September Newsletter: How Is Diplopia Diagnosed and Treated?

Blurry country road from driver's point of view.

How Is Diplopia Diagnosed and Treated?

Most of us have experienced diplopia, or double vision, at some point in our lives. In most cases, our vision soon returns to normal. Unfortunately, diplopia can be a chronic problem that makes it difficult to read a book, compare prices at the grocery store, or drive. Although double vision isn't necessarily a sign of a serious vision problem, it does warrant a visit to the eye doctor if it happens often.

Why Do I Have Double Vision?

Double vision can occur if you're sick or dehydrated but may also happen due to:

  • Eyestrain. Eyestrain happens when you focus your eyes for long periods of time. It can happen after you've spent hours reading, driving, or using your computer or digital devices. Eyestrain due to digital devices is on the rise. More than 65% of people suffer from digital eye strain, according to a systematic review and meta-analysis published in Scientific Reports in 2023.
  • Convergence Insufficiency. Your eyes turn slightly inward when you focus on a book or close object. Convergence insufficiency (CI) occurs when both eyes don't turn inward at the same degree. In addition to blurry vision, CI may also cause fatigue, headaches, and blurry vision.
  • Strabismus. Strabismus, or crossed eyes, happens when your eyes aren't correctly aligned. The brain struggles to combine the different information it receives from each eye, which leads to double vision.
  • Visual Processing Issues. You may experience double vision if your brain has difficulty processing the information it receives from the eyes.
  • Astigmatism. Astigmatism occurs when the lens inside the eye or the cornea at the front of the eye is irregularly shaped. Astigmatism makes both near and far objects look blurry and can cause double vision.
  • Nerve and Muscle Issues. Double vision can occur if there's a problem with the muscles that move your eyes or the nerves that control the muscles.
  • Head Injuries. Concussions and other head injuries can affect vision and cause double vision.
  • Diabetes. Do you notice double vision when your blood sugar is high? High blood sugar swells the lens inside the eye, causing blurry and double vision.
  • Eye Diseases and Conditions. Keratoconus, corneal infections or scars, dry eye, and cataracts can all cause diplopia.
  • Refractive Surgery. Some people develop double vision after refractive eye surgery, like laser-assisted in situ keratomileusis (LASIK).

What Can Be Done About Double Vision?

Diplopia treatment varies depending on the cause. If you're seeing double due to eyestrain, resting your eyes and taking frequent breaks when reading or using digital devices can be helpful. Wearing prescription eyeglasses or contact lenses can improve your vision if astigmatism is to blame. If you have diabetes, keeping your blood sugar under control may be all you need to do to prevent double vision.

If diplopia is caused by a vision problem or head injury, vision therapy can be helpful. Vision therapists are specially trained optometrists who help you improve the brain/eye connection. The brain processes, interprets and stores the information received from the eyes and plays a crucial role in good vision.

During vision therapy, you'll strengthen the pathways between the eyes and the brain and improve your visual abilities. Although that might sound difficult, vision therapy includes fun activities, including computer activities, games, physical tasks, and special lenses.

For example, if you have strabismus, you might wear prism lenses that bend light as it enters your eyes, improving image alignment. Or, you might play a virtual reality game that gradually realigns your eyes.

If your eyes aren't working together as they should after a head injury, you might play Whac-a-Mole to improve eye teaming and eye/hand coordination, or try a target shooting game to improve your tracking skills. In a study published in Brain Injury, people with brain injuries who completed vision therapy showed a significant improvement in near focusing ability.

Wondering if vision therapy could improve your diplopia symptoms? Therapy is effective for both children and adults and can help you manage double vision, dizziness, nausea, and related symptoms. Contact our office to schedule an appointment with the vision therapist.


Nature: Scientific Reports: Prevalence of Computer Vision Syndrome: A Systematic Review and Meta-Analysis, 1/31/2023

Taylor & Francis Online: Brain Injury: Vision Therapy as Part of Neurorehabilitation After Acquired Brain Injury - A Clinical Study in an Outpatient Setting, 12/9/2020

American Optometric Association: Strabismus (Crossed Eyes)

WebMD: Diplopia (Double Vision), 11/2/2022

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