binocular diplopia

[pat18]

Have  history  of  anisometropia  amblyopia--not  dx  until  9--suppression  occurred.  Functioned  well  until  surgery  for  detached retina  and  then subsequent  lens  surgery.  Now  have  binocular  diplopia--can  full  supression  occur  again?   Have  brief  (minutes)  periods  of  suppression,  but  doesn't  last.

Also  have recently  been  having  sudden  pain  in  affected  eye--not  related  to  activity  or  time  of  day.  Occurs  cyclically--every  2-3  days--relieved  immediately  by  lying  on  back  with  eyes  closed.  Pain  is  followed  by  massive  tearing  and  automatic  closing  of  affected  eye.   Able  to  open  eye  and  function  without  ill  effects,  but  episode  may  last  4-10  hrs.  Thank  you  for  your  interest  and  time.

[John C Hagan III, MD, FACS]

Suppression involves small areas of the retina not the whole retina itself. Supressed area usually smaller in crossed eyes than in eyes that turn out.  Now because your eyes are in different position new areas have to be suppressed. Sometimes they can and some times they can't. Much slower in adult than child.

See a strabismus specialist/pediatric ophthalmologist to evaluate your problem and to look for causes of the pain.

JCH III MD

[JodieJ]

Dr. Hagan has given you excellent advice.  It's not clear what is causing your double vision.  Possibly, residual retinal damage is to blame (as opposed to eye muscle imbalance), in which case the issue of suppression wouldn't be relevant to the treatment.  Retinal surgeons today can often perform miracles by restoring good acuity following a retinal detachment or an epiretinal membrane.  Unfortunately, the patient may be left with some residual retinal damage which can produce various symptoms, including headaches, excessive tearing, photosensitivity, and binocular diplopia.   (I know about this because I have experienced such symptoms myself following successful retinal surgery.)  An experienced strabismus surgeon should be able to diagnose binocular diplopia secondary to retinal disease, although finding treatment for the condition is much trickier.  If it turns out that you need more information about such treatment, you can email me using the feature on this website.  Best wishes.  Jodie      

[John C Hagan III, MD, FACS]

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[kg17]

Jodie, did your photophobia ever resolve on its own, or did you take measure to help?  Thanks

[JodieJ]

My two main symptoms were a difference in image size/dimension in each eye and an eye that wouldn't stop tearing.  My symptoms persisted for more than a year after retinal surgery, when I finally found a treatment provider who could help me.  By then, I had already wasted lots of time and money on treatments that didn't help at all.  I have subsequently communicated online with a number of other post-retinal surgery patients in the US and UK who have had equally frustrating experiences getting their symptoms (including headaches, nausea, extreme sensitivity to light, spatial disorientation, and constant binocular diplopia) correctly diagnosed and treated.  My current goal is to make people aware that such symptoms MIGHT be associated with residual retinal damage and, hopefully, to spare others some of the anxiety and frustration I experienced in finding treatment that worked.    

[John C Hagan]

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[arrowone]

Jodie,

what kinds of treatments worked for you ?

and when it mentions residual retinal damage, is it that some
other parts of the retina were damaged when the laser treatment
was done ? (like being done for a retinal tear ?)

and what is the definition of "suppression" in this discussion ?
I'm new to these terms but going thru some symptoms of what
pat discusses,but for me its pain/strain in both eyes, usually not
at the same time, then goes away after some hours,
also sensitvity to sunlite and tinnitus (ringing in ears) - none
of which was had until the day after the laser treatment.

[John C Hagan III, MD, FACS]

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[JodieJ]

A retinal tear and subsequent laser repair might change the distribution of photoreceptors in the retina.  This could affect the size/dimensions of the image in the affected eye, causing binocular vision problems that produce the symptoms I mentioned.  In this case, the goal of treatment would be to make binocular vision (i.e., using both eyes together) more comfortable.  Treatment possibilities might involve corrective lenses (contacts/glasses) to make the image in each eye more equal or, in some cases, slightly blurring the vision in the affected eye.

I suggest that you discuss your symptoms with your ophthalmologist, who is in a position to diagnose your problem (which might turn out to be very different from what I've described).  In the event that you do have the type of binocular vision problem I've described and your ophthalmologist can't give you a referral, I can provide you with a few possibilities.  In my case, wearing corrective lenses some of the time has been sufficient to eliminate my symptoms.





  

[John C Hagan III, MD, FACS]

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