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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11303
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have developed double vision for the past 2 months. it

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i have developed double vision for the past 2 months. it usually only happens at night when bright light hits an object. I'm scared. I went to the eye doctor and she said my optic nerve looks amazing and she doesn't know what it can be
Dr. Rick :

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

Customer: ok :)
Dr. Rick :

Were you examined by an optometrist or an ophthalmologist?

Do you wear glasses or contacts?

When you have the double vision, what happens if you close one eye?

Do you have any medical problems or take any medication?

How long does the double vision last?

Do you have any other symptoms other then the double vision?

Dr. Rick :

Good morning :-)

Customer: optometrist. she dilated me and did everything.
Customer: double vision continues if I keep one eye closed and one eye open
Customer: no medical problems. I find myself being a hypocondrkac and tend to worry a lot about health. so I think I have anxiety
Customer: it last whenever certain lighting hits an object a certain way
Dr. Rick :

Ok. Thanks for that information

Customer: I wear glasses I have astigmatism in my right eye
Dr. Rick :

It sounds like you are suffering from a tear film/anterior segment problem. This is very common and -- the good news -- very treatable.

Dr. Rick :

Here is some information about a home therapy that will help:

Dr. Rick :

It sounds like you are suffering from an anterior segment/tear film issue. Many times, for all sorts of reasons, the anterior surface of the eye starts to have difficulties. What can cause this? Well, there are a number of conditions but the most common are dry eyes, allergies and blepharitis....many times all three conditions act together to make you miserable. In order to solve your problem you need to address all of these issues at the same time.

When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.

Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.

The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.

Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.

Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

Are you still there?

Customer: can it maybe be MS?
Dr. Rick :

No. The fact that your double vision persists when you close one eye tells me that it is an ocular problem and not a systemic issue, such as MS, brain tumor etc.

There is no reason for you to worry that this is a sign of something terrible.....

Customer: oh that's a sigh of relief. when it first started my eyes would feel burning and dry
Dr. Rick :

One other thing I have noticed in reviewing your activity on have had 7 questions answered and only accepted -- and therefor allowed the expert to be paid for their time helping you -- once.

I hope you will accept my answer and allow me to be compensated for the time and effort I have put in assisting you this morning :-)

Dr. Rick :

That makes perfect sense as burning and dry sensation goes right along with what I am saying. Try the home therapy I have outlined and I'm sure you will get better.

Dr. Rick :

Is there anything else I can help you with this morning before you hit the excellent feedback button?

Dr. Rick :

Please remember the top 3 ratings are positives and Excellent service is my goal. Your positive feedback is how we are compensated. If you aren't 100% satisfied, just click "reply." I will be happy to discuss your issue in more depth and do everything I can to provide you with the information you require.

Otherwise, a high positive rating is very much appreciated, bonuses are great, and find me anytime for follow up.

Let me know if you have further questions.

Customer: replied 4 years ago.
I notice also that when I put my head low and look up I get double vision
How long does this double vision last? What makes it better?
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 at no additional charge :-)
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 4 years ago.
well it happens when I do that. nothing really makes it better. when my head is down and I'm looking up and I see it then when I look straight again then it goes away. I'm just scared that it is something neurological
It is not unusual to have some issues with single vision when your head is pointed way down and your try to look way up.
I do not believe you have to worry about this being evidence of a serious neurological condition.
Have you started the home therapy we discussed the other day?
And. See. I don't go up in a puff of smoke after you give me positive feedback lol!
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 4 years ago.

no i havent actually i will today....

so to recap you said when its neurological problem if you close one eye the double vision stops?

and if it is an optical problem then you can still see double vision with one eye cose?

It can be other things then neurological problems when you close one eye and the double vision stops.....
Yes. Double vision with one eye closed is a refractive/anterior segment ocular issue....
Hope you feel better soon. Have a good evening and let me know if I can do anything else to help.
Customer: replied 4 years ago.

how do you as a doc. know when a problem like this is neurological?

That is a very good question and there is no one thing that makes me think that a particular symptom may be due to a neurological is more of an over all picture, which varies from patient to patient.
Customer: replied 4 years ago.
based offveveeything you know. what Is your final "diagnosis"
From what we have discussed I believe your symptoms are from tear film/anterior segment issues that can be addressed using the home therapy I posted.