9 Things to Know About Double Vision

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Lorna Collier on January 5, 2021
  • Business people walking in modern lobby
    Don’t overlook double vision—it can be serious.
    Seeing double can be a scary thing, especially if it occurs suddenly. Sometimes, double vision (official name: diplopia) has relatively minor, fixable causes, such as too much digital screen time or having astigmatism (which glasses or contacts can correct). However, double vision can also be a sign of significant medical problems and should not be ignored. Learn more about this common vision problem, including its causes, treatments and when to seek medical help.
  • A close up of a young woman's blue eyes
    1. Double vision can be monocular or binocular.
    Double vision may occur in only one eye or in both. If you are seeing double, try covering each eye in turn. If your double vision clears up when looking out of each eye on its own, but reappears when both are uncovered, you have binocular diplopia—that is, double vision in both eyes. Double vision in only one eye is called monocular diplopia. The types of double vision have different causes. Also, your double vision may appear with images beside each other (horizontal), on top of the other (vertical), or separated diagonally from each other (oblique).
  • Senior doctor examining patient doing eyesight measurement in ophthalmology clinic
    2. Monocular and binocular double vision often have different, but treatable causes.
    If you have monocular double vision, it’s likely there is something going wrong in the eye itself. If your double vision is in both eyes, the cause is more likely related to eye muscle, nerve or brain issues. Some potential causes:

    These problems are largely fixable. Your eye doctor can explore options for you, such as surgery, medication or corrective lenses.
  • Young child with lazy eye or crossed eye
    3. Weak or abnormal eye muscles can cause double vision.
    Muscles in your eye socket control how your eyes move. If they become weak or paralyzed, your eyes may not move in sync with each other, causing double vision. Children sometimes are born or develop an eye muscle imbalance called strabismus (crossed eyes) and result in double vision. Infants won’t complain about their double vision and that can result in vision loss due to amblyopia (lazy eye). When caught early, an ophthalmologist (eye surgeon) can correct strabismus. Another reason for eye muscle problems is the thyroid condition Graves’ disease. Medication or surgery can usually resolve thyroid-related double vision.
  • Older woman at home with cane looking into distance
    4. Nerve problems can cause double vision.
    When nerves that connect your brain and eye muscles are damaged, you may experience double vision. The most common acquired condition is palsy of the trochlear nerve; this is often related to head trauma. Other conditions that can cause this abnormality include diabetes, cerebral stroke, Guillain-Barré syndrome, myasthenia gravis, and multiple sclerosis.
  • Paramedic checking man's blood pressure in ambulance
    5. Sudden double vision requires prompt medical attention.
    Problems inside the brain, due to illness or injury, could be the root cause of your double vision. They include migraine, brain aneurysm, stroke, pressure inside the brain, and brain tumor.

    Neurologists typically treat migraine headaches with medication. Other brain conditions, such as an aneurysm or stroke require immediate, emergency medical care, and may require surgery. If you have sudden double vision that lasts two hours, call your primary care or eye doctor or go to the closest emergency room. More gradual double vision should also be brought to your doctor’s attention.
  • Young African American man at desk in office pinching forehead with headache, stress or fatigue
    6. Digital eye strain can bring on double vision.
    Computer vision syndrome is an increasingly common problem with so many of us staring at digital screens on computers, laptops, tablets and smartphones. This can lead to blurred vision, dry eyes and, sometimes, double vision. To remedy this, try resting your eyes every 20 minutes by looking 20 feet away from your device for at least 20 seconds. Also, for every two hours of computer time, rest your eyes for 15 minutes. Remember to blink often and, if needed, use lubricating eye drops.
  • Patient Getting an MRI
    7. A double vision medical exam may involve a head MRI.
    When your eye doctor examines you for double vision, he or she will evaluate your overall vision and eye health and perform other tests based on your symptoms. Your doctor will want to find out if your diplopia:

    • is in one eye or both
    • is constant or occasional
    • came on suddenly or gradually
    • affects only far or near vision
    • changes when you move your head or gaze

    Besides an exam, you also may need imaging, such as an MRI or CT scan, and blood tests, depending on your symptoms.
  • Eye doctor and patient in exam room
    8. Double vision online tests can’t diagnose a cause.
    Some websites and apps allow you to take vision tests, usually to determine how well you see (visual acuity). The American Academy of Ophthalmology and American Optometric Association both have warned that online tests aren’t a replacement for in-person exams, because they can’t detect serious eye problems or underlying health conditions. The associations say people aged 18 to 39 who do not need glasses may use such tests. However, they advise anybody who has vision problems (such as double vision), as well as those younger than 18 or older than 39 see an eye professional, and do so in person.
  • man-adjusting-glasses
    9. Treatment for double vision.
    Your double vision treatment will depend on what’s causing it. An accurate diagnosis will guide treatment decisions. Some people get injections of Botox (botulinum toxin) in the opposing eye muscle to prevent further tightening of that stronger eye muscle. In a stroke patient, the paralyzed muscle may not fully recover after an acute palsy. Left untreated, the healthy opposing eye muscle will progressively tighten and make double vision worse. In this situation, weakening the stronger, functioning eye muscle with injections of Botox can help restore some balance. Botox needs to be repeated several times to achieve a good result.

    Small amounts of diplopia may be managed with prism spectacles. Eye patches or special lenses in your contacts or glasses can block vision in one eye, which can eliminate double vision. Surgery may be necessary for some causes of double vision.

    If your double vision is related to computer eye syndrome, you may need to learn how to rest and refocus your eyes periodically, along with such measures as getting special lenses or computer screen filters to minimize glare.
9 Things to Know About Double Vision

About The Author

Lorna Collier has been reporting on health topics—especially mental health and women’s health—as well as technology and education for more than 25 years. Her work has appeared in the AARP Bulletin, Chicago Tribune, U.S. News, CNN.com, the APA’s Monitor on Psychology, and many others. She’s a member of the American Society of Journalists and Authors and the Association of Health Care Journalists.
  1. AOA to FDA: Patients need guidance on risks of online vision apps. American Optometric Association. https://www.aoa.org/news/advocacy/patient-protection/patients-need-guidance-on-risks-of-online-vision-apps?sso=y
  2. Causes of Double Vision. Stanford Health Care. https://stanfordhealthcare.org/medical-conditions/eyes-and-vision/double-vision/causes.html
  3. Double Vision Diagnosis. Stanford Health Care. https://stanfordhealthcare.org/medical-conditions/eyes-and-vision/double-vision/diagnosis.html
  4. Seeing Double? Get Your Vision Checked Promptly. Cleveland Clinic. https://health.clevelandclinic.org/seeing-double-get-your-vision-checked-promptly/
  5. Astigmatism. National Eye Institute. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/astigmatism
  6. Strabismus. Kids’ Health from Nemours. https://kidshealth.org/en/parents/strabismus.html
  7. Graves’ disease. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/graves-disease/diagnosis-treatment/drc-20356245
  8. Ocular Myasthenia Gravis. Brigham and Women’s Hospital. https://www.brighamandwomens.org/neurology/neuro-ophthalmology/ocular-myasthenia-gravis
  9. Vision Problems. National Multiple Sclerosis Society. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Vision-Problems#section-2
  10. Guillain-Barre syndrome: Diagnosis and treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/diagnosis-treatment/drc-20363006
  11. Double Vision (Diplopia). Harvard Health Publishing/Harvard Medical School. https://www.health.harvard.edu/a_to_z/double-vision-diplopia-a-to-z
  12. Computer Vision Syndrome. Cedars-Sinai. https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/computer-vision-syndrome.html

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Last Review Date: 2020 Dec 24
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.