Vertical Double vision in Both eyes separately

[PIT31]

Here is a question I have not really been ablt to get a solid answer about.  Is there any way possible for a neurological condition to cause double vision in one eye?  I know neurological double vision is usually caused by a misalignment in the eyes due to a eye muscle problem or a nerve problem.  What if each eye has double vision separately when you close the other?  

[PinkFloydBra]

I'm having the exact same issue as OP.
I doubt that he would return to tell what it was...
They never do.

[JohnHaganMD]

Who is OP?

[PinkFloydBra]

Sorry, Dr. Hagan !
OP is short for "Original Poster".

[PinkFloydBra]

Dr. Hagan, if you don't mind me asking.
I'm having the same problem with monocular ghosting. I've just got my Wavefront OPD Scan test and I wanted to know what those green, yellow and orange colors on the internal OPD(page 3) mean.
https://imgur.com/a/sIkSM

Thanks !

[PinkFloydBra]

I've uploaded the internal OPD.
https://imgur.com/a/KAEv0

[JohnHaganMD]

If you think about the cornea as being like a ball bearing it would be all the same color. However the cornea surface is like the surface of the earth, overall curved but with many ups (hills) and downs (ditches)   The bar on the left which has colors (red are high colors) blue are low colors and a number that corresponds.  Although I don't use this particular instrument it shows you have an asymmetic elevated area on your cornea just off the visual axis (yellow/red). It is 'irregular" as "regular" astigmatism looks like a bowtie and is symmetrical. I can't tell you what that is but it could be a cause of monocular ghosting/doubling that is not corrected by glasses.  You would need to discuss with the ophthalmologist that examined your eye.

[mark7216]

It has been 5 years and I hope you found the right answer for you. I have just started having the same symptoms, at least now I know I can look up to see more clearly. The funny thing is that mine is not all the time. Some days everything seems totally normal and other days, like today, it's very noticeable.
If by chance you come back across this or anyone else does I would love to hear what you found.

Thanks

[JohnHaganMD]

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[Nancy T]

Hi--I just read this thread and wanted to say I'm another one whose bilateral monocular ghosting resolves with position change--in my case it disappears if I tip my head upward to a certain angle. OR if I squint (narrow my eyes) hard enough. But of course both those things are very taxing and you can't read that way for any length of time.

I don't have the ghosting all the time--it occurs when I'm tired but also, even when I'm well slept up, it occurs very prominently within a minute or two if I read, especially reading quickly, and MOST especially reading while looking down (such as at a book in my lap or the newspaper on the table). So in my case it definitely has something to do with eye position and movement.

I've seen optometrists and an ophthalmologist and even a neuro-ophthalmologist and they couldn't really explain it. But they gave me some strong reading glasses and this prevents the ghosting while reading. They can't explain why it occurs spontaneously (without reading) when I'm tired nor why when reading looking down, but Dr. Hagan here has been very helpful with information. (Thank you again Dr. Hagan!)

I have never had OCT or any testing of that sort, just regular eye exams.

Anyway it's interesting to find someone else for whom this resolves with a position change. Do you have to tip your whole head up, or just look upward with your eyes only?

Nancy

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

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[PIT31]

Thanks again for the great info.  

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

Given the test you've had its not likely anything serious and you can certainly spend a lot of time and money digging for a cause.  If that's what you want to do then suggest you see a corneal Eye MD specialist. Ask for a corneal topography and see if he/she will put a rigid contact lens on your eye then do an over refraction and see that eliminates the problem. If it does the problem is irregular corneal astigmatism and ridget contacts may correct the problem. Also ask the a fully dilated extra careful exam of the lens be done as a very early cataract (often difficult to see and diagnose this). Then if no answers have a macular OCT done ideally with a 2nd generation HD or spectral domain OCT.  That would eliminate every cause i can think of and in 40 years of ophthalmology that work-up has identified a cause in every patient to date.

JCH MD

[PIT31]

I really appreciate your insight helping to shed light on this subject.  I have seen an opthamologist and they say everything in my eyes are normal except the astigmatism in my right eye.  But that still makes me wonder why i see the same identical ghosting in my left eye also.  Had an MRI and all VEP test and all came back normal.  

[PIT31]

The ghosting is the same with or without glasses on.  The glasses make it easier to see futher away however it seems they actually make the ghosting more noticable.  

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

with or without the glasses on?

[PIT31]

Thankyou so much for the quick response.  I have seen an opthamologist because the glasses i was prescribed didnt help the ghosting and i was afraid it was some eye disease attributing to the ghosting.  The images separate the further away i look and most noticable the brighter the object/contrast.  When i look up just the slightest amout the images merge which is mind boggling to me.  It is identical in both eyes and still present.  I had a corneal topography done and just some green and yellow on the mapping.  the opthamologist didnt say i had any eye diseases.  What could possible cause the images to merge when i look up the slightest amount when viewing something?

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

That technically is not double vision but is called ghosting. Another term used that is acceptable is "monocular diplopia". It is extremely common. I have it when I don't wear my glasses. It has many causes by far the most common being refractive errors of the eye: hyperopia (farsighted); myopia (nearsighted) and astigmatism. So it can be caused by needing glasses, incorrect glasses RX or glasses not fitting face properly. Other common causes corneal disease, cataracts, macular problems.

It is not a eye muscle problem as that is a cause of true double vision which you do not describe.

See an Eye MD ophthalmologist to pin down the cause.

JCH MD