement of the eye. They are now thinking it's the cataract and recommend surgery to fix that. I am wearing tape on my right lens, otherwise I can't see correct, and can't work, read, watch tv, etc. My question is, if cataract surgery does not clear it up, is this something I may have for life? It's very debilitating. I have not driven since December. I bump into and knock things over. My depth is no longer accurate. I am just looking for "hope". Thank you.

    ReplyDelete
  47. this is a standard experience with retinal detachment. the surgeons all kind of act like they can fix it but here are some truths about having a RD: 1) 100% of RD patients develop a cataract. literally 100%. I'm always surprised at how many people say they were never told this, but you should have been told. developing a cataract is not surprising at all. usually having cataract extraction helps so I hope this is the case with you. 2) NO RD patient is ever the same. they kind of all hope/expect to go back to how they were before but none of them ever do. almost all of them are left with some distortion/blur/double vision that they can't get rid of. the amount and severity vary greatly depending on how much retina came off and how the repair procedure went. but all of them have some permanent compromise in vision. pretty much the best you can hope for is to gain "usable" vision in that eye. it will never go back to how it was before. I know that doesn't sound very hopeful, but I grow weary of surgeons either ignoring these facts or worse: pretending everything will be fine and like it was before. all surgeons think they can and will fix everyone, but almost all RD's end up the way you are describing. it just kind of sucks and I'm sorry you have to deal with this. good luck!

    ReplyDelete
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    1. Thank you for your reply. I have been telling my family that I don't believe my vision will ever be the same, and for some reason, I just have this gut feeling that the double will not go away, even with cataract surgery. I keep telling my doctors to just be honest with me, that I can handle the truth better than I can being treated with false hope and misinformation. What worries me is that I am at risk for more RD in the future, and one eye is better than no vision, so I get a bit freaked at the thought of being blind. Again, thank you for your honest reply.

      Delete
  48. Had cataracts removed from both eyes a few years ago. No problems at all however now when I look at a star I see two stars side by side. This happens to both eyes or with either eye closed. When looking at the moon have no problems.

    ReplyDelete
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    1. that does not sound concerning at all. that sounds like a refractive error like astigmatism

      Delete
  49. Hi

    Recently had an eye exam with optometrist. He looked at my eyes, said I had astigmatism in one and myopia in the other. Wasn't too bad and vision almost 20/20. Prescribed glasses with prism for first time in my life. Now, I am noticing a vertical ghosting of objects and text. Most noticeable when objects are white and background is dark. I close either eye and still see it. Squinting and viewing at different angles alleviates the issue. Also, I punched a hole in a piece of paper and looking through that alleviates the issue as well. It is most noticeable when objects are far away and tends to clear up when objects are closer. Any thoughts? Should I seek another opinion?

    Thank you for your time

    ReplyDelete
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    1. "He looked at my eyes, said I had astigmatism in one and myopia in the other. Wasn't too bad and vision almost 20/20. Prescribed glasses with prism for first time in my life"

      well, prism is not indicated for myopia or astigmatism, so you probably have something else going on as well.

      "Any thoughts? Should I seek another opinion?"

      sure. ghosting is not dangerous, just annoying. the fact that you can clear it up with a pinhole or with extreme viewing actually does not help us figure it out. you said you were "almost corrected to 20/20", meaning to me there's something else going on. corneal distortion or cataracts or something. so yes a second opinion is probably indicated, or at least an explanation of why you're not 20/20

      Delete
    2. Thank you so much for the reply! I should've been more clear. He diagnosed me with a slight exophoria, and that is why he gave me the prisms. He did this manually as he said I passed the machine test as I had learned to compensate. He did correct my vision to 20/20 with the glasses--I had almost 20/20 before it. The whole reason I even went was because I felt like I was getting more afterimages after viewing the computer and LCDs for a while. I am also 28 if that gives more info. Would you think it is merely a refraction error or something more serious/dangerous? Thank you again for your time

      Delete
    3. this definitely does not sound serious/dangerous

      Delete
  50. Hi, I wonder if you can help me. I noticed my sight was blurred a year ago, then I started to see double vision, one on top of the other, I am seeing a neuro opthamologist, and, when he asked me to close both eyes, when each eye was closed, I still saw double vision in each eye undependabtly. He told me I have "crowded nerves" but dont know what tho means. He also til me my eye test result was "unusual" due to a "disparity" in my eyes. I'm worried tho is a brain issue and not an eye problem. Could you shed any light on this?? With thanks.

    ReplyDelete
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    1. yeah, it sounds like a "brain issue" and not an eye problem...so you're in the right place already - neuro-ophthalmologist. NO, sorry not having seen you I cannot shed any more light in this for you

      Delete
  51. Hi, I am back for an update on my previous post. I still have double vision, but the good news? Its Clearer Double Vision. I had cataract surgery July 19. The cloudy yellowish color is gone, but the double and distorted vision is still there.

    I get to go back to my Retina Doctor to see what else we can do. I refuse to believe that with all the medical knowledge we have, a piece of Scotch Tape on my glasses will be a life long solution to helping me see a single image.

    Its exhausting to see all the time this way. I struggle because I really need a new lens for my left eye since that prescription has changed, but the docs wont prescribe one yet till they can find a solution to the double vision. I get a lot of headaches, pain behind the eye (the Cataract Doc said its because I have had 3 surgeries already on that eye) and I fatigue easy. Some days are better than others, but yesterday I could barley see walking around the store. I have TONS of little black pepper spots floating in that eye since the cataract surgery, in fact so much so that its hard for me to concentrate when seeing all that. Almost 9 months of double vision and distortion and I see no end in sight. The doctor said a Prism will not work with my kind of double vision because the double image is at an angle so that the left side tilts down and points up on the right and that the right side is distorted and the images are larger to the right and appear to melt, or droop. Hard to explain, but its jacked up. :)

    Can I ask though, why would a doctor "Scrape" my cornea during surgery for the Retina Detachment? He said he had to do that, but when I ask he is vague and just states that he could not see though. Could the scraping of the cornea have caused the double vision?

    Anyway, thank you for just listening to me rant. I am just over this and want to see correct again.

    ReplyDelete
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    1. " Could the scraping of the cornea have caused the double vision? "

      hmm doubtful. epithelium (thankfully) grows back. don't know, sorry. good luck! not an easy case

      Delete
  52. Hey out there.Ive been diagnosed with anisometripia,and amblyopia when I was 11 years old and now im 18. Ive used an eye patch for like 4 years ,to cover my healthy eye {a dioptre of +0,75},and to put on work my ambliopic eye {my right one ,with a dioptre of +3,50}.Yes, it didnt really worked out with my ambliopic eye, but there been some imporovement on reading lines when I went to the hospital. So I had these two dioptres for about 4 years, and this year in April ,I had a fungal infection on my healthy eye, causing it to be red and itchy.I suffered for 3 months, using some home remedies ,but after that I went for a visit to my doctor , and she gave me to use Maxitrol Eye Drops and Hylo Comod {artificial tears}.I used these medications for 1 months and my doctor said that in this time while I was using eye drops ,I shouldnt wear my glasses,so that I didnt. After using eye drops, my eye got better ,but in this time ,i noticed double vision in one eye{of course in my healthy one ,because I only see with it} ,a double vision that only appears when I look in distance ,i cant see clearly horizontal lines,almost everything that is horizontal I see it in double vision.For example, the sub titles on a Movie, or a person's eyebrows ,etc.I didnt have double vision never before, but only realized it after the inflammation on my eye.After the visit my doctor said there was a change in my dioptre for the both of my eyes.Now I went from +0,75 dioptre on my healthy eye to -1,00, and my ambliopic eye from +3,50 to +4,00.Im using my new pair of glasses right now ,and whenever i put them on I see very clearly,there is no double vision,but when i take them off,I see horizontal double vision in distance. The thing that is worrying me ,is that before I could see clearly with or without my glasses on with my healthy eye and the doctor said that I wasnt in need for glasses for my healthy eye just for the ambliopic one,but right now said I need the glasses. After 20 years Im able to have that LASIK surgery in my ambliopic eye,but im worryied if the double vision without my glasses on ,on my left eye ,will ever go away.Doctor said it was about the refractive error,but its been 3 months that im dealing with this.My eye was healthy ,and I read a lot ,and maybe it is due to muscle weakness because of my inflammation for such a long time, or an itchy cornea, or dry eye.But my doctor said my eye is healthy inside.Will this ever go away ?

    ReplyDelete
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    1. there are a few problems with this story:

      "I had a fungal infection on my healthy eye, causing it to be red and itchy.I suffered for 3 months, using some home remedies ,but after that I went for a visit to my doctor , and she gave me to use Maxitrol Eye Drops"

      so that's not a "fungal infection". that's bacterial or allergic or inflammatory. no one Rx's maxitrol for "fungus".

      "while I was using eye drops ,I shouldnt wear my glasses,so that I didnt"

      no one tells a patient not to wear their GLASSES while they're on eye drops. they tell patients to stop wearing CONTACTS, but no one says "stop wearing glasses". no one.

      "i noticed double vision in one eye{of course in my healthy one"

      ok that's not true "double vision". that's monocular diplopia or "ghosting", probably from refractive error.

      "Im using my new pair of glasses right now ,and whenever i put them on I see very clearly,there is no double vision,but when i take them off,I see horizontal double vision in distance."

      ok now we get to it. THIS IS NORMAL. that's just refractive error. you need glasses.

      "The thing that is worrying me ,is that before I could see clearly with or without my glasses on with my healthy eye and the doctor said that I wasnt in need for glasses for my healthy eye just for the ambliopic one,but right now said I need the glasses"

      no, sorry this is not worrying at all.

      ",but im worryied if the double vision without my glasses on ,on my left eye ,will ever go away."

      don't know, but it's not concerning at all.

      "Doctor said it was about the refractive error"

      YES

      "but its been 3 months that im dealing with this."

      you're fine. you need glasses and you're not thrilled about it. I get it, but it's ok, really.

      "My eye was healthy ,and I read a lot ,and maybe it is due to muscle weakness"

      NO

      "because of my inflammation for such a long time"

      NO

      "or an itchy cornea"

      NO

      "or dry eye"

      NO

      "but my doctor said my eye is healthy inside.Will this ever go away ?"

      you mean will your refractive error resolve itself? maybe. probably not. but still, you're fine. none of this is alarming at all.

      Delete
  53. hello i hope you can help asap cause i truly need it ok heres the deal i have this weird ghosting in both of my eyes does not go away if i close one eye not even a little bit. Ive had this now for 8 years 8 long years since i was 13 im 21 now turning 22 soon so almost 9 years. If i put a pinhole to my eye my vision is 100 percent clear no ghost image. Now ive recently gotten glasses that help with my distance but not at all with the ghosting. It seems to get worse if i look down or straight on. It dissolves with a pinhole no matter what way i look. Ive read this is not true double vision because if i close an eye it remains and that rules out neurological causes i hope. Would a pinhole help if it was neurological btw? Just maybe hoping something can fix this and its not a fatal brain disease or tumor. Sorry also forgot to mention its way worse on High contrast things way way worse but once again the pinhole clears it up completely i hope you answer back as i can use some help from stressing myself out.

    ReplyDelete
  54. "Ive read this is not true double vision because if i close an eye it remains and that rules out neurological causes"

    YES that's true

    "Would a pinhole help if it was neurological btw?"

    NOPE

    "Just maybe hoping something can fix this"

    glasses

    "and its not a fatal brain disease or tumor"

    good news! it's not. this is likely just astigmatism

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    1. Im being sent to use a wavefront machine now eye doctor thing maybe its a high order abbration think he mentioned coma i have glasses they only help with distance not at all with the ghosting does this lead to it possibly being irregular astigmitusm i read it starts in teens whitch is around the time mine began any ideas thanks so much btw i litteraly brought this reply to my eye doctor you a life saver

      Delete
  55. Hey Its me Sarah again,Just read it.thanky so much for all of ur replies.Really.But ,theres a problem as well right now I guess. I said Im seeing clearly whenever im putting my glasses on for my healthy eye.But Right now im having trouble even with my glasses on. I see cleary at all the distances with glasses but only not clearly for the horizontal lines in distances (right now with and without glasses ). I dont know if im being clear enough.If theres an object just as the closet of clothes in distance, the frames of it that are horizontal are moving and ghosting at the same time even with or without glasses.But only horizontal ones.Everything else is clear.When I turn my head down by touching my shoulder ,the vision clears up even if im with glasses or no.Could it be due to extaocular muscles that got weaken? May I use vitamins to strengthen eye nerves? And yes please Im worried as well for something else. In normal pupil ,my doctor checked my eye in the autorefractor and the dioptre said *SE +0,75 D,but when they put the eye drops and the pupil got dilated , the autorefractor said *SE -1,25 D .But my eye accepts only the dioptre of -1,00 .They didnt know what to do and they said its weird in this situation.They also said to me to to use an eye patch to close this eye that iam talking about for 1 month.I did it but theres no change for the horizontal lines Im talking about.Before two weeks I described to her as well my situation (but the problem even with glasses on didnt yet happen) and she said its not justified enough.It is causing me a lot of problems while looking in distances at horizontal lines. And im only talking about my left eye.The other one has amblyopia.Now I have one eye with prescribed -1,00 *the left one* and the other one +4,00 the right one. and yeah one question : can i use hylo comod eye drops on this eye? I feel it itchy and i work a lot on computer? Someone even told me that using sparkling water to clean up your face and eyes is good for them.Sorry for too many questions,but makes me feel comfortable when taking a lot of opinions.Thanky for your time.

    ReplyDelete
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    1. "Could it be due to extaocular muscles that got weaken?"

      no

      "May I use vitamins to strengthen eye nerves?"

      vitamins doo not "strengthen" anything, and even if they did "strengthen your nerve", that would not solve your refractive problem.

      And yes please Im worried as well for something else.

      "In normal pupil ,my doctor checked my eye in the autorefractor and the dioptre said *SE +0,75 D,but when they put the eye drops and the pupil got dilated , the autorefractor said *SE -1,25 D .But my eye accepts only the dioptre of -1,00 .They didnt know what to do and they said its weird in this situation."

      that is not weird at all. that happens all day every day. this is nothing to be worried about. an autorefractor is just a machine that estimates refractive error and it's totally wrong all the time. ours has about an 80% hit rate, which means fully 20% of all cases it gets the Rx TOTALLY WRONG. none of that means anything.

      "They also said to me to to use an eye patch to close this eye that iam talking about for 1 month"

      what? almost no adult needs to be patching. I'm starting to have doubts about where you are getting your eye care.

      "I did it but theres no change for the horizontal lines Im talking about"

      yes no surprise b/c patching doesn't work on adults and it doesn't do anything for refractive error.

      "can i use hylo comod eye drops on this eye?"

      yes those are artificial tears and they are designed for making you feel less dry and gritty. they won't help with your refractive error etc

      "Someone even told me that using sparkling water to clean up your face and eyes is good for them"

      no, it's not. it doesn't matter.

      Delete
    2. Sarah here.Thanky so much.I hope im not bothering you at all.So ,im not using the patch, because even my parents dont agree ,because no results. Im wearing glasses now ,clear everything but sometimes something that is like a horizontal line is moving, but escpecially at nights and I noticed it when im tired of not getting enough sleep.I only sleep for like 4-5 hours per day.Why do the moving horizontal lines of the shelves frames for example ,get clear when I tilt my head to my shoulder? Could any vision therapy or treatment help me to get a better vision or it was meant to become worser as I only see with it? Or can I ask the doctor to do at me (i dont know how it is called, but moisturising my eye with something and then to see it from the inside in a desktop sreen)?My vision also gets better when I expose to the sun. I know I cant change my refractive error -1,00.But I just hope those moving lines will go away.Almost 5 months now. My doctor said in my case is better to use contact lenses, but they are waiting a little bit more for me to use them.Im sorry for so many questions. But I nedded to ask you, Im scared of losing my vision as well checking my eye health to this doctor due to the fact of having no results. THANKY SO MUCH! IM SO THANKFUL for this page.

      Delete
  56. Hi there.Is it possible for a dioptre of a single eye to change from ''+''for over 2 years, to ''-'' right now? and why?

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    1. yes it happens all the time. if you're hovering around zero and your refractive error changes you could easily go from + to - and vise versa. it probably doesn't mean anything. "WHY" does it happen? because refractive error is generally not stable, hence all the eye docs out there.

      Delete
  57. Hiii.Sometimes in the morning ,when I wake up ,I see blured with my eyes.It needs some minutes for me to close it and open all over again and touch it with my fingers until its clear. Why?

    ReplyDelete
    Replies
    1. usually that's dryness. try some OTC artificial tears like Systane Ultra when you wake up

      Delete
  58. Are you an ophthalmologist?

    ReplyDelete
  59. I was used to wear glasses with a change in prescription but not changing them, for like 5 months.Now my vision got worse. Im using new glasses with correct prescription.The worse vision,Is it because of that ?

    ReplyDelete
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    1. no.

      wearing glasses does not make your vision worse
      wearing glasses does not make your vision better
      NOT wearing glasses does not make your vision worse
      NOT wearing glasses does not make your vision better
      wearing an Rx that is too weak or too strong will not make your vision better or worse.
      none of that.

      vision is clearer with glasses on if you have refractive error. vision is worse with glasses off. that's it. glasses can't affect your vision like that

      Delete
  60. why double vision goes off, when i move my head down to my shoulder?

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    1. in extreme head/eye positions the eyelids can deform your cornea. that's my guess. either that or the pinhole effect from kind of "squinting" thru the very side of your eyelid.

      Delete
    2. so what do i have to do ,to get back to my good vision without having to tilt my head down to my shoulder? using something like a medication or?

      Delete
    3. well in theory it'd be using glasses or contacts...

      Delete
  61. how long do the symptoms of a new refractive error lasts?

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    1. until you account for it with glasses/contacts or it slowly resolves on its own? possibly forever...

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  62. I don't understand your question. You mean when you get new glasses how long before you're used to them? no more than a few days usually. or do you mean when your eyes change how long do you see blurry? forever, I guess or until you get a new Rx

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    1. I meant, the symptoms including double vision, headache or something like that, due to a new change in refractive error. After getting the right glasses, how long do these symptopms lasts ?

      Delete
  63. Can I use omega 3 fatty acids for eye?

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  64. Dear doctor, first of all I jsut wanted to thank you for all the responses, that is a lot of time spent for the good of people. I have a question, during the past 2 years, I never slept before 2 a.m , I work 5 hours a day in a computer, and when I come home I spent another 5 hourts on the computer ( basically I spent 15+ hours a day in the computer). During the alst 2 years I have a lot of problems with my eyes , so I have irritability in brightness, flashes of light, foggy like seeing and so on. I jsut say that all my vision tests turn out to be all right. The optic nerve is all right, when I wake up I feel dizzy but all the mri, tests and so on turn out to be all right. When I see bright lights, I see the flashes of them for liek 10 seconds after, that means like when im typing here even thought I dont watch the computer only the keyboard, when I turn my head all the form of computer the lights even the symbols turn out to be flashes and I see them in the mirror this thing happens even in a not bright room ( that means in a room with no lights at all ) . Can you tell me whats the problem ? It isnt like Im going to live with this all my life? Right? Cheers,

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    Replies
    1. you already had your eyes/vision tested and they said you were normal? no - I am unable to tell what the problem is based solely on that description, sorry

      Delete
    2. Yes, everythings turns out to be all right. The structure of the eye, the optic nerve and so on. I see flashes of light, and can not see even the bright lights on a normal day. Sometimes I do not see clearly , kind of blurry and my eyes are itch ( red lines, ) I do not know what is going on, every test turns out to be all right but I just cant stand calm. I see flashes of lights for like 15 seconds after seeing in bright light.

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  65. Hi. I have been seeing ghosting with the past 4 -5 months its mainly there when watching tv black backround with white writing its very clear with this, it is also there when i close one eye and with glasses or without, with contact lenses its not as bad but its strange when i look at a tv screen the screen seems to carry on past d border only looking from my right eye to d left side of tv nd vi sa versa left eye to right side of tv,its there with both eyes but not as noticablelike when i close 1 eye. another example when weraing the contact lenses and this happens when i look at a street light with my right eye or left from my right eye when i look at d light d light extends to d left its very strange could you please give me an answer sorry if u find it hard to understand its hard to explain.I have been to an eye specialist and everyting looks good but i do think someting isnt right i can see d ghosting r double vision. I also get a glare like if the fire is on i get lines of light coming towards my eyes. Would greatly appriciate if you could shed some light on these problems

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    Replies
    1. yes that is ghosting. no biggie. fairly normal in both glasses and contacts. human eye and vision is a funny thing, even in normal eyes

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  66. Hi ive been seeing ghosting with d past 4 -5 months its there when i close 1 eye and with or without glasses. With contact lenses i get a very strange thing only way i can explain is when i look at my tv from my right eye il see d light from d screen carry on past d border on d left side and vi sa versa left eye to d right of tv also carrys on past d border could you explain what this could be? I also get a weird thing happening with light e.g if i look at d fire i get lines of light splitting in differen directions it happens with any type of light fire, street lamps and car headlights. Its all getting me down and feel like i cant get on with my life. I have seen an optamoligist 1month ago and said everyting looked fine in all the tests. Would greatly appriciate any info to what it could be to put my mind at ease

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    Replies
    1. ghosting. seriously it's fine. google "high order aberrations"

      Delete
  67. What kind of vitamins are the best to use for eyes?I know it wont help with refractive error,im not even thinking about it,but im trying to keep the eye health better

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    Replies
    1. most perofessionals agree it's probably areds 2 formula

      Delete
  68. can you go from -1,00? to + ,after a while?

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  69. Im having headache sometimes. Im -1,00 in one eye, and the other one +4,00. Although i see very well with glasses on

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  70. My eye is itchy and burning from the inside .Whenever I try to cry with purpose ,the tears came out very hard from that eye

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  71. Moving horizontal lines in distance, but going away when tilting my head, but then problems with vertical lines, and when i turn my head straights im ok with vertical ones but problems with horizontal lines.What do you advice me to do ?

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  72. For example titles of a movie in tv are being reflective ,or i do see another same sentence up to the sentence down.It happens a little bit even with glasses although i changed them last 3 months and i do see clear with them in general.Sometimes white stuffs ,become like ghosting, or the same object is reflective into one another going off from it. Especially lines.What do i have to do?

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  73. double vision could it be due to a sinus infections, that hadnt been cured with time ?

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    Replies
    1. yes, possible. although it's probably still ghosting

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  74. is it possible to have ghosting even with glasses on ?

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  75. Doctor ,can you help me ,I see hazy sometimes when I wake up, or some parts of the day.Feeling like my eye is itchy and not liquid enough.

    ReplyDelete
    Replies
    1. need to go to the optometrist, and try some artificial tears

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  76. Can the ghosting go away on its own ? I dont want it to be there forever ,even with glasses on

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    Replies
    1. not going to be able to answer that for you as I don't know the exact cause of YOUR ghosting. I will tell you that MOST people have some ghosting even with glasses on. they just don't know or care. people assume that NO ONE else sees ANY ghosting but almost everyone does.

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    2. sometimes it's one of those "can't learn to UN-see" things

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  77. Im -1,00.Should I wear glasses at all the time?

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    Replies
    1. literally does not matter. you need them to see clearly far away, you don't for up close.

      Delete
  78. Can pinhole glasses help to improve vision in distance?

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  79. whenever i expose to the sun , i can see without glasses.Can I use vitamin D as well?

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    Replies
    1. "whenever i expose to the sun , i can see without glasses"
      PINHOLE EFFECT

      "Can I use vitamin D as well?"
      WON'T HELP YOUR VISION AT ALL

      Delete
  80. can you cure in another way than using glasses all the time or lasik etc. the dioptre of -1,00? a treatment including medications or exercises ?

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  81. i had a sudden change in my dioptre. It happened at the time of using some eyedrops because of my red eye for 4 months. I know it happened around that time.Could it be due to them?

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  82. how can a muscle weakness be cured?

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    Replies
    1. there really isn't any such thing as "muscle weakness". that's a lay term that people throw around but it's not really a thing.

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  83. Even with glasses on ,sometimes especially when im tired there are horizontal lines of an object slighty moving. Why? When I get glasses off, its worse

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    Replies
    1. still sounds like ghosting. I feel like all these "Anonymous" posts are the same person kind of obsessing on this

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  84. Im myopic.Plus lenses therapy while close work or lower minus lenses than prescripted ,to reduce it naturally?

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    Replies
    1. nope. that's been repeatedly debunked and in fact studies how that may ACCELERATE myopia progression.

      if it were that easy, wouldn't we all be doing it already?

      Delete
    2. there literally is no "reduce myopia naturally". that does not exist in medicine.

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  85. Hey doctor. Recently ive found out that my current prescription is ok,no trouble with it, but i tried my friends glasses and they fit me as well as mines. How is it possible. Mines are -1,00, hers -0,50 ?!

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    Replies
    1. well the most likely scenario is that your Rx is "over-minused" or over-prescribed. a young (under 40) person who wears too much Rx will usually not see blurry. doing so increases your risk of headaches and eyestrain but is otherwise pretty harmless. another possibility is that when you try on your friend's "weaker" glasses you're not looking far enough away to notice the difference.

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  86. Which is the most perfect time to use laser eye surgery? A lot of people who did it, told me they never had problems back than , but some had problmes with glare and halos. It depends on the dioptre power or? Also want to ask you about contact lenses. Can I use only one contact lens for the eye Im having problems to see?

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    Replies
    1. perfect time: stable Rx between age 25-35
      YES it depends on the Rx. best Rx's for LASIK are still -1.00 to -7.00 with little or no astigmatism.
      YES you could wear only 1 contact lens for the 1 eye you see poorly from.

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    2. what about extreme astigmatism in one eye?The laser doesnt heal it at all right?

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    3. no, LASIK is not particularly good at "extreme astigmatism", as I found out from personal experience:

      http://myeyepod.blogspot.com/2016/10/lasik-regression.html?showComment=1478111161403

      contacts aren't very good at extreme astigmatism, either. most of those are stuck with glasses.

      Delete
  87. Can you do the laser if you suffer from ghosting or macular degeneration?

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    Replies
    1. alas, no. no surgeon is going to do any elective refractive surgery on a mac degen patient.

      as for the ghosting...it depends on what is causing the ghosting. if it's refractive error...yes a person could still in theory have LASIK. if its from some corneal or retinal problem, then no

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  88. A lot of sites talked about having one eye amblyopic. Can something in the next years happen to the dominant and corrected eye non-amblyopic?

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    Replies
    1. Then if the vision in the non-amblyopic eye becomes dependable on glasses, what would you recommend? For exmp. If i want to do the Laser eye surgery ,on both eyes ,for the amblyopic one *even tho not clear vision after it,but no glasses then* , and for the other one who is healthy but suffers from a mild refractive error? Or should I not risk at my healthy eye as I only see with it?"so just in the amblyopic one'. Thanky if you respond.Sorry for too many questions

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    2. most docs agree not to risk it if you only have one good eye

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  89. My condition is due to a car accident when I was younger, where the optic nerve was pinch & paralyzed by the brain when my head hit the inside of the car. My doctor was the head of Ophthalmology at Stanford at the time. After months with severe migraine headaches, I learned how to walk & feed myself again in physical therapy, but was left with permanent diplopia and back injuries. Nearly age sixty, I'm starting to use a patch!

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  90. Hi doctor. So at the hospital in this year ,in august,they dilated my pupils with eyedrops for refractive error. Now its december and they want to do a re-check and they want to dilate my pupils again. It is bad to dilate your pupil this often? There are a lot of people telling me its harmful because they can actually ruin your pupils.Please tell me. I'm going for a control tomorrow there

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    Replies
    1. it is not bad. it does not "ruin" your pupils or anything else. the people telling you that don't know what they're talking about. dilation is perfectly safe to do over and over and over again with no long term effect

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  91. So doctor i went to do the test for my retina ,and everything is clear as well. There is not even a single problem. But before two months ago I had a dioptre of -1,00 and today my doctor said it is somewhere around -0,50. So they might do a recheck and change the lenses. Can it be due to overcorrected prescription that sometimes I still see ghosting or even moving thick edges of objects with this -1,00 glasses on?

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    Replies
    1. "Can it be due to overcorrected prescription that sometimes I still see ghosting or even moving thick edges of objects with this -1,00 glasses on?"

      YES

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    2. The ghosting vision is more noticeable when my eyes are wet or full in tears ? why ?

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    3. well, your eye is not designed to look thru a *lot* of tears, only a small, thin later. if your eyes are wet from say crying...that's not conducive to great acuity

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  92. Hi doctor.Its again me up below. Went today to the hospital for the RX recorrection. As i told you, i have an amblyopic eye of +3,50 dioptre (was) and the other one was +0,75 for over 5 years. Now in july 2016 it changed. +4,00 the amblyopic one ,and the other one -1,00. I started having problems like ghosting images and stuff even with glasses. Now on december to remind you again ,they dilated my pupil. The amblyopic one stays +4,00, but the other eye went from -1,00 to SE -0,25. The doctor recommended to put a power of -0,50 on this eye for balance with the amblyopic one and she wanted to do that recheck of the eyes because in a short period of time, my eyes changed alot. Today she didnt dilate my pupil but she said she is not going to change the dioptre of my amblyopic eye +4,00, but for the other one she recommended to leave it 0,00. How come that I have to change it to 0,00 when I have problems with this eye to see things far in distance ? Like with those -1,00 and +4,00 glasses, I can see very well at distance but some ghosting problems.Shall I leave glasses like this with -1,00 for this eye ,or change them to -0,50? She said its all about because of my amblyopic eye that is causing problems in distance and ghosting for the other good eye. And yeah ,this is a new doctor btw.She even checked my retina ,and it said that my eyes are good in the inside. It was an old doctor of me who put the dioptre of -1,00 on my eyes,now I changed the doctor, and she want it 0,00.Please help me.

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    Replies
    1. I don't know how to help you. sounds like your doc is already trying stuff. great! none of this sounds serious.

      Delete
    2. Doctor you said up below: That's "monocular diplopia", or GHOSTING from astigmatism or corneal distortion (or rarely retinal distortion or "metamorphopsia" like in macular degeneration).
      I did all the tests and i had none of these on my eye that is suffering from ghosting vision. So what shall i do?
      These -1,00 glasses help me very well to see far away as i have problems in distance,but sometimes horizontal lines (for examp. on sofa or even on a shelf) they appear a lil bit wavy but as soon as i blink sometimes it changes (with glasses on). Does it has to do with the over prescription ,so i must let it -0,50,because no astigmatism on it or something like that? Never had problems with this eye tho, it started happened since 6 months ago. I changed the dioptre before 8 months,and the very first two months i had no problems with ghosting even with glasses on, but rn yes.Could it be due to over use of laptop, becuase i stay on it 5 hours per day? Thats why it changed from +0,75 to -1,00 or?
      Please help me, I know i dont deserve any more answers but youre helping me a lot, as no one of the doctors seems to be concerned about this, but it is putting stress on me ,as it is my good eye and I can only see with it. Please answer me. Do I have to do any more tests? My eyes are somewhat of a weak point of me and im very scared of their health. Ive never had problems like this with it before 10 months ago. Thanky a bilion times !

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    3. "I did all the tests and i had none of these on my eye that is suffering from ghosting vision. So what shall i do?"

      not much else you can do.

      "appear a lil bit wavy but as soon as i blink sometimes it changes"

      now *that* sounds like dry eye! try some artificial tears like Systane Ultra

      "as no one of the doctors seems to be concerned about this"

      well, none of this so far has sounded very concerning to me either.

      "Do I have to do any more tests?"

      sounds like probably not. what other tests?

      "im very scared of their health"

      don't be scared. none of this sounds alarming. this all sounds like run-of-the-mill refractive error and maybe dryness. annoying, but nothing to be "scared" about.

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  93. It may or may not be a question to put here, but my the sister of my friend was giving birth to twins.And while giving birth she went blind, but after two days of delivering she saw good as usual.Why does this happen? and can it be lead to permanent blindness if it happens? Or if the mother has already problems with refractive error,would be included here or afterward the birth, her vision may get worse or ? Thank you if you answer this!

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    Replies
    1. don't know . that's unusual. many possibilities, too many to guess

      Delete
  94. Hi I've read many of your previous posts and see similarities- (so glad I stumbled on this page!) really looking to be reassured. I've seen two optometrists - both said I have a astigmatism. I'm 38, never had vision issues in my life, and had a baby 4 months ago. About a month after I noticed I have what I call double vision. Halos around lights, print appears double(same line right above) especially on tv. Reading subtitles etc. Neither really explained and I left each place with a different prescription. Appts were a month apart. First appt script was OD -1.25, OS -1, second script was OD -0.75 0.5 BD prism, OS -0.75.
    When filling script they told me to go with the prism script as I was seeing double. I just feel like I don't understand how this happened so quickly. I see fine it's just twice in most cases. Mainly just on print. I've filled the prism script and it does help. I was frightened it was neuro issue but neither seemed concerned. I've done the tests noted online covering each eye. I see the same double image when either eye is covered. Will this get better? And how come it came on so quickly?? Thanks so much! Your input appreciated

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    Replies
    1. 1) don't know if it will get better or not - likely not bc of #2...
      2) why does this happen? bc you're approaching presbyopia. you're 38. everyone needs reading glasses/bifocals by 44. everyone - even the people who claim they don't. for a lot of people the changes in their lens shape/size in their late 30's causes astigmatism. it happened to me. no bog deal, just annoying...and sometimes REALLY REALLY annoying to people who have never needed glasses.

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    2. Thanks for your response - u've hit the nail on the head. Annoying is the word...and maybe I'm in denial lol -
      Glasses are very annoying to me and hate dependence on them to see better. Googling double vision is also insanely frightening!! I had my self freaked out but sounds like I need to accept this "ghosting" is a normal part of aging and astigmatism and come on quickly. Thanks for respond!

      Delete
  95. Thank you for your article. I'm one of those, "If someone googles double vision they may see this" folks. I believe I am an astigmatism 'ghosting' vision sufferer, not true double vision, thank goodness. However, I will go in and have it checked since up until recently it's only been one eye. Now it's both. However, it's only when I read up close and don't use my reading glasses. What used to be 'just blurry', now has a distinct supperimposed image, high and right in both eyes. I've had astigmatism in one eye all my life, but not seriously. Now I think I may have it in both eyes. Guess it's time to see the eye doctor. Been 2 years since my last exam. Again thank you for the detailed explanation and list of possibilities.

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  96. Hey doctor. Its me again .So im able to wear contact lenses. As i told you i have ambylopia, and i dont see very clear with my good eye. Can i use the contact lens only for my good eye as i cant see with my amblyopic eye? I will only use it when going to school ,than back home with glasses again/

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  97. YES! Many, many amblyopes choose to go uncorrected in their amblyopic eye. Very common!

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  98. I am confused by online descriptions of Vertical Diplopia, Monocular and Binocular, which are variously worded such as to contradict one, another. I have vertical diplopia with or without glasses, regardless of using both eyes, or left or right eye closed. I can find no description of this combination, and your article above implies I have Monocular Diplopia, but the online descriptions belay that because it is still present even if I close either eye. I will add that the degree of displacement of the ghost image varies, as does the intensity. So I'm guessing neurological, and I do suffer infrequent optical migraine where I loose vision clarity at or near the fovea point, said loss lasting no more than a couple of minutes and varying in shape, size and location through the event. FYI, unrelated, I and a fellow have invented a way of displaying ordinary reading text in a manner which allows most Dyslexic people to read more normally. I am an author of books. Proparanoidgroup at gmail com

    ReplyDelete
    Replies
    1. if you still have "double vision" with one eye closed, that cannot be true diplopia". that's MONOCULAR diplopia, usually from astigmatism. do you have glasses? you probably need some. regardless, all this needs to be discussed with a doctor who examines your eyes. schedule an eye appointment. this does not sound "neurological" at all, nor related to migraines. "vertical" diplopia is just the direction of the double images (one above the other, as opposed to "horizontal" diplopia which is where the images are side by side)

      Delete
  99. Hey Doctor, so since i was little when I looked up in the sky ,I saw an eye floater but never really bothered me and only when I looked up in the sky.Now im 18 yo and since 5 months i had a lack of sleep, tiredness ,dry eyes and so do on stuff, and just before last week this eye floater seem to get back and it is a lil bit bigger and it is bothering me not even when i look up in the sky, but even on a computer screen,or in a book , or down in the street etc. Noticed that when Im getting better sleep is less bothersome. Im trying to start a healthy diet , yoga and get some better sleep. Im too young to be bothered by it ,when it never really bothered me but since last week. What am I able to do ?

    ReplyDelete
    Replies
    1. nothing, really. get used to it. sleep, yoga, diet...none of that stuff matters. pretty much everyone has floaters. it's a normal human experience. once you "learn" to see them they can be difficult to ignore.

      Delete
  100. Can you get blind on your good eye , from the other amblyopic eye , as it gets weaker with time?

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    Replies
    1. no. amblyopia in one eye does not have any affect on the other eye at all.

      Delete
    2. also, amblyopia does not get "weaker over time"...

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    3. can I do the laser surgery on my amblyopic eye when ill be 22 , just to lower the power of it? I look so bad on glasses. One eye small the other big

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  101. I have been wearing glasses with prisms for 20 plus years for double vision. I can see single on both eye if I close either one but double with both eyes open. Have had an MRI and nothing was discovered on that. Have been examined by a doctor that specializes in pediatric double vision and the way my right eye is tilted, surgery is not recommended and it crosses and is tilted downward also. Finally got another pair of glasses with prisms as I was having serious problems driving as looking left to right with my old glasses took me too long to refocus. New glasses are great with solving the double vision (even though they are so thick and my eyelashes brush on the side of them. My problem is now when driving my distance vision is distorted, not double and not blurred, but just distorted. Also, in driving if the red light is on straight on and at an angle, I can't see if it is red or green. When I do see the stop lights, they look 3 D and smaller. Brake lights are causing the same 3 D problem and look like smaller red dots. Really nervous doing driving when I have to go where I am not familiar with the red lights. Also, some poles, signs, buildings and a yellow/navy blue edging on them and color is really distorted. Doctor has cut 3 new lenses and so far, I am still having problems. How do I make my doctor understand the color issues and severe distortion issues. It seems like the prescription for the distance is good, but distorted. I can't call it blurry, just distorted. Everyday is an emotional struggle when I have to go out. I hate the way the glasses look, and more so the fact that I can't see well. Any advise that I can take to my doctor. Someone told me to check and see if my doctor changed to a digital grinding company as that can sometimes cause problems and they should be manually ground.

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    Replies
    1. your doctor understands. this is not a case of them not understanding your problems. you just have some unfixable problems. this is unlikely to be permanently solved. this is just how you are. you're looking for the perfect fix but you're not going to get it from any doctor ever, or from any glasses ever, even "digital grinding" ones. nobody likes this answer but sometimes it's necessary

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