double vision issues, how to correct

My history is as follows, 33 male, vision perfect until mid 20's when
I started seeing double. Each eye is 20 20 on its own. My right eye
has objects appearing slightly below the left. For example, when
reading a newspaper 2 feet away the text would appear about one line
below where it should be. Consequently reading isn't so pleasurable
as I do it with only my left. I've tried prisms in glasses yet that
only works for a few seconds and then the objects separate as they
would without the glasses. Increasing the prism strength didn't seem
to matter. The really odd part occurs at night when my blue vcr
clock, which is at least 12 feet away at the far end of the bed, comes
in perfectly. I noticed this was the case 6 months ago and it happens
anytime near complete darkness exists. If I try turning on a bedside
light or even strong flashlight the double vision kicks in and the
'time' literally starts separating in front of me. As soon as a
sufficient level of darkness exists (turning the light off) I can seem
to bring the times back together to form one. It seems obvious that
my eyes can't have more than one target or distraction.

So, that being said, I'm confident my problem isn't muscular or
physical as I wouldn't ever be able to experience clear binocular
vision in any circumstance. On the other hand, I can't seem to fix it
during normal conditions. I've heard there are convergence exercises
and would like to know which types to do ( if any will help ) or who
to see. I'm in the Toronto area. Two optometrists I've been to over
the years have both indicated there was nothing I could do, very
frustrating to hear that one.

Thanks,

Richard

 

Hallo Richard,
I have double vision from Graves' eye disease, and the prisms work only
'alrightish' for me. The separation that you mention is very difficult to
accommodate.
Why do think this problem is not a muscle problem? Each eye has six muscles
which have to work in total harmony. Have you considered eye muscle
surgery?

I would not be confident getting advice from optometrists alone. Can you
get a referral to an ophthalmologist who is familiar with your particular
problem?Perhaps? A Graves' eye disease specialist would may be able to give
you some answers.
Kindest regards,
Diana
(west coast of Canada)

 

If you see single in the dark when fixating on the central area, but double
when the lights are on, it sounds like there is a disparity between your
central (macular) vision, and the peripheral vision.

Most people with traditional muscle alignment issues are the opposite. They
get better fusion in the light, since peripheral fusion is stronger than
central fusion. Their problems get worse when they lose the peripheral
fusion targets, such as when driving in the dark, and then they get doble
vision looking at headlights, for example.

You may have macular heterotopia (displacement or dragging) due to some
retina problem. If this is so, there is no prism solution - they act as you
said, seeing better for a few seconds, then the double comes back. Reason
is, there is no way to move the central macular vision separately from the
peripheral vision. In such cases, once the diagnosis is established, a
"solution" is to blur the image in one eye just enough so the macular vision
is not fusing with the other eye. This blur is not so much that it
interferes with the peripheral fusion mechanism. Graded blurring is achieved
through fogging filters such as the Bangerter foils.

In any case, the reason for this needs to be worked out. If your 2
optometrists have not figured it out, see someone else. Someone who
specializes in double vision would be preferable. They may need help from a
retina specialist in case it is a macular dragging problem.


David Robins, MD
Board certified Ophthalmologist
Pediatric and strabismus subspecialty
Member of AAPOS
(American Academy of Pediatric Ophthalmology and Strabismus)

 

(Richard) wrote in

I will assume for the purposes of this discussion that covering one eye
eliminates the diplopia, and therefore you have binocular diplopia, not
monocular diplopia.

From your description, it appears as though you have a hyperdeviation, i.e.
one eye points higher, or lower than the other. It sounds like your right
eye points higher because it displaces objects lower. One of the most
common causes of vertical diplopia is a paretic superior oblique muscle,
which in ennervated by the fourth cranial nerve. The primary action of
this muscle is depression, the minor action is intorsion. Also, this
muscle's primary action varies with gaze. This means that the elevation
will not be constant, or will be more severe in certain positions of gaze.
People with this problem will have an increase in symptoms when they tilt
their head toward the shoulder on the side of the affected eye, or look in
the opposite direction. If your right eye is affected, then tilting your
head toward your right shoulder should make the diplopia worse. The double
vision would also be expected to be worse when looking down, i.e. when
reading. This is one of the reasons why prism doesn't work very well. The
power of the prism is only effective within a narrow range of positions of
gaze.

This may or may not be accurate in your case.

DrG

 

Hi Diana,

I'm a total novice and that is perhaps my reason for saying it is not
muscular, only since I can see perfectly in certain circumstances. If
I wasn't able to see perfectly at all then I'd be more inclined to
think muscles may be the issue. Regardless, thank you very much for
your input, I'd love to figure a solution out soon. Surgery I'm not
sure about since the deviance is so very small the risks are likely
not worth it, surgery could easily make it worse I'm guessing.

I'll have to look into ophthalmologists who know about double vision
in the Toronto area, if anybody readying this knows of a good source
to start with please let me know.

Richard

 

Hallo Richard, you are fortunate.

I have the solution for you.

HONESTLY!

Your problem is solved by LEARNING TO LOOK AT THE SUN.

For doing this you first have to discard glasses, contacts, or
sunglasses.

Then you have to learn how to look at the sun.

First, start by getting accustomed to strong electric light.

Then, go outdoors and learn how to look at the sky, opposite to the
sun.

Then, start to look to the part of the sky where the sun lies.

Then, start to look more closely to the sun.

If you continue with the practice, you will see that in few weeks the
sun won't give you any discomfort.

Then you can start the real thing, which is sun-gazing.

Gaze as much as you can, without discomfort. Five minutes, ten
minutes, half an hour.

You will see that your eyesight will be again in balance in few days.

Don't follow the advice of idiotic doctors that know nothing about
vision, as you have had the opportunity to check for your own case.

If interested, please visit http://TheCentralFixation.com, or write to
me privately.

 

I have given to you the source.

Now you prove yourself intelligent and follow it.

 

The fact that the man can see perfectly well in SOME CIRCUSTANCES,
perfectly contrary to what is commonly observed, does not raise any
question to this strange doctor who seems to know everything but is a
great ignorant indeed!

 

dated 25 May 2004 11:57:22 -0700,

Try this yourself first, signore Rishi Giovanni Gatti.

 

On the contrary - this circumstantial vision situation is a well known
problem, and is not treated by burning out one's foveas by staring at the
sun, which is very dangerous indeed.

 

Now I have proof of your full stupidity.

I can look at the sun (not stare) for half an hour without any after image.

So, you are an idiot, speaking things without knowledge of the actual facts.

You are anti-scientific.

Please resign.

 

I do it regularly whenever the sun shines.

Mind well that if the sun is shy, with clouds, I do not do it because it
is boring.

Best results are on midday.

If you give me your email address I can send a picture.

 

Good luck with your problem, Richard. When you have time, check out one
of the posts under the subject "Welcome to sci.med.vision". The level
of loon activity rises and falls, and this seems to be a particularly
active period.

 

I you stare at the sun, you are guaranteed to burn a spot onto the retina,
the same way any schoolboy knows that he can burn a bug with a magnifying
glass. It is no different. You are advocating an extremely dangerous
activity, which shows your total, inept and dangerous recommendations, and
you should be banned from giving such dangerous advise that some gullible
fool might follow, and end up peramantly damaging their vision. I have seen
many examples of this, especially at eclipse times, when peole tend to stare
at that phenomenon.

You have proven why you should get off of this group.

You are the most insulting of any person I have ever talked too, without any
understanding of basic medical physiology. I DO KNOW the actual facts, since
I have seen the unfortunate results of people staring at the sun.

Too bad, I have just made the grievous error of feeding a troll...

 

It's scary to think someone could recommend staring into the sun. But
I'm not a doctor so what do I know. Just for another point of
information, I have diplopia when I'm very tired. Several years
ago I had LASIK. It left me farsighted in my right eye. I wear
glasses now. The right lens magnifies images a lot more than the
left. My eyes seem to work hard at bringing the left and right eye
into one image. When I'm tired the muscles weaken and the diplopia
starts. Sometimes I've taped one eye closed to be able to work
without the annoyance of double vision. I don't know how this might
apply to your problem but I thought it was worth a mention. No less
useless than the suggestions about staring into the sun.

 

Dear friend,
to look at the sun is different than to stare at it.

However, since you had LASIK, it is impossible for you to learn to look
at the sun. Forget about it.

Sincerely,
rgg

 

Please don't you feel offended.

This is a free newsgroup and I think that I have the right to respond to
insults with other insults as well.

People with normal sight can look at the sun very easily.

People with imperfect sight cannot do it, but can learn it again if they
start to practice accordingly.

People operated upon with butchery procedures like LASIK, are most
unfortunate because their situation is irreversible.

 

Hallo Richard,

You could this link :
http://www.uhn.ca/programs/ophthalmology/about/kraft.asp

Perhaps this ophthy could recommend a suitable ophthy for your particular
problem. I hope you find a resolution to your situation.
Kindest regards,
Diana

 

I can't. If I look at any bright light, I sneeze.

Ann

 

It occourred to me also, it is a sign of strain.

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