Diplopia Definition - Double Vision Double Vision By Troy Bedinghaus, OD Updated April 10, 2016 Are you seeing double? Double vision is the simultaneous perception of two images of a single object. The images may be displaced horizontally, vertically, diagonally, or rotationally in relation to each other. What is double vision? Double vision usually occurs when the eyes are misaligned, or not pointed at the same object, causing us to see two different images. Both images are sent to the brain which we process as double vision. Most of the time, both of our eyes are pointed at the same object. This produces a clear, single image with just enough difference between the two images to give us a slightly different line of sight. This subtle difference gives us depth perception , often referred to as stereo vision. In fact, the farther apart an animals eyes are, the better depth perception it has. Double vision can cause problems in life, including great difficulty in completing simple tasks. Luckily, the brain naturally guards against double vision by suppressing, or ignoring, one of the two images. We have a complex set of eye muscles and nerves that communicate with each other to keep both eyes moving along together.

Causes of Double Vision The medical term for double vision is diplopia. Diplopia can be intermittent or constant. Because the pathway for the three main nerves that control eye muscle movement is long, complex and originates in the brain, double vision can be a sign of a serious neurological problem. A defect anywhere along these pathways can possibly cause double vision. Some defects are caused by an injury to the head, stroke, aneurysm, brain tumor or brain swelling. Diabetes, hypertension and multiple sclerosis are common diseases that can cause a temporary paralysis of the nerves that control the eye muscles, which may cause double vision. Another cause of double vision is strabismus . Strabismus is a condition that causes the eyes to be misaligned, often referred to as an "eye turn." Most people with strabismus are born with it and have an eye that tends to move inward or outward. Strabismus can also cause one eye to be pointed up or down. In many infants, it is difficult to find a true cause. Sometimes strabismus is caused by a large refractive error (need for prescription glasses) and sometimes eye tumors.

Most young children do not suffer from double vision even though their eyes are misaligned. Our brain often compensates and prevents us from seeing double by suppressing one of the images and making it disappear. Our brain learns to ignore the extra image, known as suppression. Children seem to adapt quickly and their brains suppress one of the images quickly. However, when one image is suppressed, a child is at risk for developing amblyopia, often referred to as lazy eye, because the eye is not being used properly. When strabismus develops in adults, double vision is more likely to occur. An adult brain has difficulty suppression one image at first because for a large part of their life, both eyes were functioning to their fullest potential. Monocular Diplopia For the most part, you must have two fully functioning eyes to experience double vision. However, there is one type of double vision that can occur in one eye, called monocular diplopia. The most common cause of monocular diplopia is a cataract . A cataract is a clouding and opacification of the normally, clear lens inside the human eye. Most cataracts develop as we age. Some cataracts can be caused by trauma to the eye.

Occasionally, the clouding occurs in sharp junctions in the lens which causes light to split into two when it enters the eyes. Some individuals perceive that as double vision. Astigmatism can also cause double vision out of one eye. Astigmatism , a common vision problem that distorts vision, can sometimes elongate or stretch out an image so much that it appears to be double. Treatment of Double Vision Cover It - The simplest form of treatment of double vision is to cover one eye with a patch. This quickly eliminates one image but has the negative side effect of decreasing your dimensional vision or depth perception. Fresnel “Press-on” Prism - Another useful way of treating double vision is to apply a Fresnel prism on top of your eyeglasses. Fresnel prism is a thin sheet of many little prisms that shift light in a certain direction. The prism moves the image that the misaligned eye is seeing into a position so that both eyes can fuse the image into a single, clear image. Fresnel prism has the advantage of being temporary. The fresnel prism can be peeled off of the glasses easily as the diplopia resolves itself. Fresnel prism is useful when double vision is caused by conditions such as diabetes or hypertension.

Most often, the double vision lasts less than 6-9 months and then goes away when the underlying systemic condition is being treated. Ophthalmic Prism - If double vision is more permanent, then regular, ophthalmic prism can be ground into your eyeglass prescription. It occasionally increases the thickness of the lens on one side but is better looking cosmetically than a Fresnel prism. Vision Therapy - Vision Therapy (VT) encompasses a lot of different techniques to correct double vision and strabismus. Sometimes certain machines and computer models are used to give the person behavioral feedback to control the double vision. Other times, specific eye muscle exercises are done to strengthen the eye muscles. Surgery - Surgery for double vision is very successful in most cases. Eye surgeons who specialize in eye muscle surgery use a variety of techniques that involve shortening or moving eye muscles. Adjustable sutures are used to fine tune the eye muscle correction directly after surgery. Botox - Botulinum toxin is injected directly into one of the muscles controlling eye movement. This temporarily blocks the nerve impulse and causes the muscle to be paralyzed. This muscle relaxes and the other eye muscles take up the slack to straighten the eye.

Side effects including a droopy eyelid or worsened double vision. What You Should Know Double vision is a serious health concern. However “sudden onset” double vision is of special concern. When diplopia comes on suddenly, a neurological problem in your brain should always be ruled out before investigating more common causes. If you are experiencing double vision, you should be evaluated by an optometrist, ophthalmologist , neurologist or other medical professional immediately. Upon evaluation, your doctor will ask you the following questions: Did the double vision appear suddenly, or has it been there for some time? Is it constant, or does it seem to come and go? Does the double vision go away when you cover one eye? Do you see double out of one eye, or both eyes? Source: Neuro-Ophthalmology - Textbook of Ophthalmology. Slamovits, Thomas L. and Ronald Burd. Copyright 1994, Mosby-Year Book Europe, Ltd. Continue Reading Diplopia | definition of diplopia by Medical dictionary Diplopia | definition of diplopia by Medical dictionary [dĭ-plo´pe-ah] the perception of two images of a single object; called also double vision .

binocular diplopia double vision in which the images of an object are formed on noncorresponding points of the retinas. crossed diplopia horizontal diplopia in which the image belonging to the right eye is displaced to the left of the image belonging to the left eye (divergent strabismus). direct diplopia horizontal diplopia in which the image belonging to the right eye appears to the right of the image belonging to the left eye (convergent strabismus). horizontal diplopia diplopia in which the two images lie in the same horizontal plane, being either direct or crossed. vertical diplopia diplopia in which one image appears above the other in the same vertical plane. di·plo·pi·a diplopia /di·plo·pia/ (dĭ-plo´pe-ah) the perception of two images of a single object. binocular diplopia double vision in which the images of an object are formed on noncorresponding points of the retinas. crossed diplopia diplopia in which the image belonging to the right eye is displaced to the left of the image belonging to the left eye.

direct diplopia that in which the image belonging to the right eye appears to the right of the image belonging to the left eye. homonymous diplopia direct d. horizontal diplopia that in which the images lie in the same horizontal plane, being either direct or crossed. monocular diplopia perception by one eye of two images of a single object. paradoxical diplopia crossed d. torsional diplopia that in which the upper pole of the vertical axis of one image is inclined toward or away from that of the other. vertical diplopia that in which one image appears above the other in the same vertical plane. diplopia di·plo′pic (-plō′pĭk, dĭ-plŏp′ĭk) adj. diplopia [diplō′pē·ə] Etymology: Gk, diploos + opsis, vision double vision caused by defective function of the extraocular muscles or a disorder of the nerves that innervate the muscles. It occurs when the object of fixation falls on the fovea in one eye and a nonfoveal point in the other eye or when the object of fixation falls on two noncorresponding points.

Also called ambiopia . Compare binocular vision . diplopia Double vision Ophthalmology A condition whereby a single object appears as 2 di·plo·pi·a [G. diplous, double + G. ōps, eye] diplopia Double vision. The perception of two images of a single object. This occurs in squint (strabismus) when both eyes are not aligned on the object of interest. Diplopia with one eye is rare but possible. Diplopia Mentioned in: Nasal Trauma diplopia The condition in which a single object is seen as two rather than one. This is usually due to images not stimulating corresponding retinal areas. Other causes are given below. Syn. double vision (colloquial). See differential prismatic effect; haplopia ; myasthenia gravis ; retinal corresponding points ; polyopia ; multiple sclerosis ; strabismus ; diplopia test; triplopia . binocular diplopia Diplopia in which one image is seen by one eye and the other image is seen by the other eye. crossed diplopia See heteronymous diplopia .

heteronymous diplopia Binocular diplopia in which the image received by the right eye appears to the left and that received by the left eye appears to the right. In this condition the images are formed on the temporal retina. Syn. crossed diplopia. homonymous diplopia Binocular diplopia in which the image received by the right eye appears to the right and that received by the left eye appears to the left. In this condition, the images are formed on the nasal retina. Syn. uncrossed diplopia. incongruous diplopia Diplopia present in individuals with abnormal retinal correspondence in which the relative positions of the two images differ from what would be expected on the basis of normal retinal correspondence. Example: an exotrope experiencing homonymous diplopia instead of heteronymous diplopia. Syn. paradoxical diplopia. See abnormal retinal correspondence . monocular diplopia Diplopia seen by one eye only. It is usually caused by irregular refraction in one eye (e.g. in early cataracts, corneal opacity) or by dicoria or polycoria. It may be induced by placing a biprism in front of one eye.

See ghost image ; luxation of the lens . paradoxical diplopia See incongruous diplopia . pathological diplopia Any diplopia due to an eye disease (e.g. proptosis), an anomaly of binocular vision (e.g. strabismus), a variation in the refractive index of the media of the eye (e.g. cataract), a subluxation of the crystalline lens, or to a general disease (e.g. multiple sclerosis, myasthenia gravis). See exophthalmos ; luxation of the lens . physiological diplopia Normal phenomenon which occurs in binocular vision for non-fixated objects whose images fall on disparate retinal points. It is easily demonstrated to persons with normal binocular vision: fixate binocularly a distant object and place a pencil vertically some 25 cm in front of your nose. You should see two rather blurred pencils. The observation of physiological diplopia has been found to be useful in the management of eso or exo deviations, suppression, abnormal retinal correspondence, etc. (Fig. D4). See Brock string; retinal disparity . diplopia test See diplopia test.

uncrossed diplopia See homonymous diplopia . Fig. D4 Physiological diplopia. The subject fixates a distant object A di·plo·pi·a [G. diplous, double + G. ōps, eye] diplopia (diplō´pēə), n seeing a single object as two images. May occur after fracture of the bony orbital cavity as a result of displacement of the globe of the eye inferiorly. diplopia seeing two images; double vision. Patient discussion about diplopia Q. what is the cause for double vision A. Double vision, or diplopia, as it's called, may be due to many conditions, including disorders of the muscles of the eye (extra-ocular muscles) and the nerves controlling them, disorders of the eye ball (enlarged eyeball as in Graves' ), and sometimes disorders of vision. Diplopia may manifest important conditions, so consulting a doctor (e.g. neurologist or ophthalmologist) may be wise.

You may read more here: Double Vision, Diplopia: Symptoms, Causes, Treatments Double Vision Double Vision Double vision – also called diplopia – will make you see two separate images of a single object. There are several different types of diplopia, and many different causes. Sometimes, double vision can be a symptom of an serious underlying disease or condition. For that reason, if you encounter double vision at any time, you should make an appointment with an eye expert straight away. Symptoms of double vision Double vision means that you simultaneously see two separate images of the same object. In some cases, double vision can be little more than a feint ‘ghost’ image, which is easily confused with blurred vision. Double vision can be horizontal, where the images appear side by side; vertical, where the images appear one above the other; or diagonal, where the images are both vertically and horizontally displaced from one another. Double vision makes it difficult to see objects at any distance, and can particularly affect your spatial awareness, and therefore your ability to drive. Children with double vision may frequently cover one eye, or they may tend to squint or turn their head in an unusual way to try to see properly.

Causes of double vision In normal vision, the two separate images from each of your eyes are combined by the brain into a single image. Double vision occurs when the brain cannot combine the images from each of the eyes into a single image. This is usually because the images are not similar enough, because of problems with the muscles or nerves that control precisely where each eye is looking. There are two main types of double vision – binocular and monocular. Binocular diplopia Binocular diplopia is the most common type of double vision. It occurs when your eyes don’t align with each other as they normally would. Those with binocular double vision will find that covering either eye gets rid of the double image. Binocular double vision is usually caused by a squint, but if it occurs suddenly, it could be a symptom of a much more serious medical condition. Diseases of the thyroid or arteries, along with diabetes, multiple sclerosis, stroke and a number of other serious conditions can cause double vision. It’s therefore essential to make an appointment with an eye specialist as soon as possible if you have double vision.

Monocular diplopia Monocular diplopia is double vision in one eye only, and is much less common than binocular diplopia. If you have monocular double vision, only covering the affected eye will make the double image disappear. Monocular double vision is usually caused by an abnormality within the eye itself, such as a refractive error like astigmatism , or a rare type of cataract . It can also be caused by abnormalities of the iris, lens, or fluid within the eye, and even dry eye . Treatment for double vision If you suffer from double vision, your treatment will depend entirely on the type and cause of your diplopia. Treatment can be as simple as wearing an eye patch, or special glasses or contacts. Botox® injections or eyelid surgery may be used to correct a squint that causes double vision. Similarly, a cataract operation may be necessary if a cataract is the cause, or dry eye treatment may help if dry eye is the cause. For a full diagnosis of your condition, and to discuss all of your available treatment options with an expert, please make an appointment with one of our eye doctors today.

Double vision - NHS Choices Double vision Double-vision Treatment Introduction Double vision (medically known as diplopia) is seeing two images of a single object. The two images may be one on top of the other, side by side, or a mix of both. Double vision may be constant, it may come and go, or it may only occur when you're looking in a particular direction. The cause of your double vision depends on whether your double vision is coming from one eye (monocular) or both eyes (binocular). This also affects which treatment you receive. Treatment ranges from special glasses and eye exercises, to surgery to remove a cataract . Read more about treating double vision . Recognising double vision in children Adults are able to describe what is happening with their sight, but young children may not be able to explain what is wrong clearly. If your child has double vision, they may narrow or squint their eyes closed in an effort to see better, or they may frequently cover one eye with their hand. They may also turn their head in unusual ways (for example, tilting their head) or look sideways instead of facing forward to try to avoid double vision.

When to see your GP Visit your GP as soon as possible if you develop double vision or you suspect your child has double vision or a squint. If you've never had double vision before, it's important to have it checked as it could be a symptom of a serious medical condition. Your GP will probably refer you to an ophthalmologist (eye specialist) at your local hospital, or an orthoptist (eye movement specialist). Tests for double vision in hospital Your eyecare team will usually start by assessing your vision. They may ask you to read letters off a chart, measure any current glasses, look at the position of your eyes, and assess how well you can move them. They may also assess how well your eyes are working together (your binocular vision). Your ophthalmologist will also use a microscope with a very bright light called a slit lamp to examine the front and back of your eyes. These results, together with your medical history and any other symptoms you have, should determine what could be causing your double vision. Further tests Further tests depend on whether the double vision is monocular or binocular, but may include taking images of your eye.

A picture of your brain or eye muscles may also be taken using: a computerised tomography (CT) scan , which takes a series of X-rays at slightly different angles and uses a computer to put the images together a magnetic resonance imaging (MRI) scan , which uses a strong magnetic field and radio waves to produce detailed images Blood tests may also be used to check for an underlying condition. What causes binocular double vision? Each eye creates its own slightly different image because the two eyes are physically located in different positions. However, you usually only see one image. This is because your brain joins the images produced by each eye together into a single image in a process known as fusion. If your eye muscles or nerves are damaged, the muscles may not be able to control your eyes properly and you may develop double vision. Your eye muscles can also be weakened as a result of a health condition, or your eyes may not be aligned properly. This is sometimes known as a squint . Adults who had a squint as a child may sometimes develop double vision over time. Read more about the causes of double vision . What causes monocular double vision? Double vision in one eye is known as monocular double vision.

You should be able to see normally if the affected eye is covered, but double vision continues when the unaffected eye is covered. In cases of monocular double vision, the two images are often only slightly separated. This is sometimes referred to as "ghosting". Causes of monocular double vision can include: refractive errors – such as short-sightedness or long-sightedness corneal disease retinal abnormalities Double vision in both eyes Double vision in both eyes is known as binocular double vision. It happens when both eyes fail to work together properly. If you have binocular double vision, your vision will usually return to normal if either eye is covered. Physiological double vision You may experience physiological double vision when objects in your background field of vision, which you're not specifically focusing on, appear double. Your brain usually compensates for this type of double vision, and it often goes unnoticed. However, children who complain of having double vision sometimes have physiological double vision. Driving If you have just developed double vision, or you have other eye-related conditions, your driving ability is likely to be affected. Check with your GP or ophthalmologist (eye care specialist) if you have an eye condition and you're unsure whether it affects your ability to drive safely.

If problems with your vision affect your ability to drive and you hold a current driving licence, it's your legal obligation to inform the Driver and Vehicle Licensing Agency (DVLA). Visit the GOV.UK website to find out how to tell the DVLA about a medical condition . Page last reviewed: 24/12/2014 Double Vision Causes, Symptoms & Treatment Medical Author: Patricia S. Bainter, MD Patricia S. Bainter, MD Dr. Bainter is a board-certified ophthalmologist. She received her BA from Pomona College in Claremont, CA, and her MD from the University of Colorado in Denver, CO. She completed an internal medicine internship at St. Joseph Hospital in Denver, CO, followed by an ophthalmology residency and a cornea and external disease fellowship, both at the University of Colorado. She became board certified by the American Board of Ophthalmology in 1998 and recertified in 2008. She is a fellow of the American Academy of Ophthalmology. Dr. Bainter practices general ophthalmology including cataract surgery and management of corneal and anterior segment diseases. She has volunteered in eye clinics in the Dominican Republic and Bosnia.

She currently practices at One to One Eye Care in San Diego, CA. Medical Editor: William C. Shiel Jr., MD, FACP, FACR William C. Shiel Jr., MD, FACP, FACR Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology. Share Your Story There are dozens of causes of double vision ranging from benign to life-threatening. Therefore, it is important for the doctor to carefully review the history and the examination to determine the cause and initiate appropriate treatment when necessary. Sometimes, emergency treatment is needed. Most causes of monocular diplopia stem from poor focusing of light by the eye. Refractive errors ( myopia , hyperopia , astigmatism ) are common. Dry eye (from a variety of causes such as meibomitis, Sjögren's syndrome , and decreased tear production following refractive surgery) can produce diplopia that varies with blinking.

Cataracts (clouding of the natural lens ) and posterior capsule opacification (after cataract surgery ) are common in people over 60 years of age. Other conditions that interfere with proper focusing of light include corneal irregularity from swelling or scars and retinal conditions, such as epiretinal membranes. Rarely is the underlying cause a medical emergency in cases of monocular diplopia. Binocular diplopia on the other hand is produced by a misalignment of the eyes, which can be caused by life-threatening conditions. For example, aneurysms, strokes, trauma ( head injury ), and brain swelling (such as from brain cancer ) can interfere with the nerves that control the extraocular muscles. The extraocular muscles move the eyes in different direction of gaze, much like the strings on a marionette, and when one or more muscle is weakened or paralyzed, it is referred to as cranial nerve palsy. In multiple sclerosis , lesions in regions of the brain that control eye alignment may result in diplopia that varies over time. Guillain-Barré syndrome can produce diplopia from restricted eye movement due to nerve damage. Migraine headaches can cause a sudden but temporary eye misalignment.

Diseases such as myasthenia gravis can interfere with the communication between the nerves and the eye muscles to cause diplopia. And the eye muscles themselves can be damaged or compressed by conditions such as Graves' disease (often associated with thyroid disease ), orbital inflammations, vascular disease (as seen with diabetes and high blood pressure ), and others. Following traumatic fracture of the orbital bones, muscles and orbital tissue may be trapped in the fracture, leading to restriction of eye movement in certain directions of gaze. Sometimes the cause is relatively harmless, such as when the eye muscles or neurologic signals to the muscles weaken with fatigue or illness. Inability to align the eyes when focusing on a near object (convergence insufficiency) is a common benign cause of intermittent binocular diplopia that can often be treated with prism glasses. Medically Reviewed by a Doctor on 5/26/2016 DIPOPIA - DOUBLE VISION HOME | VISION PROBLEMS Doctors use prism to correct for either vertical or horizontal misalignments in a person�s eye position.

The normal result of this is that the patient starts with double vision (Diplopia), the doctor then induces prism into the prescription, and hopefully after the end result is done, the person sees one image again. Doctors test for the need for vertical and horizontal prism using a Worth Four Dot Flashlight with a special pair of eyeglasses with one lens red and one lens green. Most people who are making eyeglasses are always following the instructions of the worksheet that is in front of them. Lab techs are not licensed opticians in most cases. When a person enters measurements for a client with prisms, it is more common than not that after the lenses are cut, they are in the wrong spot consistently over and over again, which is Einstein�s Theory of Insanity. What actually happens is that all these high tech layout machines for cutting eyeglass lenses are done on photography. When you put an eyeglass lens into this unit, the prism displaces the fitting cross on the other side of the eyeglass lens. What really has to happen here is that they eyeglass lenses have to be placed onto the tracer into a compensated place to end up with the lenses aligning properly.

Also very common is that people with large astigmatisms with oblique axes, generally will get their lenses back from the laboratory twisted due to the same kind of phenomenon that happens. We recognize these problems at the Vision Fore Golfing laboratory and we will compensate for this so that your eyeglasses do turn out accurate. While correcting for vertical or horizontal misalignments is a challenge when manufacturing eyeglasses, golfers who may have stopped playing because of double vision can now get back on the course with our custom made Vision Fore Golfing Eyeglasses. DIPLOPIA commonly known as double vision, is the perception of two images from a single object. The images may be horizontal, vertical, or diagonal. When a object (A) is closer to the person than the fixation point (F). The images of (A) fall on non-corresponding points of the two retinas. The images are then projected on to different points and vision become blurred. BINOCULAR DIPLOPIA Double vision can occur when the two eyes are not correctly aligned while aiming at an object, such as in esotropia and exotropia - these result in uncrossed diplopia and crossed diplopia, respectively (i.e.

"crossed eyes", in esotropia, result in uncrossed diplopia). When the eyes are misaligned and aimed at different targets, two non-matching images are sent to the viewer's brain. When the viewer's brain accepts and uses two non-matching images simultaneously, double vision results. Double vision is dangerous to survival, therefore, the brain naturally guards against its occurrence. In an attempt to avoid double vision, the brain can ignore one eye (suppression). Due to the brain's ability to suppress one eye, double vision can appear to go away without medical evaluation or treatment. The causes of the double vision are very likely still present and loss of vision in one eye can occur due to lack of treatment. The loss of vision in one eye can be temporary or permanent depending on detection and treatment. It is in this way, that diplopia contributes to loss of depth perception and binocular vision, amblyopia (lazy eye), and/or strabismus (deviating eye). MONOCULAR DIPLOPIA Diplopia can also occur when viewing with only one eye; this is called monocular diplopia, or where the patient perceives more than two images, monocular polyopia.

In this case, the multiple vision can be caused by a structural defect in the vision system, such as cataracts, subluxation of the crystalline lens or Keratoconus causing irregularities in the refraction of light within the eye. TEMPORARY DIPLOPIA Temporary diplopia can also be caused by intoxication from alcohol or head injuries, such as concussion. If temporary double vision does not resolve quickly, one should see an eye doctor immediately. It can also be a side effect of the anti-epileptic drugs Phenytoin and Zonisamide. Treatment for binocular diplopia Treatment for binocular diplopia includes prism lenses and/or vision therapy. Daily wear of prism lenses is the passive compensatory treatment. Vision therapy is an active treatment which retrains the visual and vestibular systems (brain, eye muscles, and body). Vision therapy may eliminate the need for daily wear of prism lenses.

Torsional diplopia | definition of torsional diplopia by Medical dictionary Torsional diplopia | definition of torsional diplopia by Medical dictionary Related to torsional diplopia: horizontal diplopia diplopia [dĭ-plo´pe-ah] the perception of two images of a single object; called also double vision . binocular diplopia double vision in which the images of an object are formed on noncorresponding points of the retinas. crossed diplopia horizontal diplopia in which the image belonging to the right eye is displaced to the left of the image belonging to the left eye (divergent strabismus). direct diplopia horizontal diplopia in which the image belonging to the right eye appears to the right of the image belonging to the left eye (convergent strabismus). horizontal diplopia diplopia in which the two images lie in the same horizontal plane, being either direct or crossed. vertical diplopia diplopia in which one image appears above the other in the same vertical plane.

di·plo·pi·a diplopia /di·plo·pia/ (dĭ-plo´pe-ah) the perception of two images of a single object. binocular diplopia double vision in which the images of an object are formed on noncorresponding points of the retinas. crossed diplopia diplopia in which the image belonging to the right eye is displaced to the left of the image belonging to the left eye. direct diplopia that in which the image belonging to the right eye appears to the right of the image belonging to the left eye. homonymous diplopia direct d. horizontal diplopia that in which the images lie in the same horizontal plane, being either direct or crossed. monocular diplopia perception by one eye of two images of a single object. paradoxical diplopia crossed d. torsional diplopia that in which the upper pole of the vertical axis of one image is inclined toward or away from that of the other. vertical diplopia that in which one image appears above the other in the same vertical plane.

diplopia di·plo′pic (-plō′pĭk, dĭ-plŏp′ĭk) adj. diplopia [diplō′pē·ə] Etymology: Gk, diploos + opsis, vision double vision caused by defective function of the extraocular muscles or a disorder of the nerves that innervate the muscles. It occurs when the object of fixation falls on the fovea in one eye and a nonfoveal point in the other eye or when the object of fixation falls on two noncorresponding points. Also called ambiopia . Compare binocular vision . diplopia Double vision Ophthalmology A condition whereby a single object appears as 2 di·plo·pi·a [G. diplous, double + G. ōps, eye] diplopia Double vision. The perception of two images of a single object. This occurs in squint (strabismus) when both eyes are not aligned on the object of interest. Diplopia with one eye is rare but possible.

Diplopia Mentioned in: Nasal Trauma diplopia The condition in which a single object is seen as two rather than one. This is usually due to images not stimulating corresponding retinal areas. Other causes are given below. Syn. double vision (colloquial). See differential prismatic effect; haplopia ; myasthenia gravis ; retinal corresponding points ; polyopia ; multiple sclerosis ; strabismus ; diplopia test; triplopia . binocular diplopia Diplopia in which one image is seen by one eye and the other image is seen by the other eye. crossed diplopia See heteronymous diplopia . heteronymous diplopia Binocular diplopia in which the image received by the right eye appears to the left and that received by the left eye appears to the right. In this condition the images are formed on the temporal retina. Syn. crossed diplopia. homonymous diplopia Binocular diplopia in which the image received by the right eye appears to the right and that received by the left eye appears to the left. In this condition, the images are formed on the nasal retina. Syn. uncrossed diplopia.

incongruous diplopia Diplopia present in individuals with abnormal retinal correspondence in which the relative positions of the two images differ from what would be expected on the basis of normal retinal correspondence. Example: an exotrope experiencing homonymous diplopia instead of heteronymous diplopia. Syn. paradoxical diplopia. See abnormal retinal correspondence . monocular diplopia Diplopia seen by one eye only. It is usually caused by irregular refraction in one eye (e.g. in early cataracts, corneal opacity) or by dicoria or polycoria. It may be induced by placing a biprism in front of one eye. See ghost image ; luxation of the lens . paradoxical diplopia See incongruous diplopia . pathological diplopia Any diplopia due to an eye disease (e.g. proptosis), an anomaly of binocular vision (e.g. strabismus), a variation in the refractive index of the media of the eye (e.g. cataract), a subluxation of the crystalline lens, or to a general disease (e.g. multiple sclerosis, myasthenia gravis).

See exophthalmos ; luxation of the lens . physiological diplopia Normal phenomenon which occurs in binocular vision for non-fixated objects whose images fall on disparate retinal points. It is easily demonstrated to persons with normal binocular vision: fixate binocularly a distant object and place a pencil vertically some 25 cm in front of your nose. You should see two rather blurred pencils. The observation of physiological diplopia has been found to be useful in the management of eso or exo deviations, suppression, abnormal retinal correspondence, etc. (Fig. D4). See Brock string; retinal disparity . diplopia test See diplopia test. uncrossed diplopia See homonymous diplopia . Fig. D4 Physiological diplopia. The subject fixates a distant object A di·plo·pi·a [G. diplous, double + G. ōps, eye] diplopia (diplō´pēə), n seeing a single object as two images. May occur after fracture of the bony orbital cavity as a result of displacement of the globe of the eye inferiorly. diplopia seeing two images; double vision.

Patient discussion about diplopia Q. what is the cause for double vision A. Double vision, or diplopia, as it's called, may be due to many conditions, including disorders of the muscles of the eye (extra-ocular muscles) and the nerves controlling them, disorders of the eye ball (enlarged eyeball as in Graves' ), and sometimes disorders of vision. Diplopia may manifest important conditions, so consulting a doctor (e.g. neurologist or ophthalmologist) may be wise. You may read more here: Diplopia | Everything About Your Eyes Everything About Your Eyes Friends Diplopia Diplopia, commonly known as “double vision”, it is the simultaneous perception of two images of a single object that may be displaced horizontally, vertically or diagonally. There are numerous causes of diplopia including infection, autoimmune, neoplastic, neuropathy and causes derived from systemic disease such as diabetes or myasthenia gravis. Let’s break down diplopia and try to explain this condition a little bit more. Binocular double vision can be the results of the following (yeah that’s a long list): Damage to the third, fourth, or sixth cranial nerves, which control eye movements.

Cancer Lyme Disease Keratoconus Most commonly diplopia is the result of a binocular issues, where both eyes are involved. However, monocular diplopia can occur. Monocular diplopia refers to double vision when viewing with only one eye. Corneal surface problems such as keratoconus, high astigmatism, severe dry eyes, sublaxtion or displacement of intraocular lens after cataract surgery, and even a wrong glasses prescription can cause monocular diplopia. Bioncular diplopia occurs when there is a misalignment of the two eyes relative to each other. This can happen because of the conditions listed above. Serious problems such as brain tumors, aneurysms and strokes can also be the cause of double vision. Some people are born with eyes that don’t work together, a condition called strabismus. Eyes can be crossed inward or turn outward. One eye can even go up while the other goes down. The treatment for double vision depends on the underlying conditions causing double vision. Generally, treatments for double vision can include surgery, vision therapy, prism in the glasses prescription or medications.

It’s important to have a comprehensive eye exam to help determine the cause of the double vision as soon as possible. Your eye doctor may then treat the double vision or send you to a specialist such as a neurologist. Double Vision (Diplopia) Guide: Causes, Symptoms and Treatment Options Double Vision (Diplopia) What Is It? Double vision, also called diplopia, causes a person to see two images of a single object. There are two types of double vision: monocular and binocular. Monocular diplopia is double vision in only one eye. The double vision continues even when the other eye is covered. The doubling does not go away when you look in different directions. Monocular diplopia can be caused by: Astigmatism — This is an abnormal curvature of the front surface of the cornea. Keratoconus — The cornea gradually becomes thin and cone-shaped. Pterygium — This is a thickening of the conjunctiva, the thin mucous membrane that lines the inner surface of the eyelids and the whites of the eyes. The thickening extends on the cornea, the clear part of the surface of the eye. Cataracts — The lens gradually becomes less transparent.

Risk factors include being older than 65, having eye trauma or long-term diabetes, smoking, using steroid medications or having radiation treatments. A dislocated lens — The ligaments that hold the lens in place are broken, and the lens moves out of place or wiggles. This can be caused by trauma to the eye or a condition known as Marfan's syndrome. A mass or swelling in the eyelid — This condition can press on the front of the eye. Dry eye — Your eyes do not produce enough tears. Some retinal problems — Double vision can happen when the surface of the retina is not perfectly smooth, which can have a variety of causes. Binocular diplopia is double vision related to a misalignment of the eyes. The double vision stops if either eye is covered. Any problem that affects one or more of the muscles around the eyeball that control the direction of the gaze can cause binocular diplopia. These are called extraocular muscles. Such problems include: Strabismus — This is a childhood misalignment of the eyes that affects about 4% of children younger than age 6.

Damage to nerves controlling the extraocular muscles — Nerves can be injured by brain damage caused by infection, multiple sclerosis, stroke, head trauma or a brain tumor, especially a tumor located at the lower back portion of the brain. A tumor growing inside the eye socket or trauma to the eye socket can damage a nerve anywhere along its route to the eye muscles. Diabetes — This disease can lead to problems with the nerves that control eye muscle movements. Sometimes this can happen before the person is aware that he or she has diabetes. Myasthenia gravis — This is a neuromuscular illness that causes the body's muscles to tire easily and become weak. It occurs because the body's immune system mistakenly attacks the places where nerves transmit impulses to muscles, telling the muscles to contract. Graves' disease — This is the most common cause of an overactive thyroid (hyperthyroidism). Some people with Graves' disease develop double vision due to swelling and thickening of the muscles that move the eyes within the eye socket. Trauma to the eye muscles — The muscles of the eye socket can be injured by facial trauma, especially by a fracture of the thin bones of the eye socket. Symptoms The only symptom is seeing two images of a single object.

Diagnosis The first step is to determine whether your double vision is monocular or binocular. To do this, your doctor will ask you to cover one eye and then the other. If you have monocular diplopia, your doctor will evaluate you for conditions, such as cataracts, that could be causing the problem. You will then need to see an eye specialist (an ophthalmologist). If the problem is binocular and there has been no facial trauma, then your doctor will want to know if you have diabetes, Graves' disease or neurological disorders. In diagnosing binocular diplopia, your doctor has to determine which eye muscles are affected. To do this, you will be asked to look at the doctor's finger as he moves it up, down, left and right. This lets the doctor see how far your eye can move in each direction. Your doctor also will cover one eye and then the other, while you focus on a target. If the doctor sees your eyes shift as the eye cover is moved, it means your eyes are not aligned properly. Prisms may be placed over your eye to shift the image, and the test is repeated.

The prisms allow the doctor to measure the amount or degree of your double vision when you look in different directions. This helps to diagnose the problem and monitor the problem over time. Your doctor will use the results of this exam, together with your medical history and additional symptoms, to determine if you need more tests. For example, if your doctor suspects that you have hyperthyroidism, then you will need blood tests to measure thyroid hormone levels. If your doctor suspects that something is affecting the nerves to your eye muscles, you may need a magnetic resonance imaging (MRI) or computed tomography (CT) scan of your head to check for signs of trauma, bleeding, tumor or blood vessel malformations in the brain. In most cases, double vision is easy to pinpoint in adults, because they can describe what they are seeing. Symptoms are tougher to pinpoint in children, who may not be able to explain what is wrong. Parents may notice that the child is squinting, covering one eye with a hand, tilting or turning the head abnormally, or looking sideways. Expected Duration How long your double vision lasts depends on what is causing it.

For example, cataracts and pterygium may become worse over time, but both can be corrected immediately with surgery. In people whose double vision is caused by diabetes, the nerve often regrows after several months. When this happens, double vision gradually disappears. Children with double vision caused by strabismus can improve with treatment. Prevention Some causes of double vision can be prevented. To help prevent double vision related to head trauma, wear a seat belt with a shoulder harness while driving, and wear protective goggles and headgear during sporting activities and at work, if your work carries a high risk of eye injury. People with diabetes can decrease their chance of nerve damage, which can lead to double vision, by controlling blood sugar. There is no way to prevent age-related cataracts or some other forms of double vision. Treatment Treating double vision depends on its cause. For example, people with astigmatism that causes double vision can wear special contact lenses. Sometimes, simply updating your prescription eyeglasses takes care of the problem. Surgery is used to treat cataracts and pterygium, and surgery on the eye muscles can treat certain types of double vision.

Often, adjustable stitches are used so that the position of the eyes can be fine-tuned a few hours after the surgery. That way, the patient is alert for the adjustment and can report whether the double vision is gone. Prisms also may be used in the glasses to fine-tune the surgery by moving the image seen with one eye to coincide with the other eye. For children with strabismus, treatment includes wearing prescription eyeglasses, prism vision therapy to train the eyes to align properly, or surgery. Double vision caused by a medical or neurological disease may improve by treating the disease. Eye specialists may consider other strategies to help improve the eye movements. Injections of botulinum toxin ( Botox ) can weaken strong eye muscles opposite the weakened one to help balance vision. When To Call A Professional Call your doctor right away if you have a dramatic change in vision or sudden difficulty seeing clearly. Children should have their first eye exam before they are 6 months old, with a follow-up exam at age 3. Adults older than age 40 should have an eye examination every two years, even if they have no noticeable vision problems. Prognosis The outlook for double vision depends on its cause.

For example, surgery improves the vision of more than 90% of patients with cataracts. Although surgery also can remove a pterygium, the abnormal growth can come back and eventually become larger than the original. For most children with strabismus, the prognosis is excellent if the condition is detected and treated early. Learn more about Double Vision (Diplopia) Symptom checker: Diplopia and Ocular Muscle Balance | Fitness to Work Guidelines Fitness to Work Guidelines AVIATION MARINE MOTOR RAIL MOTOR - CCMTA Medical Standards for Drivers Diplopia (double vision) is the simultaneous perception of two images of a single object. These images may be displaced horizontally, vertically or diagonally in relation to each other. Diplopia can be binocular or monocular. Binocular diplopia is present only when both eyes are open, with the double vision disappearing if either eye is closed or covered. Monocular diplopia is also present with both eyes open, but unlike binocular diplopia, the diplopia persists when the problematic eye is open and the other eye is closed or covered.

Binocular diplopia, or true diplopia, is an inability of the visual system to properly fuse the images viewed by each eye into a single image. It may be caused by the physical misalignment of the eyes (strabismus) or diseases such as Parkinson’s disease or multiple sclerosis. Two of the most common causes of binocular diplopia in people over 50 are thyroid conditions, such as Grave’s disease, and cranial nerve damage. Monocular diplopia is not caused by misalignment, but rather by problems in the eye itself. Astigmatism, dry eye, corneal distortion or scarring, vitreous abnormalities, cataracts and other conditions can cause monocular diplopia. Prevalence There are no data on the prevalence of diplopia. Adverse driving outcomes There is little or no research on diplopia or nystagmus and driving performance. Guidelines for assessment This guideline applies to drivers with diplopia within the central 40 degrees of primary gaze (i.e. 20 degrees to the left, right, above, and below fixation).

STANDARD Opinion of vision specialist whether adequate adjustment has occurred Rationale Consensus medical opinion in Canada indicates that a individual who has diplopia within the central 40 degrees of primary gaze is not eligible for a licence unless they can compensate for this impairment by wearing an eye patch or prism lenses while driving. Nystagmus Nystagmus is an involuntary, rapid, rhythmic movement of the eyeball. The movements may be horizontal, vertical, rotary or mixed. Nystagmus which occurs before 6 months of age is called congenital or early onset, whereas that occurring after 6 months is labelled acquired nystagmus. Early onset nystagmus may be inherited, or the result of eye or visual pathway defects. In many cases, the cause is unknown. Causes of acquired nystagmus are many and it may be a symptom of another condition such as stroke, multiple sclerosis, or even a blow to the head. Many individuals with nystagmus have significant impairments in their vision, with some having low vision or legal blindness. Prevalence Although the prevalence of nystagmus is not accurately known, the condition is believed to affect around 1 in 5,000 individuals.

Adverse driving outcomes There is little or no research on diplopia or nystagmus and driving performance. RAIL - Canadian Railway Medical Rules Handbook Screening for extra-ocular muscle disorders that could result in double vision is accomplished, in part, through the medical history. A history of double vision, strabismus, turned eye, eye exercises, or a lazy eye require further assessment. There are also a number of systemic conditions where there is an increased likelihood of diplopia. Examples of these conditions include Grave’s disease (i.e. hyperthyroidism), diabetes, stroke, multiple sclerosis, and myasthenia gravis. The visual acuity standard is the other part of the screening process. Failure to meet the acuity standard in the worse eye may be a result of a strabismus or long-standing ocular muscle problem, particularly in the younger individuals. Individuals who have been identified as being at risk for developing diplopia either by their medical history or visual acuity should be assessed further by an eye care professional. Assessment Methods The medical history can be used to identify individuals who are at risk of developing double vision while at work.

These risk factors include a past history of double vision, strabismus, turned eye, lazy eye, eye training exercises, or extra-ocular muscle surgery. There are also a number of systemic conditions that are associated with an increased risk of diplopia. Examples include Grave’s disease (i.e. hyperthyroidism), diabetes, stroke, multiple sclerosis, and myasthenia gravis. Individuals who have any of these risk factors should be assessed further by an optometrist or ophthalmologist to determine the likelihood of developing double vision. Failure to meet the acuity standard in the worse eye may be a result of a strabismus or longstanding ocular muscle problem, particularly in the younger individuals. Individuals who fail to meet the worse eye acuity should also be referred to determine the cause of the reduced visual acuity and whether diplopia is likely. Diplopia within 30 degrees of fixations can be tested by the Broad H test. The Broad H test is common screening procedure to test the integrity of cranial nerves III, IV, and VI.

The examiner asks the individual to follow his pen (or similar object) without moving their head as the examiner traces out an “H” pattern in front of the individual. The examiner starts with the pen directly in front of the individual and moves it slowly to the right approximately 30 degrees straight along a horizontal line. From this location, the examiner then moves the pen up 30 degrees, back down to the horizontal line and then down another 30 degrees in the inferior gaze. The pen is returned back to the horizontal line and then moved back through the straight ahead position to a point 30 degrees to the left of straight ahead. The upper left and lower left gaze positions are then tested by moving the pen up and down 30 degrees. The examiner looks at the individual’s eyes to make sure that they are both fixating on the target and asks the individual to report whether the pen appears double in any position. A report of diplopia or a misalignment of the eyes in any position would warrant further assessment by an eye care professional.

Fitness for Duty Criteria Individuals who experience diplopia at different eye positions within a 30º radius of their habitual straight-ahead gaze or have a restriction of eye movements within 30º of straight-ahead cannot occupy a SCP. MARINE - Medical Examination of Seafarers Physician's Guide For Marine diplopia vision standards, refer to Vision section. AVIATION - Handbook for Civil Aviation Medical Examiners Ocular muscle balance can be tested with the cover test, the Maddox rod or an approved vision tester. Report the results of the cover test in the space provided. The Maddox rod results should be noted in the appropriate spaces. Checking the orthophoria box means that there is no deviation and the other spaces can be left blank. Any deviations should be noted in the esophoria, exophoria and hyper phoria boxes. Maddox Rod Test - This is described in detail in Appendix 1 and on the aviation vision video. The results should be recorded in the number of dioptres of esophoria, etc.

The use of this instrument is demonstrated in the video "The Vision Examination for Aviation Medical Examiners" Cover Test - The purpose of this test is to determine whether manifest strabismus is present, or whether there is any tendency of the eyes to deviate when the two eyes are dissociated. The examiner stands in front of the candidate who is told to fix his eyes on a small target such as a small examining light. An occluder card is then placed in front of one eye and the other eye checked for movement. If there is none the card is removed and the covered eye examined to see whether it has remained fixed or whether it has moved medially or laterally and has to be re-fixated. The test is then repeated with the other eye covered. If the candidate is orthophoric no movement of the eyes will take place. If there is esophoria one eye will move in and then re-fixate when the occluder is removed. In exophoria the opposite is true. It should be noted that less than 10% of individuals are orthophoric! Figure 3 - Vision Standards

Question: Double vision, the perception of two images from a single object, is properly called what?
Answer: Diplopia