"Double Vision" is not a good song

January 23, 2008 6:27 AM

Please help me describe (diagnose?) my vision problem for the next ophthalmologist I see...

I have had a gradually worsening problem with my vision that I started noticing about 3 years ago when I was doing a lot of reading/ studying to take the LSAT. I am wondering if there is a name for this condition?

My vision in both my eyes, individually, is 20/20. But, coordinating my binocular vision is becoming harder and harder- so I tend to feel as if I am seeing slightly double unless I strain very hard to make a crisp image.... When I read text, it's as if there is a slight "ghost" effect which blurrs the letters...

Two visits to two different opthalmologists have been thus far unproductive- they tell me my vision is perfect and then they tell me to get reading glasses. Reading glasses are not helping- they are causing headaches...

I spend a lot of time in front of a screen- this may be worsening the problem..

Any ideas?

posted by ohdeanna to health & fitness (17 comments total)

A guess:

Eyestrain/tiredness - Too many hours staring at the screen results in eye muscle fatigue. It only happens after a long session of such, which is why it is hard to diagnose and 'fixes itself' after you take a break/get a night's sleep. Solution? Eye breaks every 30-60 minutes. Close your eyes, relax, take a walk.
posted by unixrat at 6:34 AM on January 23, 2008

I believe fatigue is a factor- but even when I have "fresh" eyes I still struggle. Could it be chronic/ persisting muscle fatigue?
posted by ohdeanna at 6:42 AM on January 23, 2008

Could be strabismus - meaning, your eye muscles aren't working together. Get the doctor to check for that, it's a fairly simple test. Unfortunately, the only way I know of to fix it is surgery, but it's relatively minor.
posted by Mr Bunnsy at 6:45 AM on January 23, 2008

you could ask your ophthamoligist if you have strabismus
posted by sero_venientibus_ossa at 6:47 AM on January 23, 2008

I say see a neurologist. Something is clearly happening in your head, and if an eye doctor can't help, maybe a brain doctor can.
posted by stonefruit at 6:49 AM on January 23, 2008

Some research on strabismus led me to "Convergence Insufficiency" which seems to match my problem... Wonder why my mds have not mentioned this?
posted by ohdeanna at 6:52 AM on January 23, 2008

My Dad experienced something similar. In addition to the double/ghost vision, however, he had an increased sensitivity to light as well. It turned out to be Fuch's Corneal Dystrophy. He did have a lot of trouble getting diagnosed - it took a couple of years of him going to different specialists. Many told him just what you have been told - that his vision was ok and that he needed reading glasses or bifocals.

I also think it could be eye strain. I once had a job where deadlines often forced me to work 12-14 hours in front of a computer screen. When I would get in my car to drive home, it would take a while for my eyes to focus on the dashboard if I had been looking at the road and vice versa. Sometimes it would be physically painful to focus on something near when I had been looking at something far away. Car headlights appeared as slightly double. It would usually start to get better on weekends.
posted by Ostara at 6:55 AM on January 23, 2008

Deanna - your doctors may not be looking out for it because it usually occurs in children. I had to go to a pediatric ophthalmologist once I was diagnosed, regular ones simply don't see it often.
posted by Mr Bunnsy at 6:56 AM on January 23, 2008

I have strabismus.

It (sometimes) can be corrected with surgery. Strabismus is considered a pediatric-only problem by most eye doctors... it is just recently that they are finding out it is correctable in adult patients. Usually doctors won't worry too much about it because it is only dangerous in young kids.

When I was a baby I underwent 3 eye surgeries to try and correct my strabismus. While the surgeries did not correct it 100%, they did allow my brain to develop correctly. If a baby's eyes do not work together, the optic section of their brains do not develop fully, and may cause them to go blind.

Currently I am 20 years old, and after a 4th surgery when I was 13, my strabismus is still hanging around. My doc wants me to get surgery again... I may consider it in my 30's, when I am sure my muscles and such have stopped growing.

One note, though, is that I had 20/20 in both eyes before my surgery when I was 13. After that I am 20/20 in my right, and my left is often 20/30 or 20/40. It is quite frustrating, especially combined with my non-binocular vision.
posted by sindas at 7:30 AM on January 23, 2008

Like Mr. Bunnsy, I had to go to a pediatric ophthalmologist to get diagnosed. My strabismus is slight and in one eye. The doctor prescribed glasses that were supposed to help. If I sat perfectly still and stared at the computer, they helped. Somehow they moved the computer image slightly apart or something. However, if I got up to walk around, it was like walking in crazy land. I probably should have stuck with the glasses, but instead I sit farther back from the monitor. I also use TimeOut to remind me to look away a lot.
posted by PatoPata at 7:54 AM on January 23, 2008

I have a friend with strabismus and she is currently undergoing vision therapy (an alternative to surgery) - I hope she weighs in here - her problems sound very similar to yours.
posted by pointystick at 8:50 AM on January 23, 2008

IANAD.

One thought is that your eyes are not working well together. I have this problem and the eye specialist said I've probably always had this problem (I use to have "better than normal vision"). When my eyes started to change due to my age (normal in your early 40s) it unmasked this problem. You don't say how old you are.

One suggestion is for you to find a "vision therapist." S/he is usually an optometrist with special training. Ophthalmologists may "poo poo" this but if you've already seen one, you might want to give it a shot. Vision therapists often work with children who have "lazy eyes" to train their eyes to work together. He spent a good deal of time with me to help figure out what was going on.

What precipitated all of this: I started to have strange sensations in my head when I would lay down and just relax my eyes. The only way I could describe this to doctors was that I felt like I was going down an elevator shaft for about 5 seconds. I saw all sorts of specialists who had never heard of such a thing.

To make a long story short, the sensation I was describing was my eye muscles "spasming" after being so tense from trying to focus. They were just relaxing. My eyes don't work perfectly together, as I said, but the vision therapist said my problem wasn't acute and that while a good eyeglass prescription wouldn't eliminate the problem, it would be best to give my eyes the best chance of not getting over strained.

I've been wearing glasses for a while. My distance is almost perfect but I wear progressive lenses to help the transition from close to far (before glasses this transition was a real strain on my eyes). I'm fine now.
posted by Taken Outtacontext at 8:52 AM on January 23, 2008 [1 favorite]

Hi there- pointystick's friend here.

I was diagnosed with strabismus, together with amblyopia ("lazy eye") when I was in sixth grade. I have undergone two surgeries for it, and am currently in my third week of vision therapy.

I highly recommend finding a behavioral or pediatric optometrist who provides vision therapy in his/her practice and has experience treating strabismus. A doctor who is expert in strabismus and similar eye issues will be able to tell you if that's what you have or not, and talk with you about treatment options. (You may be sent for a neurological consult as well just to rule out that as a cause.)

My pediatric opthamologist scoffed at the idea of exercises for me because at twelve I was "too old for them to work," so I had two surgeries that only fixed my problem for about 5 years each. When my double vision and its accompanying crippling headaches started getting worse again, I did research on my own and looked for another option, and that's when I learned about vision therapy.

Vision therapy is like a combination of physical therapy and occupational therapy; it both strengthens your muscles and helps your brain relearn the proper way to see. Strabismus is a neuromuscular issue, and to get permanent relief it is necessary to address both the eye muscles and the part of the brain that controls the eyes and processes visual imput. Surgery and prism glasses can help alleviate the double vision for a time, but they don't address the underlying issue.

As far as coping with the symptoms while you are trying to get a proper diagnosis, here is what works for me:
-Use the largest computer monitor you can
-Use your computer's accessibility and/or display settings to make your fonts, icons, mouse pointers, etc., larger.
-Use a color scheme that offers high contrast in colors that you find soothing. If need be, set your browser to override web pages with your preferred color choices.

Basically, the tinier the thing you're looking at, the harder it is to focus on it- so making the stuff you have to look at on the screen as large as possibe will help. Doing this helped me considerably.

Sorry for the epic reponse- please feel free to memail me if you want more details. what to expect/look for in an eye doctor, etc.
posted by oblique red at 9:32 AM on January 23, 2008 [1 favorite]

Some research on strabismus led me to "Convergence Insufficiency" which seems to match my problem... Wonder why my mds have not mentioned this?

Maybe they suck.

I don't say that to be glib; it's easy to take for granted the idea that all our doctors are above average but by definition they are not. Also by definition, they spend the majority of their time dealing with things that are typical. So if you're at all off the beaten path it may take an above average doc to diagnose you accurately.

Your profile doesn't say where you are but I see from a question that your parents are in DC. Are you in the area? My darling girlfriend has an esoteric eye condition that was inadequately diagnosed by a local eye doc and which she eventually got good care for at the Wilmer Eye Institute in Baltimore. If you're at all close to there I'll put you in touch with my DG and she can give you a quick primer on who you'd see there.
posted by phearlez at 11:22 AM on January 23, 2008

These responses are all so helpful!

I'm 37, in the DC area, and the two doctors I saw participate in my crappy insurance plan which is why I was stuck with them...

It's time to go out of network...
posted by ohdeanna at 11:35 AM on January 23, 2008

My version of this was diagnosed as esophoria. The oddest piece of diagnostics done was when they showed the little red dot in the darkened room-- I just cannot see that as one dot, I always see it as two.

In my case, I was given bifocals to give my eyes a bit of help in going from distance to close vision. It's a bit of an imperfect solution for me, but it works ok, I guess.
posted by norm at 9:03 AM on January 24, 2008

Here's one very simple thing you can do to narrow down the problem (and you may already have done so). While you're having the double or blurred vision, cover one eye (and then the other) and see if the problem persists.

If it does, it is unlikely that the problem has anything to do with coordination between your eyes. If the problem occurs with one eye, but not the other, then it is likely a problem in that eye (although it could be neurological).

Certain problems with the cornea can cause a doubling or smearing of vision. If my eyes dry out for a while, I sometime get visual defects where images appear to be doubled, up and to the right, with a smeared image between the two main images. It's especially noticeable looking at small bright lights (like LEDs on phones or answering machines).

(I am not an ophthalmologist)
posted by notbuddha at 9:13 AM on January 24, 2008