Double Vision

[diana0421]

I have been seeign double vision now for 3 weeks straight. I have seen 3 doctors, spent 11 hours in the ER, done 2 estensive MRI's and 2 sets of blood work. I still see double, clear and distinct double vision, I do not have MS or a legion in the brain, I have spoken and been seen by a neurologist and he is pretty sure I have a swollen optic nerve. I have called for a follow up, and have yet to hear back from him. The blood work wont be back for another week still since it was sent to the Mayo clinic. I do not have diabetes or any other conditions at all to be honest. I have poor eyesight and wear contacts evry day.

I would like to know if there is anything I can do since there haven't been any answers thusfar for me, and I am really getting sick of seeing double and feeling incompetent for my own life since this is making things  a lot harder and no one has given me any answers or any treatments or anything.

[Ray T Oyakawa, MD]

You seem to have had an extensive workup without a reason for the double vision. In my experience, neurologist or ophthalmologist are not very good a determining mild optic nerve swelling.  The two MRIs did not show anything and if this is due to a mild stroke in the brainstem or the nerves to the eye muscles, it may be missed.  

A decompensated may cause double vision with nothing being found on work up.  I would suggest you see a neuro-ophthalmologist.

It would be helpful to know if this double vision is horizontal, or vertical and if eye movements looks normal to a lay person.  Does the double vision get worse when you look to a certain direction?  Such as to the right or left, up or down,  Does tilting your head to one side or the other make it better or worse?

[diana0421]

The double vision is horizontal and it is constant no matter if I am laying down or if i tilt my head. It does not change if I look to any direction.

I do have a throbbing in my left ear that started a little before the double vision started. The first doctor I saw claimed that I was stressed and sent me home. The secodn doctor thought I had an inner ear infection, put me on 875mg Amoxocillin twice a day for ten days, after that I went to the ER and they said there was nothing in my ear. The throbbing is consistant with the double vision.

[Nancy T]

Can you explain what you mean by "throbbing" in your ear?

Also, when you say it is "consistent" with the double vision, what do you mean exactly?

Just curious...

[diana0421]

The throbbing tends to go with my heartbeat, its a throbbing, I don't know how else to explain it. Have you ever seen the movie the Langoliers? Teh sound that the Langoliers makes is liek the trhobbing in my ear. And the throbbing started when the double vision started and both have been constant, never ending.

[Nancy T]

I haven't seen that movie. Hearing a heartbeat sound in your ears is not too unusual, but you should tell your doctor about it next time you see him or her. Both your problems sound very annoying; good luck getting them figured out.

[diana0421]

Update, still having double vision. FINALLY got an appointment to see an opthomologist via my primary care doctor in a few days. Other than that, have not had any reliable contact with the neurologist, their office was awful, giving me such trouble and never gave me my blood work results. My primary care doctor really went out of their way to get my insurance info figured out and fixed because it got messed up in teh system somehow, so yeah. Nothing new though, still have double vision and throbbing in the ear, been taking a lot of vitamins and antioxidants to try and help in any way I can over the counter.

[NMgal]

In Aug of 2008 my husband started having increased double vision which over time progressed to intense light sensitivity.  He immediately went to his eye doctor, thinking it was a problem with his glasses. His eye doctor immediately sent himto his physician who then referred him to a neurologist and a neuro-opthomologist, (both of whom he now sees at least monthly).  He has had at least 2 MRI's (one with contrast) and a spinal, with nothing unusual found. After many blood tests, he had a positive test for West Nile.

It has been 7 months now and the double vision persists. When he is on high doses of Prednisone, the light sensitivity is gone and the double vision is nearly gone. As he reduces the Prednisone, the double vision problem increases and then the light sensitivity returns. It is so severe his eyelids close and he is unable to open his eyes.

This led to thinking that MG was the cause, but he has taken all the tests and a common medication for MG, and nothing bears out that diagnosis, although it is still a possibility.
His neurologist believes there may be an auto-immune problem and they will start some treatments for this soon.

If you have not been tested yet for West Nile, it is a simple blood test that can probably be done at your local health department.

Here in New Mexico, there appeared to be a delay in communication between some of the local hospitals and the state health department. The test for West Nile is not often done because it is a relatively new problem here in the USA (1999) and it seems many hospitals or medical offices don't know where to send the blood for examination. Also, the symptoms for West Nile virus can vary widely among people who test positive.

From what we can assume, West Nile Virus can easily go undiagnosed (if they don't test for it, how does one know?) and problems are assumed to be something else. We feel if more tests were done initially for the WNV, and positive tests and various symptoms were medically recorded, the problems with this virus could be better understood and studied. We keep an eye on the CDC's information on WNV and the cases across the US are certainly on the increase! Southern California has had many recent cases in both humans and horses.

We both feel West Nile can be an underlying problem that many people have, which simply goes undiagnosed or mis-diagnosed.
Unfortunately, right now, there doesn't seem to be much that can be done to treat it.

I hope you are doing better, and please consider a simple blood test for the West Nile Virus.