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Diplopia or double vision is characterized by seeing two images of the same object. Sometimes surprising and sudden, this symptom can be a sign of temporary and intense fatigue or of a more serious illness. Diplopia can affect both eyes (binocular diplopia) or more rarely just one eye (monocular diplopia). In any case, double vision should not be ignored and should motivate to consult a doctor.
Causes, consequences, treatments… Here is everything you should know about double vision.
How to define diplopia?
What is diplopia?
Diplopia is an eye disorder characterized by seeing double, two images instead of one. It is related to a problem with the muscles that control the eye or the nerves that stimulate the muscles. When double vision affects only one eye, we speak of monocular diplopia. When double vision affects both eyes, we speak of binocular diplopia.
What is the difference with blurred vision?
Diplopia must be differentiated from blurred vision, which is characterized by the disappearance or blurred appearance of details.
In general, therefore, reference is made to a decrease in sharpness. Double vision is not necessarily blurred, but doubles.
How does diplopia manifest?
Diplopia or double vision is a symptom that can occur at any time during a lifetime. It can reveal the presence of a pathology ranging from simple fatigue to a more serious problem (neurological impairment). This is why it is necessary to consult a doctor who will establish an accurate diagnosis and propose a treatment to relieve the affected person.
Sometimes surprising and often a cause for concern, double vision can happen suddenly without any other symptoms or particular signs. In this case, do not be too alarmed, it is surely just stress or the consequence of extreme fatigue.
What are the causes of double vision?
There are two types of diplopia, and these do not have the same origin.
The so-called monocular diplopia, which affects only one eye and which persists when the eye is closed, is not responsible for the disorder. In question, we mainly find ophthalmological damage:
A corneal lesion;
A lesion of the iris;
Damage to the lens, such as cataracts (partial or total opacification of the lens);
Macular degeneration (the macula being the central area of the retina).
When we talk about disturbed binocular vision, it means that both eyes are affected. They disappear when one eye closes. In this case, the coordination between the two eyes is not done correctly.
The oculomotor muscles are affected. In question, most frequently fatigue, hypoglycemia, excessive alcohol consumption and vascular problems affecting the arteries of the eye or the brain.
Other causes of double vision
Oculomotor paralysis: it can be of traumatic, vascular origin or due to certain infections;
A muscle condition: such as myasthenia gravis (a relatively rare autoimmune disease of the neuromuscular junctions) or endocrine myopathy;
Heterophoria: a disorder of binocular vision linked to variations in the balance of the oculomotor muscles. The deviation of the eye is usually corrected spontaneously, but returns quickly in case of fatigue or alcohol intoxication;
Neurological diseases: including certain cancers (for example, a tumor of the brainstem) and multiple sclerosis;
Infectious diseases: such as botulism (caused by a toxin);
Taking certain medications, such as hypnotics.
What are the consequences of diplopia?
It is easy to understand that the fact of seeing double is disturbing or even extremely embarrassing for daily activities, whether it is a question of reading, driving, working, etc. It is therefore imperative to be taken care of quickly.
Several unpleasant symptoms can accompany double vision including pain or redness in the eyes, numbness, speech disorders, migraine and dizziness.
How to prevent and treat diplopia?
Diagnosis of diplopia
Only an ophthalmologist can diagnose and determine the origin of the symptom. The treatment for diplopia obviously depends on the underlying cause. The doctor will carry out an ophthalmological examination under a biomicroscope or on the fundus of the eye depending on the cause, and will be able to establish his diagnosis. In case of binocular diplopia, a specific orthoptic test will allow him to determine which is the deficient oculomotor muscle.
Treatment of monocular diplopia
To treat monocular diplopia, the treatment is that of the cause (the treatment of a cataract, surgical repair in the event of damage to the iris).
Treatment of binocular diplopia
In order for a person with binocular diplopia to be able to continue with day-to-day life while awaiting recovery, it is advisable to first cover one eye with a blindfold. If diplopia persists, it is possible to use a Fresnel prism. This one comes to stick on the lenses of glasses.
The doctor can then offer drug treatment. For example, Mestinon (or other long-acting anticholinergic) or corticosteroids.
In case of permanent paralysis, surgery will be necessary.
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