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Double Vision
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Double Vision

I am a 34 year old female who had brain surgery two months ago to drain a pineal cyst.  My only symptom prior to the surgery was double vision.  I would get a real pressure feeling behind one eye and my eyes would be moving around I suppose to try and focus.  My vision would not necessarily be double in all quadrants.  It began with one or two episodes a month lasting around five minutes.  By surgery time (five months later) my episodes were every other day.  I never had more than one episode a day and I never had one driving.  Now that the surgery is over, I continue to have the double vision episodes.  I also feel like the eye that feels most of the pressure is not as clear as it was.  It feels a bit tighter/dryer and my vision is slightly blurred.  The frequency can be up to as often and I have gotten one while driving.  The episodes do not always last as long and at times I feel like I can shorten or perhaps stop them from happening by not letting my eyes search and breathing slowly.  My surgeon was disappointed that the episodes were as frequent and wasn't sure why.  Is it just a matter of healing?  The back of my head is still healing from the surgery.  How long does it take inside?  What causes the double vision?  What nerves are involved?  I think I can corrolate it to change in blood flow.  Does that make sense?  It occurs most when I am crouching down to tie shoes or looking at something on the ground or straining to carry something heavy.  It can happen however, if I am sitting on a hard chair or even just standing.  If the cyst is gone, why is this still happening?  Does this mean the surgery was all for nothing? Can it happen because of damage to a nerve?  Will it heal over time?  Could the feeling in my one eye and the slight vision change be a result of this surgery too?  I am going back to the surgeon in seven weeks and will have another MRI done prior to that visit.  I would like to have as much info for that appointment as possible.  Thanks.
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Avatar_n_tn
Thanks for the note and sorry to hear about your problem. Double vision as you can imagine can have many causes I assume when you close eithere eye alone the double vision goes away - if not then the problem is probably related to one of your eyes itself. We see alot of pineal cysts and I can't remember the last time we did surgery on one. If the cyst is drained then it can refill with fluid. It would be interesting to know if the cyst got smaller after surgery. We see alot of people with all kinds of neurologic complaints who have cysts but they are usually not the cause. If you have not see a good neuro-ophtholmologist then you should so that a detailed eye exam can be done. If patients get into trouble from cysts it is usually because they are exerting pressure due to their size against the brain stem which then affects the control of eye movements. Sorry to hear you are still having problem and I hope that things improve for you. gs
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Avatar_n_tn
My mom just had a meningioma removed about 4 weeks ago, she is having double vision too, she was diagnosed because she was suffering from trigeminal neuralgia and had an MRI taken.Her doctor told her that it will take 8 months to recover her sight completly. Like you she sees double when looking down, she covers her left eye to see better (that's the side where the tumor was located. She also can't read full lines, she says that the lines don't look straight. Good luck, I hope you get a full recovery.
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I,too,have been seeing double--for almost two months. I had a MRI and it evidently was negative for anything serious. I do not know what happened to me, but the neurologist told me that my left eye muscle is not getting enough blood. He talked about a damaged nerve. I will have to wait until our next visit, which is two weeks away,to find out what my options are. I first went to the opthalmologist and he said that I did not have any damage and that my vision was the same as my glasses. That day I went to three doctors. I can not drive a car unless I close my left eye--which is scary. I have a driver now. I am 55 years. I hope all goes well with you. I do know that seeing double is scary. Take one day at a time. :)
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Avatar_n_tn
Greetings Kristy,

I has a pretty massive craniotomy a little over 2 years ago to excise networks of tumors known as schwannoma .  They removed half of my forehead in order to access the left temporal lobe, 7th cranial nerve, my left orbit and the optic nerve.  I even had one in the deep cavernous sinus that had to be treated with stereotactic radiosurgery 6 months later.

Like you, double vision began prior to the craniotomy.  It not only was frustrating, but frightening also... because I never knew when it was going to happen?  After the surgery, things got considerably better all the way around.  I had the radiosurgery... and the vision problem returned with a vengence after 2 months.  I consulted my oculoplasty opthalmologist about the problem and he said, "nerve damage" in combination with the already existing problem of pressure caused by the existence of remaining mass that could not be excised.

Now, I wear an eyepatch around my neck most of the time and there is a eyepatch hanging somewhere in every room, especially beside my computer.  I know what activities "bring it on" and try to avoid them as much as possible.  Crouching for too long, lifting and carrying heavy objects, cutting my eyes to the left too quickly or looking down for extended periods of time.  I believe the worst episodes I have occur while blow-drying my hair on the left side as I watch in the mirror.  It happens every single time I do it.

I sympathize with you, Kristy... and want you to know that you are not alone in the dilemna.  I hope and pray that your problem doesn't get any worse and in fact "begins to recede with time" as you continue to heal.  Good luck in the future and take care of yourself.

Always,
Lady Jay
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Avatar_n_tn
Lady Jay,
Thank you for your response to my question.  You are the first person I have found that has the double vision come and go.  I am interested to learn whether any of your doctors have told you exactly what is happening inside your head when you get the double vision.  Some of my questions are:  Is something pressing on the nerve?  What nerve exactly?  Is is related to blood flow?  I know when I am squating or carrying something heavy blood flow is constricted.  What exactly does nerve damage mean?  If the nerve is damaged, why not have the double vision all the time?  I know you said you avoid the things that make your vision go, but does it happen sometimes when you are just standing talking to someone?  I am hoping mine is still caused by swelling in my head from the surgery in May.  Or just my head getting used to not having the cyst.  However, the more I learn the better prepared I will be for my next appointment.  Any info you have will be a help.  Again thanks for the response.

Kristy
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Avatar_n_tn
Dear Kristy and Lady Jay, I am so frustrated. I, too, have so many questions. I must write them dowm to ask the neurologist next Tuesday. My chiroprator says the nerves in my neck are affecting my vision. I am having neck problems,  too. I can see normal when I close one eye--left or right--. But, the problem is left. I see double all the time--lighting has a lot to do with my problem. Have you tried to wear sun glasses in the day to see if that helps you? I am told that the opthalmologist can fit me with prisms in eye glasses to help me. I just want this to go away. If someone could tell me that my wision will evidently be corrected I would be very glad. Please keep us posted on your progress. I guess you have been tested for other medical problems--high chlorestral, blood sugar? Take care.
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Avatar_n_tn
Kristy- you are 3 months post and still healing.  Each craniotomy is different.  This is why I believe in playing 20 questions with your doctor... and every single one of your questions are good ones.  Usually, any questions that you pose will bring lengthy answers by your doctor.  I think they like a patient who reaches out to "know thyself".  As for nerve damage... the best I can tell you is that nerves when resectioned never heal to be normal like before.  They can twist and turn this way or that and even flip upside down when they heal... hence, some damage.  Check with your doctor about CN 2, 3, 4, & 6.  Could be some pressure that waxes and wanes on one of them that is causing the double vision.  I sure hope that your problem goes away when you are healed.  Good luck.- Lady Jay
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Avatar_n_tn
Hi...
Don't shoot the messenger.  Double vision and vision problems can be caused by using the artificial sweetenter, aspartame, Equal, NutraSweet.
Check out www.dorway.com and put in the 'search'  What's Blinding
The World--or Dr. H.J. Roberts.  Roberts has just published a 1,000 page medical text, Aspartame Disease: An Ignored Epidemic--see www.sunsentpress.com   but all the inro on dorway and http://aspartamekills.com and www.presidiotex.com/aspartame is free.
You can contact me at ***@****.
Best wishes for everyone's complete recovery.  60 days do it as far as vision.  Chane in vision is no. 6 on the FDA list of symptoms caused by aspartame--a list they were forced to reveal under the Freedom of Infroation Act in 1995.  

Anyone who wants in on the class action lawsuit, send your case history to ***@****
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Avatar_n_tn
I went to my Neurologist and he said that I had a bruised nerve caused by my car accident 2years ago. I have been having neck trouble so I guess he is right. No one knows how long it will take to get my vision normal again--sound familiar? I did get some help with some prism's in my glasses--now I don't see double straight ahead, only to my left. I do know the frustation, but it could be a lot worse. The aspartame theory is interesting. I have used it very little since my eye trouble 3 months ago. I will check the site out. Thanks for the heads up. Good luck to you all.By the way ,prism's are not so expensive. I think that they can be added to any eyeglass.
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Avatar_n_tn
Double vision can be either monocular (seen with one eye) or binocular (seen with both eyes).  When you have "double vision", you should note if it is abolished by closing one eye.  If it is, then you have a binocular condition which usually involves one or more of the cranial nerves.  The nerves are usually the third cranial nerve (which can be partial or complete involvement), the fourth cranial nerve, or the sixth cranial nerve.  The third cranial nerve involves eye movements toward the nose, elevation and depression of the eye (up and down movements).  The fourth cranial nerve usually is involved after trauma to the head.  This manifests with double vision where the second image is slightly to the side and a little higher than the first image.  It can also be from a vascular cause.  The sixth cranial nerve is usually involved because of a vascular or traumatic cause.  This often causes the eyes to cross to some degree.  Images are usually side by side with no up and down.  Double vision seen with one eye closed usually indicates a problem with the eye that is open.  This is often a problem with the ocular media.  i.e.  the cornea, vitreous, lens etc.
I am an orthoptist that works with a predominantly pediatric population, but have seen many adults that complain of double vision.  Your best bet to resolve this issue is to find a local PEDIATRIC ophthalmologist that has an orthoptist working with them.  We can almost always eliminate the diplopia a.k.a. "double vision" with either prism therapy or by surgical intervention.  I hope this helps.
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I hope someone can offer me some insight into my problem. For the past 2 years I was having some pain in my left arm. I had alot of MRI's and many different neurology visits. No one could tell me anything. I finally figured out that if I pressed the right side of my neck I felt a sharp pain.  Massaging this area alievated the pain temporaraly. I determined it most be disc pressing on a nerve. Went to neuro, nothing.  More recently I started having a tingling sort of stabbing pain on the left side of my face(scalp, lip, nose, etc..).  My PCP rx prednisone. It went away for a while, but came back. On the next occasion I experienced double vision.  I went to the ER and was given an eye patch and stronger steroids.  It went away. My pcp referred me to a neurologist (at my insistance). The neuro rx Neuontin but could not tell me why these things were happening. He ordered another MRI and blood work - all normal.  I currently am having double vision for 6 days now and still having face pain. Nerontin helps a little with face. Neurologist wants me to see an ophthalmologist. I have an appointment on this friday.  I am very afraid.  I feel like no one will care enough to really help me. I have not been able to get a diagnosis.  Anything I know, I have learned on the internet. Please help.
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