Doctors can't find cause of double vision

[kcross57]

About 3 years ago, I began having difficulty driving at night due to any lights  being so bright I could not see.  Then 2 years ago my vision became blurry and at times I would see a word with the same word being seen either above or below the original word.  My night vision also became worse as I would see double or triple car lights, traffic signal lights and lighted business signs. this occurred even if I covered each eye. I went to my eye doctor and she said I had cataracts and sent me to a specialist.  The specialist ran a bunch of vision tests and found I had Fuch's. The tech doing the testing said my eyes were not aligning but the doctor said she didn't see this.  I was sent to a cornea specialist, 3 hours away, who said I had severe Fuch's and needed a cornea transplant for both eyes and removal of the cataract.  He said I would stop seeing double after the surgery.  The left eye was done however there were complications that delayed surgery on the right eye and my double vision was rapidly getting worse.  He referred me to neuro eye doctor.who did not find any problems.  She told me there was now a cornea doctor in my town and I had an exam  and he could find nothing that would cause the double vision.  He did not want to do a cornea transplant and cataract removal until the double vision was fixed.  He thought it might be caused by how the light reflected on my eyes and recommended hard contact lens.  3 times the contact doctor.tried to fit me with contact lens but each time the fit was wrong, my prescription changed and I still saw double or shadows all the time with it getting worse as the day progressed.  I was also diagnosed with severe, a 2 on the tear test, dry eyes.  After the third fitting I decided that these doctors didn't have the answer either and gave up. Then my son wanted me to come live with him in Fort Worth and see the eye doctors there. I sold my home and moved to Fort Worth last week.  

I am 64 yo with kidney disease, heart disease, and high blood pressure.  About the time I started having eye problems I also began having balance problems and the room spinning.  I have had numerous falls that have included hitting my head and currently I have bruised ribs.  I saw a neurologist for the balance problems and asked if my double vision could be related to the balance problems and he said no.  I also had an MRI that came back negative.

Can anyone recommend a good eye doctor that specializes in eye disease, in DFW area?   Any feedback on what might be the causing the double vision and shadowing.would be appreciated.  

[John C Hagan III, MD, FACS, FAAO]

I have read you posting seveeral times. I gather you did not have "cataract surgery and corneal transplantation" PLEASE CONFIRM.  Please know that the combination of severe Ruch's, clinical cataracts and bad dry eyes can cause double vision.  True double vision is see two distinct things and goes away when one eye is covered.  What many people call double vision is see shaddows and ghost images in one or both eyes that does not go away with covering one eye. ALSO cornea transplants are almost never done anymore for Fuch's dystrophy. A much better safer, quicker operation  abbreviated DSEK is done. These should always be done by a cornea specialist that is familiar with the procedure.   True double vision can be caused by your condition if the vision is so bad the eyes can't track and slip out of alignment.  That causes true double vision that clears with covering one eye and can usally be helped by having the cataract removed and DSEK done.  You might consider the department of ophthalmology at U of Tex SW.  Neither of these two scenarios should cause vertigo and 'spinning sensation"  Since all doctors are swamped I would schedule the appointment with the cornea serve ASAP and don't forget to personallly get copies of all your medical and eye records and take a copy with you to your consultations.  

[kcross57]

I was diagnosed with Fuch’s corneal dystrophy, cataracts and glaucoma in 2021.  The first specialist diagnosed the cataracts and Fuch's as well as provided laser treatment for the glaucoma.  Both Dr. Riaz and Dean McGee Eye Institute and Dr. Goins at KU
eye clinic , both cornea specialists, confirmed the Fuch"s and the cataracts and recommended Phaco DMEK.  Dr. Goins preformed Phaco DMEK on my L eye as it was much worse than my R eye (thickness 701 and visual acuity 20/100).  My R eye still has Fuch's (thickness 681 and acuity 20/50-2) and a cataract.  

I see the same image twice, sometimes the 2nd image is very clear and at other times is almost transparent.  This mainly affects letters/reading and night vision.  The position of the 2nd image changes (above, below or behind) but almost always the images overlap.  Visual acuity also changes, most often due to the time of the exam as my eyesight gets worse as the day progresses.  And it doesn't matter which eye is covered, my vision doesn't change.

Anyway, thank you for the recommendations and I will check them out.

[John C Hagan III, MD, FACS, FAAO]

The ophthalmologists you have seen are very competent. What made me worry is about any surgeon recommending a 'corneal transplant"  DMEK and DSEK are essentiall lamellar procedures.  Hope TX SW dept of ophthal can help you