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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Hello, and hope you can help me. I was hit in the face 6 weeks

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Hello, and hope you can help me. I was hit in the face 6 weeks ago & have had double vision when looking up since then; and not seen any improvement to date. A CT scan (carried out 3 weeks ago) has shown no fracture to the orbital floor, but a fracture to the nasal bone (I had a procedure to realign a deviated septum 2 weeks following the injury). To date, I have seen several ophthalmologists & consultants & have been prescribed antibiotics, eye drops, pain killers & now steroid drops. My eye still has pockets of blood where the white area normally is (it's turning an orange colour now), my eye ball feels like it's aching (and appears sunken), and the area around the bone feels tender & sore. I'm having lots of headaches and my eye feels like it's pulling itself towards my nose. I've explained these symptoms at each follow-up appointment, and am being advised to sit tight as the bruising needs to settle & which is causing the eye to be restricted on movement, especially when looking up. The most recent appointment with the consultant advised that my eye is swollen & there are pockets of fat in the nasal fracture which is causing the double vision. The numbness I experienced in my cheek, upper lip & teeth has improved, with some residual feelings in my teeth remaining. My questions are:
Will the double vision improve by itself without intervention & how long should I wait until I can expect to see improvements?;
What is causing the double vision itself if it's not a fracture to the orbital area?
Should I get seen by another clinic for a second CT scan / treatment?
Would be really grateful for any advice you can give me. Thank you.

Dr. Dan B. : Hello and thanks for your question. Are you available to chat?
Dr. Dan B. : Assuming the double vision is due to the swelling/bruising of the tisssue around the fracture, then presumably this should improve as the swelling improves. If there is still significant swelling/bruising and changes to this region, then it's still understandable that the double vision persists. And therefore it may persist as long as these changes are present. However, I would expect that once the swelling subsides, if there is not entrapment of the muscles that move the eye, or there is not significant shifting of the eye inside the orbit, that the double vision would subside then.
Dr. Dan B. : I would expect that by two months after the injury, provided the swelling, brusing and so forth has resolved, that the double vision should be on its way out. If not, I would think that another reason needs to be explored for the double vision, such as entrapment of one of the extraocular muscles in a fracture, or traumatic/contusive injury to the nerve/muscle that moves the eye. In this case, I would make sure you are seeing an orbital/oculoplastic specialist who may, in fact, order another CT scan of the orbits to determine this. Does this all make sense?
Customer: Yes, it does make sense & thank you for responding to me. I've been feeling very anxious about not seeing an improvement over the past 6 weeks & the double vision is affecting my work from looking up at the PC from a position of writing to looking up. I've never had double vision before & this has been difficult to adjust to.
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