Bilateral Monocular Diplopia Help!

[larshy]

I have been experiencing a number of symptoms associated with my eyes as well as other areas of my body but more recently have been experiencing bilateral monocular diplopia. My first vision problem was an awareness of floater which started out as one black dot in my right eye then later a dot in my left eye and now many dots and lines as well as transparent dots that I can only describe as water bubbles (clear transparent circles) in both eyes. These visual floaters are most noticeable against a bright background. I am also experiencing blurred vision that comes and goes in either eye as well as a glare from light sources in either eye if I am in a dark area. I have been to see an optometrist and in his opinion my eyes were in great shape.

Since the visit with the optometrist the monocular diplopia has become more of a problem and is most noticeable when looking at light sources but I can also see ghosts images of objects if they are dark against a light background or vice versa. The diplopia is vertical; the ghost image is overtop of the real image. The only way it seems to disappear is if I tilt my head down and look upwards at the object or sometimes if I squint the ghost image will disappear. I have also tried a homemade pinhole test. When the pinhole in directly in the center of my vision the double image goes away, however when the pinhole is slightly above my center of vision the double image comes back.

Other symptoms that I have been having include tinnitus, frequent headaches, muscle spasms, pins and needles, and numbness.

I have had a CT scan done which came back normal and am now waiting to see a neurologist in 6-8 weeks.

Do these symptoms sound like it is something wrong with my eyes or is it something wrong with my brain? I am afraid that it could still be a brain tumor that didn’t show up on the CT scan, or is that even possible? I am also afraid that this could be some malignant form of MS. Please any input would be greatly appreciated.

[Chrystalheart]

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[Nancy T]

Hi larshy, thanks for the update. The answer your neurologist gave you sounds about typical. They like that diagnosis of "stress" for symptoms that "will go away."

I wasn't ever actually told "stress," but I was certainly painted as a hypochondriac after the MRI didn't show anything significant.

Fortunately my ophthalmologist has never suggested "stress" or any other doubtful diagnosis. He just says he doesn't know. Lord knows what he's thinking, but thank goodness he isn't one of those doctors who ASSUME they know everything about you and your symptoms.

Hopefully your  neuro will talk to you more seriously once the MRI is done, even though it may well not show anything (usually they don't).

How long has your double vision been going on, and do YOU think it's due to stress?

Nancy T.

[larshy]

Well I went to the neurologist Tuesday. She did a general neurological exam and told me that I seemed fine from those findings but has ordered an MRI to be done just to make sure. My floaters have been getting less prominent as of late while my double vision and tinnitus is going strong. I asked the neurologist what she thought they could be caused from and she told me most likely stress and that they would hopefully, eventually go away. I will keep checking and posting on here, especially if I find out any more information that could help.

[sixfootblonde]

I have had floaters and tinnitus for over a year now.  Similar symptoms!  Be interested to hear you results.  Although I put mine down to Post Natal Depression after my youngest was born - I suffered from terrible anxiety which caused many, many physical problems.

[Nancy T]

Interesting site! I guess for me the opacity is around 50 percent; the ghosting is slightly above the real image; and I guess all colors seem to do it--can't tell very well from the picture. My ghosting is lots more noticeable with items closer up, and especially in reading.

Larshy, I'll be interested to hear what your neurologist says. I've had lots of weird symptoms unexplained by neurologists, but I never told them about the ghosting because it began after I was all through seeing neurologists (or, rather, they were through with me) in the early 2000s. Only the ophthalmologist has heard this from me.

[larshy]

Like i said in my first post this is one symptoms of many. It is definitely monocular diplopia in both eyes, hence title "bilateral monocular diplopia". My other main symptoms at this time are floaters in vision and constant tinnitus but my condition started with many other symptoms which have not been bothering me for a couple weeks to a month now. But because of all the symptoms that I was experiencing and finding no physical explanations for them my GP decided to send me into a neurologist.  

[sixfootblonde]

"First, determine whether the diplopia is monocular or binocular. If the diplopia is still present with one eye covered, it is monocular. The common causes of monocular diplopia include cataract, refractive error, corneal abnormalities, retinal surface abnormalities, and psychogenic. If diplopia clears with the pinhole test, one can assume that the etiology was optical."

Taken from http://www.aan.com/familypractice/html/chp2.htm just over halfway down. :)

[sixfootblonde]

Why a neurologist?  Is it not an eye issue?  How long has it been going on for?  Are you concerned?  Thanks :)

[larshy]

I am scheduled to see a Neurologist towards the end of the month. It was my GP's advice to wait and see if the neurologist wanted to have the MRI done but i am sure it will be done eventually. The waiting list around here is sooo long. My GP said for him to book it, it would be like booking an appointment with God but if the neurologist thinks that it is necessary than it would be a lot quicker for her to do so.

Brock

[sixfootblonde]

Thanks for that.  Well mine is light colours although I do get some dark but only on light backgrounds and faintly.  Opacity 27 and really I needed to position the yellow circle above and below by about 1/6th.  Good luck with your scan results.  Out of interest how come they do not use MRI imaging? :)

[larshy]

http://www.thevisioncommunity.com/index.php?option=com_content&task=view&id=52&Itemid=145

[larshy]

Hey everyone...great to see all the coments and it is funny how every gets this ghosting differently. I am still waiting on the results from my CT scan (I should here back from the doc soon and to be honest if it was any kind of emergency i think i would have heard from him by now). Anyhow I have been searching the web for more info on this phenomena and came across this interesting website. It has a simulator on it to display what your double image, or "ghosting" as they put it, looks like. My settings are - ghost light colors - opacity at 50 - and the one circle is set about halfway up the other one. Was wondering what everyone else was seeing, or how similar we all are to each other. Anyhow again if I get any news from the doctor i will pass it on.

Thanks,

Brock

[sixfootblonde]

Thanks for your reply.  I think it indicates it is a refractive issue.  With a pinhole at certain angles my sight is perfect - so this rules out brain issues as I understand it. :)

[Nancy T]

Why did the optician think it might change after having the baby? Did s/he give any reason for thinking that?

My comment is that you should see an ophthalmologist (MD).

Odd how it seems we all have different things that make the ghosting worse--in your case low light, in my case reading looking down...who knows??

I wish one of the doctors would comment on your "ghosting is worse in low light" problem.

Nancy T.

[sixfootblonde]

I too have recently started getting ghost vision in both eyes and it is in each separately.  I am 33 years old and pregnant - so the optician said to wait and see what happens after I have had the baby.  With a pinhole mine clears up fine.  I have a slight astigmatism in my left eye so that might be the cause of that.  I obsessed about brain nasties too - but from the little I have read that seems very unlikely.  I noticed the problem in November but thought my vision had been a little odd for a month or two before then.  Mine is not very noticeable during the day or in good light, but as soon as light starts to fade in the day I start to get ghosting.  So I guess if it were a brain problem it would not be linked to light - wouldn't that be more a refractive issue?  The optician said I had good vision otherwise and did give me some glasses that have helped a little with my left eye.  Any comments gratefully received :)

[Nancy T]

Brock, I would really try to find an ophthalmologist who is willing to work on solving your problem. I know next to nothing about the eyes, but I would think that if your problem IS a refractive one, they ought to be able to do something about it with glasses.

Perhaps after your CT results the doctor will discuss all of this with you and find a solution.

I think it would drive me nuts to have double vision all the time. Tinnitus is one thing--you can tune it out--but not seeing clearly is not something I could ignore!!

I don't see my ophthalmologist again until July 1, but I'll try to remember to ask him then what is different about the glasses he gave me. I have no idea what my prescription is--I can't ever remember numbers like that--I just hand it over to the optician and forget about it.

Best of luck to you, and keep us updated.

Nancy

[larshy]

It seems to me that everyone else that has this problem only acquires it after reading or doing some sort of concentration with their eyes for an extended period of time. My diplopia lasts from 80-100% of the day after doing nothing to provoke it. I simply wake up with it and fall a sleep with it. It is very annoying for the most part but it seems that I am now getting use to it and just ignore it. It is very similar to the constant tinnitus, or ringing in my ears, it is there but my senses are just use to it and ignore it. I am very interested in the prescription that you received Nancy as my ophthalmologist had mentioned nothing about glasses at all but if it could help me I would be forever in your debt. As I have mentioned before I have tried the pinhole test and it seems to clear up the double vision so as Nancy has already stated and from what I have read it is most likely a refractive error and not neurological (fingers crossed). I am going for a CT scan of my ocular area (I forget exactly what the area is called) tomorrow and should be in contact with my ophthalmologist soon so i will post again any findings they see or not see. Thank you everyone for sharing your stories. It is a good feeling knowing im not going through this alone and others have experienced to some degree what i am going through.

Brock

[Nancy T]

Maybe I should ask my ophthalmologist at my next appointment exactly what he "put" in my special reading glasses to prevent the ghosting from occurring with reading. I do remember he said that the optician would think the prescription was for bifocals when it wasn't.

However, in my case the ghosting only occurs when I read looking down (e.g., with a book or papers in my lap or on a table). It doesn't occur when I'm reading straight ahead, as on a computer screen.

But it does occur without any previous reading if I'm very tired (sleep-deprived).

Surprised to hear so many others have this problem--the two ophthalmologists I saw, one of them a neuro-ophthalmologist, had never heard of it.

Did anyone read the article for which I posted the link? What do you think about it?

Nancy T.

[BillIsherwood]

I, too, suffer from bilateral monocular dipolia, beginning maybe 20 years ago.  It comes on when I read or work on the computer too long, and gradually goes away if I distance focus for 1/2 - 1 hr.  It starts with ghosting, but can progress to two full, essentially equal, images if I keep working/reading.  At the time I was first 'diagnosed', I was told that little was known about such conditions and no 'cure' was known -- so I've lived with it - taking 'eye breaks' as necessary.  As time goes on, the period of reading or other close work seems to decrease before the symptoms reappear.  I wear bifocal reading glasses and have needed bifocals for many years.  About 8 years ago I had Lasik surgery for my severe near-sightedness (to allow me to function in snow storms without glasses).  It seemed that the diplopia diminished somewhat after the Lasik, but has come back, now worse than ever.  (I am now 66.)

I had not heard of the pinhole test and just tried it.  My double vision does seem to go away when looking thru a pinhole -- but I can't read or work like that.  Tilting my head doesn't seem to change anything.  My eye doctors have never found any observable 'health ' problem with my eyes.

I'll now follow this thread in case anyone has found a real cure for this condition.

Bill I.

[Nancy T]

Marilyn, do you know the cause of your multiple images? Have you seen an ophthalmologist, and what have they told you? Is there anything you can do that makes it go away temporarily?

Nancy T.