Expected Recovery Time for Post-Traumatic Diplopia

Hi,

I had a snowboarding accident 4 weeks ago, where I hit the back of my head and was knocked briefly unconscious. I have experienced double vision since then and was subsequently diagnosed with Post-Traumatic Diplopia. I have extraocular eye muscle paresis of one eye (where the muscle is damaged but not completely paralysed). At the time I received blood tests, a CT scan, and an MRI, which all came back clear. I was seen in an Italian hospital, and I speak only English so communication was very difficult. The first specialist advised that my double vision may or may not go back to normal, and if it heals itself it will repair in 6-8 months. The second specialist (after seeing the MRI) advised that the diplopia will heal itself within 20 days, and prescribed me treatment of 25mg Deltacortene, and to practice eye-muscle strengthening exercises. This was 4 weeks ago and I am still seeing double.

How important is it to seek further treatment early (e.g. vision therapy)? And is it possible that suppression will occur (where the brain learns to ignore one image), as opposed to the muscle strengthening and repairing? How long do you think I should wait before I seek further treatment? Is it recommended to patch the 'good' eye to make the other one work harder?

Also, what are the chances of complete recovery and how long is this expected to take?

Thanks :)

[Houman Vosoghi, MD]

The first doctor seems to have been more in line with reality.  Suppression and "lazy eye" only really happen in kids so you don't have to worry about that.  Patching should be only to keep you seeing better to function and will not help "strenghten" any eye.  The double vision should start to improve slowly.  The longer you go without improvement the less the chances that it will improve on its own.  If after six months you are not better, you will likely need surgery to straighten the eyes again.  You most likey have a traumatic fourth nerve palsy.  Go see a pediatric ophthalmologist/strabismus specialist now so they could measure the exact degree of diplopia and monitor it for you to see if there is any improvement over time.

HV