How does fatigue affect the cornea?

[Nancy T]

Several people have posted about unexplained bilateral monocular double vision or ghosting that is said to be a corneal or refractive problem. Yet some of these people (including me) find that the problem is worse when fatigued.

What I don't understand is how fatigue can cause the CORNEA to get out of whack?

For example, I can get the ghosting under two circumstances: when I'm very tired; or when I read for a couple of minutes looking down.

How can just being underslept, in itself (or simply being up for two hours, as was the case with a recent poster), affect your cornea to make you see double or have ghosting? I don't understand.

I understand that using your eyes for hours on end can cause eyestrain of some sort or another, but what about when you HAVEN'T been using your eyes to any signficant extent and you get this problem?

Thanks, doctors, for any insight into this.

Nancy T.

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

Yes, true diplopia that goes away if one eye is closed.

JCH III MD

[Nancy T]

Thank you, Dr. Hagan. This is what I thought must be the case (that fatigue would not affect the cornea itself).

The common "double vision when tired" that you're talking about must be binocular, right? (I.e., goes away with one eye closed?)

Thanks VERY much for the info you provide here!

Nancy T.

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

Fatigue will not affect the cornea. Sleep is a different story for weak cornea with endothelial disease. The reduced oxygen with the eyes shut cause the cornea to swell and blurry vision on awakening which clears over several hours.

Some double vision when tired is common, I have it myself. Fatigue interfers with the fusion reflex and the eyes can slip out of balance.When I'm exhausted I have some crossed double vision with some torsion (image rotated inward).

JCH III MD