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Ask Dr. Dan B. Your Own Question

Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3164
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Ok, so for the past 3 months iv been experienceing monocular

Customer Question

Ok, so for the past 3 months iv been experienceing monocular diplopia in both eyes, or ghosting. it is always vertical so i see an image above or below something, i find when i wake up in the morning it is a lot better but gradually gets worse and worse as the day goes on. The image is clear and not doubled through a pinhole so i assume this rules out nuerological causes? im currently waiting to see a consultant opthamologist but am very scared i have a brain tumour. I have worn glasses all my life for short sightedness and astigmatism. In your opinion what is the most likely cause of this?
THANKYOU
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 2 years ago.

Doctor DanB : Hello and thanks for your question. Who did your eye test and exam? An optometrist (OD), an ophthalmologist (MD), or someone else?
Customer :

i went to specsavers opticians and then an eye emergency department

Customer :

hi are you there?

Doctor DanB : Did they test you for a new glasses prescription?
Customer :

hi yes they did

Customer :

they said the lenses in my glasses did not line up with my pupils

Customer :

but the optician was not sure if that was the problem and mentioned something called keractonus?

Doctor DanB : Are they remaking your glasses to line up the lenses with your pupils?
Customer :

no, well they refered my to a consultant at the eye hospital , incase i wasted another £200 and the new glasses did not work, i must add the optician did not think that would make me have diplopia and there was another cause

Doctor DanB :

Okay, let me put you at ease here. Monocular diplopia (or diplopia that is happening only when one particular eye is open) is almost universally a refractive cause, or something changing the refractive status of the eye. Let me elaborate...

Doctor DanB :

95% of the time, this refractive problem is caused by an inappropriately corrected refractive error that you have. That can range anywhere from not having the correct prescription in your glasses to having the glasses decentered (as you were told yours were). So, yes, having your glasses decentered can absolutely cause this type of phenomenon!

Customer :

ah ok thankyou, i mean it happens in both eyes but invdividually if you get what i mean

Doctor DanB :

Does that make sense?

Customer :

yes it does, thankyou

Customer :

does it still apply if its happening with both eyes?

Customer :

but is monocular in nature

Doctor DanB :

Absolutely--if both eyes' lenses are decentered, it can still do this.

Customer :

ok thankyou, i mean iv had the same glasses for like 12 months and just one day i woke up put my glasses on and the ghosting occured,

Doctor DanB :

That is a bit odd, I admit. But even still, monocular diplopia is almost never a sign of anything serious, like a brain tumor. Yes, keratoconus can cause this also, but that isn't a life-threatening condition, and it would also be an odd presentation for it. I suspect that you are likely just in need of new glasses, but the complete dilated eye exam by the ophthalmologist is the most important thing, just to rule out other things that can cause this (again, which are almost never serious). I wouldn't trust an optician to diagnose causes of monocular diplopia, anymore than I would trust a chef to do heart surgery.

Customer :

one last question, is it possible a brain tumour would cause this, last 6 months iv been suffering terrible headaches and have had a ct scan and it was all clear so im just wondering if that could cause the double vision possibly

Customer :

haha ok thankyou

Doctor DanB :

No, brain tumors don't cause monocular diplopia--if your CT of the head was normal, that essentially rules out a brain tumor also. Headaches are very common, unfortunately, and usually aren't the sign of some significant neurological issue. Try to relax with this because I seriously doubt anything serious is going on here.

Customer :

ok thanks very much you have put me at ease

Doctor DanB :

You're welcome.

Do you have any other concerns or questions about this topic?

Customer :

no you have covered everything, im very greatfull for that

Doctor DanB :

Great. Good luck. Please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.

Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. There will be an opportunity to provide either or both of these after you press the ACCEPT button. Thanks for your inquiry!

My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

Customer :

Hi sorry me again lol, just another question when i look at text on a pc or on tv i get an image below and above the actual image, so would this mean that i suffer from polyopia and not diplopia? on other things this is not the case, thankyou

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