Diplopia (Double Vision)

Overview

What is diplopia?

Diplopia is the medical term for double vision or seeing double. Diplopia is defined as seeing two images of a single object when you’re looking at it.

Double vision is usually a temporary issue, but it can also be a sign of more serious health conditions. Even if it’s caused by something as simple as needing new glasses, it’s important to get your eyes examined by your healthcare provider right away if you start seeing double.

Monocular vs. binocular diplopia

Your healthcare provider will classify your double vision as either monocular (one eye) or binocular (both eyes). Monocular diplopia is present when you use only one eye at a time. It may appear as a shadow. Binocular diplopia is present when both eyes are open at the same time. It goes away if you cover one of your eyes.

Monocular diplopia is more common and usually less serious. Binocular diplopia is usually caused by your eyes being out of alignment or other, more serious underlying conditions.

Horizontal diplopia vs. vertical diplopia

If you have binocular diplopia, your double vision can appear either vertically (top to bottom) or horizontally (side to side). Which one you have depends on what’s causing your diplopia and how (or why) your eyes are out of alignment.

Who does diplopia affect?

Diplopia can affect anyone, but it’s most common in adults older than 60.

How common is diplopia?

Experiencing some form of double vision is extremely common. More than 800,000 people a year visit their healthcare provider because of diplopia. It’s also one of the most common reasons people go to the emergency room (ER). Around 50,000 people every year go to the ER because they have double vision.

How does diplopia affect my body?

The most obvious effect diplopia has on your body is the double vision itself. In addition to the physical symptoms, it can be scary when something affects your eyesight. The good news is that almost 90% of cases of double vision are temporary and have no long-term or serious implications for your health. But diplopia can decrease your depth perception, making driving or walking more difficult.

Symptoms and Causes

What are the symptoms of diplopia?

Other than seeing double, diplopia can be associated with other symptoms like:

  • Headache.
  • Nausea (upset stomach or feeling sick).
  • Dizziness.
  • Pain (including when you move your eyes).
  • Blurred or unclear vision in one or both eyes.

What causes diplopia?

There are many possible causes of diplopia. The most common causes include:

Monocular diplopia

Binocular diplopia

Diplopia caused by other conditions

Diplopia is often caused by other issues and conditions in your body and eyes. That’s why it’s so important to get your eyes checked right away when you notice any changes in your vision.

Diplopia and myasthenia gravis

People with myasthenia gravis have muscle weakness that worsens throughout the day. This can affect your ocular muscles (the muscles that control your eyes and eyelids) and cause double vision.

Diplopia and proptosis

Proptosis is the bulging of one or both of your eyes from their natural position. Bulging eyes are usually caused by thyroid issues, like Graves' disease or hyperthyroidism, and may come with diplopia.

Diplopia and keratoconus

Keratoconus occurs when your cornea (the clear part of your eye that you see through) loses its shape. Usually, your corneas are round, but keratoconus causes your cornea to bulge outward like a cone. This distorted shape causes vision issues, including diplopia.

Diplopia and vertigo

Vertigo is a sensation that the environment around you is spinning in circles. It’s usually caused by issues in your inner ear. However, if you’re experiencing severe double vision, you might feel vertigo, too. Diplopia and vertigo are usually symptoms of other issues in your body.

Diplopia and diabetes

If you have diabetes, your body isn’t able to properly process and use glucose from the food you eat. Diabetes can damage your eyes and cause symptoms like diplopia and serious issues like diabetes-related retinopathy.

Diagnosis and Tests

How is diplopia diagnosed?

Your healthcare provider will diagnose diplopia and any other conditions causing it. They’ll perform a physical exam and might ask you to see an eye specialist like an ophthalmologist or optometrist.

What tests will be done to diagnose this condition?

If you have monocular diplopia, you likely won’t need additional tests beyond having your eyes examined. If you have binocular diplopia, you might need imaging tests, including:

These tests will capture a complete picture of your eyes and the area around them. They’ll help your provider identify issues with your bones, brain or spine.

Management and Treatment

How is diplopia treated?

How your double vision is treated depends on what’s causing it. Talk to your healthcare provider about the cause of your diplopia and what needs to be done to correct it.

How can I manage my diplopia symptoms?

Follow the directions your healthcare provider gives you. Some treatments for correcting double vision involve covering one eye for a while, or wearing a special contact lens. Your healthcare provider will walk you through all the ways you can get your symptoms under control, including eliminating your diplopia.

How soon after treatment will I feel better?

It depends on what’s causing your diplopia. Some cases of double vision go away on their own, while others get better after your healthcare provider prescribes a treatment.

If you need surgery (to remove cataracts, for example) to correct the issues in your eye, it might take a few weeks for you to feel better.

Prevention

How can I prevent diplopia?

There aren’t any ways to specifically prevent experiencing double vision, but taking good care of your eyes and seeing your healthcare provider regularly are the best ways to catch issues before they cause you pain or other symptoms. Follow these steps to maintain good eye health:

  • Don’t smoke.
  • Give your eyes a break from looking at electronic screens throughout the day.
  • Wear appropriate protective glasses or goggles for all of your work, sports or other activities.
  • Schedule an eye exam every one to two years (or as often as your healthcare provider recommends).

Outlook / Prognosis

What can I expect if I have diplopia?

If you have double vision, you should expect it to be a short-term issue.

How long does diplopia last?

Most cases of diplopia are temporary. In fact, your double vision might go away on its own. If you experience double vision more than once, or if it comes and goes, you could have what’s called transient (or intermittent) diplopia. Even if your double vision clears up on its own, you should see your healthcare provider.

When can I go back to work or school?

You might need to miss work or school while you have double vision. You shouldn’t drive or do anything else that could hurt yourself or others while your vision is impaired.

What’s the outlook for diplopia?

The outlook for diplopia is very positive. It doesn’t have a long-term effect on most people. Depending on what’s causing your diplopia, you might need to make some adjustments to your daily routine.

Living With

How do I take care of myself?

Make sure you tell your healthcare provider about any changes in your vision. If you wear glasses or contact lenses, have your eyes examined regularly so your healthcare provider can adjust your prescription as often as necessary.

When should I see my healthcare provider?

See your healthcare provider as soon as you notice any changes in your vision. Whether it’s something as simple as needing new glasses, or a more serious condition, don’t wait for symptoms to get worse before having your eyes checked.

When should I go to ER?

Go to the emergency room (ER) if you’re experiencing double vision that doesn’t go away in a few hours, or if you have any other symptoms like pain, dizziness, weakness, slurred speech or confusion. Diplopia can be the first sign of a serious issue like an aneurysm or stroke, and you shouldn’t ignore it.

What questions should I ask my doctor?

  • What’s causing my double vision?
  • How long will this last?
  • Will I need to see a specialist?
  • What tests will I need?

A note from Cleveland Clinic

It’s scary whenever something is wrong with your eyes, and that’s especially true when you’re having double vision. Even though it can be a sign of something serious, diplopia is almost always a temporary issue. However, never take your eyesight for granted. Talk to your healthcare provider right away if you notice changes in your vision or something doesn’t feel right.

Last reviewed by a Cleveland Clinic medical professional on 12/15/2021.

References

  • Iliescu DA, Timaru CM, Alexe N, et al. Management of diplopia. (https://pubmed.ncbi.nlm.nih.gov/29450393/) Rom J Ophthalmol. 2017 Jul-Sep;61(3):166-170. Accessed 12/15/2021.
  • Merck Manual. Diplopia. (https://www.merckmanuals.com/professional/eye-disorders/symptoms-of-ophthalmologic-disorders/diplopia) Accessed 12/15/2021.
  • National Eye Institute. Keep your eyes healthy. (https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/keep-your-eyes-healthy) Accessed 12/15/2021.
  • NHS. Double vision. (https://www.nhs.uk/conditions/double-vision/) Accessed 12/15/2021.
  • StatPearls. Diplopia. (https://www.statpearls.com/ArticleLibrary/viewarticle/20542) Accessed 12/15/2021.

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