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Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2069
Experience:  MS Ophthalmology with 11 years of surgical expereince
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I experience vertical double vision in both eyes after watching

Resolved Question:

I experience vertical double vision in both eyes after watching TV for 2 hours or more. The double vision gradually goes away 3 to 4 hours after I stop watching TV. I have noticed this since age 34 or so. I am 76 now. Cataract surgery with Crystal Lens replacemets made no difference in that I experience the same vertical double vision after watching TV. My vision was 20-20 until age 40 or so. I took no medications until I was diagnosed with Type 2 Diabetes at age 50. This double vision is an annoyance to me and I am curious as to what causes this. I have asked many other persons about this and only 1 person experienced this TV watching induced vertical double vision.
Submitted: 9 months ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 9 months ago.

Dr. A.S. Desai :

Hello, Thank you for the question.I am Dr.A.S.Desai and I look forward to assisting you .

Dr. A.S. Desai :

Are you available for chat now?

Dr. A.S. Desai :

Occasional double vision or diplopia could be due eye muscle imbalance. However such muscle imbalance is more often seen as horizontal diplopia.

Dr. A.S. Desai :

Vertical diplopia can occur due to superior oblique muscle weakness.

Customer:

I am available for chat

Dr. A.S. Desai :

It is difficult to explain why such a diplopia is noticed only while watching TV.

Dr. A.S. Desai :

It would be better to get your eyes examined by a squint specialist who can specifically look for superior oblique muscle function.

Customer:

I see an opthomologist regularly and he does not give me a clear answer. If I cover one, I still see vertical double vision with the other eye.

Dr. A.S. Desai :

Superior muscle weakness can either be congenital (since birth) or can occur later in life following trauma.

Dr. A.S. Desai :

Ok. If the double vision continues to persist even after covering one eye, then it could be due to high astigmatism. But this would have resulted in persistent diplopia and not just after watching TV.

Customer:

I did not experience this vertical double vision at age 18 when I watched TV for an hour or so. I did not watch TV again until I was 34 as I lived in a location where there was no TV. I have not experienced trauma. Both eyes have the temporary double vison in the same way.

Dr. A.S. Desai :

Your condition is certainly very different and would require a detailed eye exam by a squint specialist. If the eye muscles are found to be functioning normally, then there is a remote possibility of this being a variant of migraine without headache.

Customer:

My opthomolgist sees me every 6 months and performs a diabetic retenopathy check My vision is close to 20-20.

Customer:

Also, my vertical double vision does not start when I start TV viewing, rather it starts to slowly build up as TV viewing time goes on. after 2 or more hours, the double vision is quite noticeable.

Customer:

Is there any other information I could give you that might help answer my question?

Dr. A.S. Desai :

Interesting observation. Until you get through to visit a squint specialist, you can try using lubricating eye drops regularly, 1 drop 4 to 5 times a day. These are available OTC such asRefresh tears eye drops.

Dr. A.S. Desai :

Yes, does the double vision disappear momentarily on blinking?

Customer:

No

Dr. A.S. Desai :

In that case it may not due to any tear film issue. I strongly believe that the superior muscle needs to be evaluated in detail. It's weakness can get precipitated under stress or in your case after watching TV for few hours.

Customer:

What function does the superior perform?

Customer:

Both eyes perform the same regarding this vertical double vision

Dr. A.S. Desai :

The superior oblique muscle is supplied by the fourth cranial nerve. When affected it can cause vertical diplopia. If both eyes have similar problem then we have to investigate for myasthenia gravis.

Customer:

I have heard of myasthenis gravis. I have experienced this TV watching induced vertical double vision for over 40 years.

Dr. A.S. Desai :

Myasthenia gravis or MG is an auto immune neuromuscular disease.

Dr. A.S. Desai :

I understand that your condition is very different than most and we are analysing just a few possible causes.

Dr. A.S. Desai :

Investigations are diagnostic and confirmative. It is better to be investigated for the probable conditions.

Customer:

I will ask my opthomologist to check for MG. Looks like we have persued this as far as possible.

Dr. A.S. Desai :

I tried my best to give you a satisfactory explanation.

Customer:

Thank you for your efforts.

Dr. A.S. Desai :

If you need more help, please use the reply tab to continue our conversation. If you do not require further assistance, kindly rate my service.Thank you and best wishes.It was a pleasure to have answered this question.Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2069
Experience: MS Ophthalmology with 11 years of surgical expereince
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