With very occassional minor doubled vision being a new thing over the last few months (I'm 53), eye doc observed palsy of the 6th cranial nerve, and suspected the cause was "just getting old" given the sporadic nature of the doubled vision and the fact that I had amblyopia as a kid. (Palsy of the 6th cranial nerve doesn't cause double vision in kids, it causes amblyopia.)
On MRI a small .5 cm BCT was observed in basically exactly the right spot to potentially be causing this. My eye doc freaked out and immediately reached out to a leading brain guy specializing in vascular issues who said "sure, send him over. And I want him to have an MRA"
Based on everything I've read about BCTs, this seems like a gross overreaction. I've read nothing suggestive they cause progressive problems (its rare they cause problems at all), and indeed, it seems possible I had this one since I was a kid. While I read that surgery is done in 12% of symptomatic cases with good results, it seems like it would be totally crazy to even consider that given my mild symptoms, which should be very correctable with glasses.
My eye doc is really pushing this, but I sure don't feel like having an MRA for no good reason, and even going to see the guy seems like an overreaction given the mild symptoms and the fact that BCTs aren't, as far as I know, progressive.