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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Double vision when look directly down which gives me double

Resolved Question:

Double vision when look directly down which gives me double images stacked on top of each other when I read, look down at my phone or computer keyboard. Short puts on the golf course are very hard to make. Started 3 weeks ago and has not improved. Have seen my eye doctor but need a second opinion.
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Other than the recent sinus infection, do you have any medical problems or take any medication?

Dr. Rick :

What happens if you close one eye?

Dr. Rick :

Do you have double vision when looking at the computer screen with both eyes open, or when looking off in the distance?

Expert:  Dr. Rick replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick : Other than the recent sinus infection, do you have any medical problems or take any medication?
Dr. Rick : What happens if you close one eye?
Dr. Rick : Do you have double vision when looking at the computer screen with both eyes open, or when looking off in the distance?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.
Customer: replied 1 year ago.

I am hypertensive(controlled) and type 2diabetic(controlled)...I take medication for both conditions


 


NO PROBLEM WITH ONE EYE CLOSED...ONLY BOTH EYES AND ONLY LOOKING DOWN OR CLOSE UP

Expert:  Dr. Rick replied 1 year ago.
OK. Well, what this tells me is that you have a problem with the functioning of one or more of the muscles that move your eyeball.

From what you are saying, I would venture a guess that the problem is possibly with your medial rectus muscles and/or your superior oblique muscle.

Statistically speaking, the superior oblique, which is controlled by the 4th cranial nerve, is more likely to be the culprit. But, without doing a complete eye exam I can't pinpoint it any further.

I suggest you see an ophthalmologist for a complete eye exam as she will easily be able to figure this out.

As what the prognosis is and what to do, that depends on the primary cause of your double vision.....

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 1 year ago.


WAS THE SINUS INFECTION A POSSIBLE CULPRIT?


 


DOES THIS CONDITION USUALLY SELF CORRECT?


 


ANYTHING I CAN DO IN THE MEANTIME?

Expert:  Dr. Rick replied 1 year ago.
Oops! I forgot that part of the question. my bad :(

Unless the sinus infection spread to your orbit, no. I would not have anything to do with the double vision.

As to whether it will self correct, that depends on what is causing the double vision, what nerve is involved etc. If you have already seen an eye doctor and had a diagnosis...and if you share that diagnosis with me....I can give you direct answer.

To take care of the problems reading you can wear a "pirate patch" over one eye when reading, or if you use bifocals, put scotch tape across the bifocal on your glasses.

Does this make sense to you?

Expert:  Dr. Rick replied 1 year ago.
I just want to make part of my answer clear:

The scotch tape would only be applied to one bifocal lens, the other one would be left alone.

Customer: replied 1 year ago.

MY EYE DOCTOR HAS DONE THOROUGH EXAMINATIONS AND RULED OUT AN OPTHAMOLOGICAL ETIOLOGY AND BASICALLY CONCLUDED IT IS A NEUROLOGICAL. HER CONCLUSIONS ARE SIMILAR TO YOURS. SHE THOUGHT I OUGHT TO WAIT 30 DAYS AND IF THE CONDITION HAS NOT SELF CORRECTED THEN GET A MRI BRAIN SCAN AND WE WILL GO FROM THERE. MY ENT WANTED TO DO AN MRI OF THE SINUSES BUT I THINK I WILL WAIT THE 30 DAYS AND SEE IF IT LEAVES AS QUICKY AS IT CAME. IT IS VERY IRRITATING NOT TO BE ABLE TO TREAT

Expert:  Dr. Rick replied 1 year ago.
Was your eye doctor an ophthalmologist, a neuro-ophthalmologist, a pediatric ophthalmologist (the true experts in this area) or an optometrist?

I do not usually use an MRI in the workup of double vision....but that, of course, depends on what else is going on with the patient and what my exam shows.

Like I said above, it is safe for you to mash the positive feedback button....I won't run off on you :)
Customer: replied 1 year ago.


She is a Doctor of Optometry ..

Expert:  Dr. Rick replied 1 year ago.
Ok. The problem you discussed in your thread it beyond the ability of an optometrist to diagnose and treat.

I would make an appointment with an ophthalmologist for a full eye exam to make sure what is really going on.


It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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