double/ghosting vision?

[cdlink14]

To give you guys a quick run up of the problem:
December 13th last year I got a corneal abrasion. It healed without complications (it did scar, but the scar is not in my view area)

late january I began getting blurry vision in general, and sometimes my eyes would act like I was looking through a cloudy frosted glass.

After running around with the doctor I saw an optician in late february who said my eyes were fine apart from some strange inflammation on the eyelids, he said it was likely blepharitis and sent me on my way.

I went to my doctor for advice the next day who gave me some basic stuff to help control blepharitis (eye hygiene routine, anti-dandruff shampoo and skin moisturiser) and sent me away for a month.

At the end of March nothing had gotten better so the Doctor referred me to an ophthalmologist (the only way to see one with the UK NHS), my appointment wasn't until May 14th though.

Mid-April I went to visit family at the beach one day, my eyes seemed fine during the visit. But the next day I noticed some bad blurring and double vision in my right eye (the one with the abrasion) after a few days it seemed to begin happening on my left eye.

I finally saw the ophthalmologist who said the problem is dry eye syndrome (he's given me 6 months of liquifilm tears) but said he can't find the cause of my double/triple vision and refused to get me a second opinion on it. He did get an optician to do some lens tests, and whilst they did make some text slightly clearer the double didn't change at all.

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The double vision is very variable. I usually see text, and then a copy of it on top (and in the cases when it's triple, I see one on top and one slightly below.) it can range in seethrough-ness.

This happens in both eyes, and happens even if I cover the other eye.

I can also seem to minimize it by squinting my eyelids (so I'm looking through the lashes) though this usually causes lights or light emitting displays to streak a lot.

I don't use any kind of glasses or contacts. I've been taking the dry eye drops for about 5 days now and whilst the blurriness of my eyesight seems to be very slowly phasing out (I'm getting patches during the day where my vision can be almost perfect in both eyes but it only lasts a few minutes to an hour) the double vision seems to be unaffected.

[cdlink14]

Also to point out the doubles I see don't seem to curve they're very straight but ghostly. Tilting my head forwards and backwards does seem to move the double slightly, but it's not very noticeable.

[cdlink14]

Are those things that you've done so far? I've already been to 2 GP's an optician (possibly an optometrist) and also a ophthalmologist.

I get the feeling you're not in the UK. Afaik across here it's impossible to get a lot of those tests, and for a few it's only possible via private healthcare, which is something I can't afford I barely have enough to pay my own bills. I feel extremely scared hearing all these different things.

I do have the problem in both eyes, but it's much stronger in my right eye. Right now I'm looking across my room at a poster. I can make out the words rather clearly with my left eye despite the double vision. But my right eye is extremely blurry, it's so bad that a letter I clearly know is a capital G, is showing up as a Q.

If I had to describe it, it's like the right eye is very short sighted. Whilst the left one still maintains some range.

Before the double/triple vision occurred (back when it was just dry eyes) I used to get some very bad painful feelings in my eyes, the pain was so the type that makes you feel like you're about to throw up. But around the time I began getting double vision this pain went away.

When I went to see the ophthalmologist (2 weeks ago today) I was given an eyesight test by an optician at the time she tried a few different lens, one of them did improve my vision slightly but she told me I wouldn't need glasses. Even whilst wearing the clear lens I remember telling her that I could still see the double it was just a bit clearer.

The triple vision for me seems to be very variable, I can't recall a day I woke up with triple vision. But I notice it a lot more often after spending a while at the PC or watching TV.

[PedroPrado]

Also, check out this website that has a lot of info about our condition:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2258122/

[PedroPrado]

Same symptoms here. When squinting it makes it better but it adds streaks of light for the ghosting images. Also, the pinhole effect (when you see trough your fingers) makes it dissapear.

Now, usually, when you do the pinhole test and the issue dissapears, it means that the issue is a refractive problem, usually astigmatism. Some people in this forum have found that a correct eyeglass prescription for astigmatism fixes the issue 100%, while not for others.

The fact that this issue is present even when you close one eye, means that this is monocular diplopia, and this means that the issue is in the eye itself, usually in the cornea. I know you have this in both your eyes but maybe some external disease is affecting them both at a time.

You need to set and apointment with and ophtalmologist and he must check you for corneal disease (keratoconus, abrasions, etc), lens, macular, retinal, etc. Its a good idea to request a corneal topography, in order to check the curvature of your cornea.

In the meantime, grab a cellphone or a tablet and create an image with a dark background and with letters. Go to walmart or any of those places that advert "Free eye exam", where they test your visual acuity. When they have a result, ask them to put the cellphone/tablet with the image and check if the ghosting dissapears by looking trough the lens that have your prescription. If the ghosting doesnt dissapear this means that you need to have your eyes checked but with a corneal specialist, in order to rule out corneal diseases and in order to ask for a topography.

I hope you can find a cure for your issue, and if you do let me know because i have the exact same issue.

Take care and good luck.

[cdlink14]

My eyelids aren't puffy and after following through with the blepharitis hygiene for nearly 4 months I have no improvement. It is really noticeable in high contrast at first but since mid April I see it on everything.

I've found that squinting my eyes so I'm looking through my eyelids minimises it but adds light streaking.

I've found that if I pinch my fingers together with a small horizontal gap between them and I look through it everything is cryatal clear with no double or tripling or light streaking.

Did you suffer any kind of injury to your eye before the problem?

I can't exactly take a break from the PC since its my work.

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

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[PedroPrado]

Im having the EXACT same symptoms that you describe, only that im suffering it in just my right eye and i DO have blepharitis symptoms. I purchased artificial tears and Ocusoft Lid Scrub Foaming Eyelid Cleanser, and after more than 2 weeks i dont see ANY improvement at all. My eyelid is still puffy and the ghosting is still there.

In the morning, is noticeable but little, and bad towards the end of the day, just like you. Some days, is not double but triple vision, just like you. And this is specially noticeable in high contrast scenarios (like TV subtitles, alarm clocks, etc)

Im also a lot in the computer. Sometimes i think the ghosting is created by the strain i put in my eye.

In fact, one thing that i noticed, and i dont know if it was coincidence or not, is that last saturday i spent the whole day without using the computer, tablet, cellphone, etc. When i arrived home at night, i watched a subtitled movie and the subtitles had the usual ghosting, but it was WAAAAY less noticeable than usual. So i dont know, maybe we need some time away from screens...

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

No an abrasion would not cause it, besides you said you have problems with both eyes but scratched only one.  Over and out on this.
JCH MD

[cdlink14]

Also to add that my vision and tear production was perfect before the abrasion even occurred, this problem I'm experiencing now occurred before the scratched eye had even fully recovered vision (things in the distance were still slightly blurry). So that also fuels my curiosity that I may have strained my eyes into the way they are now?

[cdlink14]

I'm sorry to yet again be dragging this out. But is it possible at all for this to be triggered by the initial abrasion? I used to get quite a lot of crust on my eyelids, but since having the abrasion I can't recall once when I've had any of the crust on either eyelids.

I have a friend who claims that 7 weeks after she had an abrasion (back in 2004) the interior of both her eyelids had dried out causing repeat abrasions. Speaking with my Doctor, optician and even the ophthalmologist they all claimed they never heard of such a thing. And apparently there is no such drops that are designed to soften the eyelids in such a case. I'd really like your opinion on if this is possible?

Hopefully this should be my last post before i mark this thread as best answered! :)

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

Sad indeed

[cdlink14]

Unfortunately that's not possible. The only way I can see that ophthalmologist again is if I was to go through the whole loop again, which means I'd probably get to see him in another 4 months. I've tried looking for contact details but can't find anything for him.

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

I suggest you ask your questions of the ophthalmologist that has examined you.  Liquifilm lubricates the eye that's all.  A corneal specialist would seem to make the most sense.

JHC MD

[cdlink14]

Thanks again, I'm sorry to be dragging this out even longer, but as an eye specialist I'm sure you understand my concern about the only pair of eyes I'll ever have.

1.) The blurriness does subside when I put the liquifilm tears in, the double vision however, stays.

2.) I probably should clarify, the ophthalmologist didn't describe it as debris. He used another big word. He said whatever it was, was scratching my eyes and likely causing light sensitivity (it is, but it's slowly getting better) he said it's not blepharitis as I have no signs at all of blepharitis being present. He did say 3 months of liquifilm drops would fix it, but he put me on 6 months to be on the safe side.

3.) If I was to look for private healthcare (this is unlikely though as I honestly don't have the money for it) what type of ophthalmologist would you recommend? What qualifications should I really look for?

I get the idea that maybe I've got this the wrong way around? Maybe the "debris"-stuff is causing the dry eyes and also scratching both eyes causing small scratches that are causing the double vision? The ophthalmologist never used fluorescein so if there was any scratches or abrasions  I doubt he would find them without fluorescein, right?


Again a lot of thanks, and I apologise for dragging this out.

I also forgot to mention the problems seem to be more intense in the eye which had the abrasion before xmas.

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

1. No, not due to dry eye. With blurred vision due to most dry eyes better when blink or instill artificial tear. Read this article on dry eyes: http://www.medhelp.org/user_journals/show/143745/General-information-on-dry-eyes-tears-dysfunction-syndrome

2. Liquifilm will not remove debris on eyelids.

3. Not a bad plan.  In USA these tests would likely be done: tear osmolarity e.g. TearLab, corneal topography, macular OCT  You likely will have problems going through NHS, more and more our UK posters go through private consultants.

JCH MD

[cdlink14]

Thanks anyway. Do you think there's a chance the double/triple vision could be caused by the dry eyes?

And do you know if the liquifilm drops will get rid of the debris on my eyelids? I assume if so it will be once my eyes regain proper moisture?

My plan for now is to spend a month and half on these drops and see if there is any improvement if not I'm going to my doctor to get a second opinion from a different ophthalmologist.

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

Sorry I thought your symptoms were only in the scratched eye. I don't think I can help you but there is quite a bit available on dry eyes and blepharitis by using the search feature and archives
JCHMD

[cdlink14]

I'm getting quite forgetful, I also forgot to mention that with the abrasion in december the specialist I saw at the A&E used a small metal tool to clean the abrasion with hopes that it wouldn't scar so bad (or at all) and she also gave me 7 days of antibiotics.

[cdlink14]

I'd also like to point out that during the early months of the problem I would get pretty bad nauseating pains in the eyes. But they seemed to stop around the time the double vision started. Now it's just a general gritty feeling.

[cdlink14]

There may have been once or twice I woke up with pain in the scratched eye but it would have been many months ago. Both eyes do tend to feel a slight bit gritty but I think that's the dry eyes.

There have been a few times before sleeping that I've received an abrasion-like pain in one eye but it fades after a few moments.

Whilst I'm no expert I also don't think it could be a recurrent corneal erosion, since the problems are in both of my eyes (only one had an abrasion). And I think the chance of it happening in both of my eyes around the same time is slim.

The optician I saw in february did a test with eye stain and found nothing wrong with the eye.

When I saw the ophthalmologist though he never used any eye stain he looked at my naked eye through the slit lamp. I'm unsure if that's normal, but he was able to tell me that the corneal abrasion scar I got isn't on my viewing cone.

The blurriness is always there and varies in a way similar to a camera lens, one moment things are in focus the next they're not.

The double vision is variable in the way that it tends to be little (but noticeable) in the morning, and rather bad towards the end of the day it also seems to get cloudy towards bedtime it is noticeable on everything though, not just light sources.

I also forgot to mention that the ophthalmologist did say I had bits of debris on my eyelids which were scratching my eyes but he said there's no way they could be causing the double vision. He didn't mention how to get rid of them, he said it's not blepharitis and my eye hygiene shouldn't affect it in anyway. I can only assume the liquifilm drops will get rid of this debris? (I'd like if you could confirm this)

I do use the computer a lot (as my job demands it) and I do take regular breaks from it (at least 20 minutes break every 1.5 hours).

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

Your symptoms could all be accounted for by a recurrent corneal erosion in the visual axis. If your monocular diplopia was due to a refractive error or cataract the symptoms should be constant and not come and go.

Do you ever awake from sleep with pain in the scratched eye? Or do you wake up in the morning afraid to open the eye because you know its going to be painful?

JCH MD