Sudden case of double vision - Diplopia - seek advise and insight

Last Monday, (July 24th) I woke up with double vision - mostly in my
right eye.

I had a slight headache, which for me is sort of normal.

I really noticed how my sight had changed in my commute to work and
later in the day when I couldn't focus my eyes on objects to might
right.

That evening I went to California Pacific Medical ER.

They gave me either a CAT or a MRI scan and said they didn't find
anything out of the ordinary.

The next morning I met with several Opthamologists.

They confirmed that the back of my eyes looked healthy.

They confirmed the symmetry of my face. (There may have been some
symptom like a drooped eyelid - but if that's the case the effect is
very subtle and not that noticable. Ditto with some blackness to the
side of the eye.)

They confirmed I could feel tickelling on my cheeks.

Hearing was OK.

Blook sugar OK (108).

Blood pressure OK (normal reading).

They asked if I'd felt weak. No.

They asked if I was in pain. No.

I have had occassional pangs of nausa.

They did not actually review the MRI (or CAT) scan.

The othamologist team met privately and one of them returned and
insisted something "wasn't right". As if I was putting them on or
lying.

He talked about possible causes, physical and reflective, and concluded
this was an
instance of a reflective cause - because other than double vision I
didn't have any symptoms.

The doctors gave me a new perscription, which turned out to be nearly
identical
to my current perscription except he notched the astigmatism correction
down slightly.
My "prescription" was to get new glasses and come back in two weeks if
problems persist.

(I've done that but I'm waiting for the new glasses.)

He said everyone has diplopia when they look too far out of their
peripheral vision and wondered if I was just noticing it for the first
time. I told him that couldn't be the case because on my left side I
could focus and see a single object but if I rotated my body and looked
at the same object I could see two.


Since Tuesday morning I've developed a slight diplopia in my left eye -
but not as intense as what I have in the right.

I also have a slight diplopia when looking straight ahead - I'm able to
work from a computer with no problems but when when I look at objects
10 feet away I notice it.

Anyway, during my visit to my optometrist to get new glasses he scoffed
that an overly strong glasses prescription might be the source of
either my developing diplopia - or that a new pair of glasses would
help. Especially considering that I'd used my current prescription for
over a year.

The optometrist had me focus on his finger and confirmed the diplopia
diagnosis.

Considering that my site might be getting worse I've pondered making a
second trip to the ER - but since the hospital doesn't have
othamologists in the ER - they only have general practitioners who call
on-call othamologists, I've wondered what's the point? I've done the
ER thing and if I go again I'll get the same run around.

In the meantime, I can forget about driving a car or walking around too
much. Instead of seeing three cars in three lanes in a street I see
five. And the situation takes the fun out of just walking around.

Sometimes I can focus and I think my eyes are getting better. Other
times I see no difference.

I can work OK.

I use my eyes extensivelly and do computer programming about 8 hours
every day. Sometimes I push it to 9 hours.

My plan is to set up an appointment with another Othamologist which
will be in 3 days - because of the weekend.


Well, does that sound like a plan - or should I go to the ER room ASAP?


BTW, I occassionally get a buzzy sensation (kind of like when your leg
falls asleep) on the top of my head. And sometimes my tongue feels
numb. Both sensations go away quickly. The worst symptom is the fear
that I'll see like this forever.



Thanks.

 

<snip>

Just want to second the advice of Anon to get it checked out very soon
by a neurologist or ideally a neuro-ophthalmologist.

If you go back to the ER room at a different time maybe you'll get to
see a different doctor? A second opinion sounds like it might be very
valuable for you.

Let us know how you go.

Dom

 

It must be monocular.

The diplopia is not present when I cover either eye.

It is not intermittent although the intensity can vary.

Usually if I focus on something to me left and then focus on an object
on my right it is worse than if I close my eyes and then focus on
something on my right.

I see double when I look to my right (and since about Wednesday to my
left).

I see two objects. But actually, PER eye, my vision either is or just
feels sharper.

It would be great if it was non-physiological. That would mean my site
would probably return to what it was.

Thanks, I'll try to do that.

BTW, I have developed a very slight drooping of my mouth on the right
side.

 

wrote in @i42g2000cwa.googlegroups.com:

While its impossible to know that this what's going on for you through an
internet posting, so this is more an explanation of what this doc was
talking about and not really about your specific case, this is not an
uncommon thing. For example, if you're looking at your finger just 20 cm
in front of your eyes or so, everyone who can properly fuse on their
finger will "see" one finger, and double vision in the background.
Because of how vision works, the brain pays no attention to the double
vision in the background. In some cases, for whatever reason, some
people have trouble ignoring the double vision in the background.

So, the ophthalmologists, for an exam like this, should be doing alot of
testing to make sure your two eyes are aligned (as it's the misalignment
that would cause a non-natural double vision). They might have you look
at a distant target, and alternately cover one eye at a time to see if
you make a gaze adjustment when the cover is switched from one eye to the
other. They might use a Maddox rod, which looks sort of like a red
bicycle reflector. This "smears out" a spot of light for one eye, but
not for the other, and they'll ask you whether the spot of light sits
right on the streak of light. They'll ask you to look at a variety of
targets in a variety of different positions of gaze, and look for obvious
misalignments, as extreme gaze positions tend to make the misaligniments
more dramatic.

That said, I've been to an ophthalmoligist with a complaint about a spot
that appeared in the lower periphery of each eye following a migraine.
The guy had me refracted, and then spent all of a few minutes with me
doing an indirect ophthalmoscopic exam. He told me that there was a
congenital cataract in one eye that shouldn't impact my vision at all,
and my retinas were fine, then he left. Of course, that didn't answer my
worries in the least, and that's an ophth that I wouldn't recommend.
Fortunately I was in a position where I was working with a
neuroophthalmologist, who sat me down for a thorough exam, found the
floaters under a slit lamp, told me that I have floaters, and described
the exact shape of what I was seeing. Why did they start bothering me
suddenly after a bad migraine, when they had been there for some time--
years, probably?? Who knows-- but that's a similar example to suddenly
noticing normal double images. It doesn't mean I'm making things up, or
a little off the wall, or anything like that. It just means that I
suddenly noticed a chronic problem and it started to bother me.

So, if you feel that your doctors did a thorough exam for misalignments
and didn't find any, you'd treat your situation very differently from a
case where you don't think the ophthalmologists checked you very
thoroughly for misalignments. If you think the latter is what happened,
by all means start with another doctor. You might have to shell out a
few bucks for a neuroophth visit, and the neuroophth might tell you
exactly the same thing your other doctors did, but the patient education
will be better and you'll probably feel better about your situation. The
neuroopth, or even a second ophthalmologist, might be better at detecting
subtle misalignments than the previous docs, and find something real. My
own feeling is that if you're worried, find a doctor who's willing to
explain it to you so you won't be worried. Certainly, if you can't
drive, you have a very real problem--regardless of the cause.