Monocular Diplopia in BOTH eyes after IOL implants 18 months ago....

[Wobegoner]

Double vision in each eye even with one or the other closed.  No problem on arising but develops as the day goes on. Initially every few days in late afternoon.  Now......daily two hours after arising.  In last month the ability to focus properly (would guess about 20/80+ in both eyes) has been experienced all the time with the monocular diplopia. Total faith in surgeon......outstanding reputation, etc.  Have had numerous MRI's......with and without dye for cerbral causes......hours and hours of exams by doctor (literally), referred to another specialist at University Medical Center and also a neurologist specializing in opthomologic problems..  I've had computer generated maps of corneas.  The lens manufacturer has been consulted with noresults...ReStor.  Post surgery had laser surgery to improve the opening in each eye (not sure how to term that....smile).  Even ruled out myasthenia gravis.  Tried five different pair of contacts with idea that they would give stability to the surface of the eye.......no help and couldn't tolerate any of them anyway.  Eye strain such as reading or working on the computer accelerates onset on any given day.  Once it starts....which is very quick onset wise.......that's it for the rest of the day.  Interestingly, if I really strain HARD to open my eyes as wide as humanly possible, it improves the focus dramatically......but of course......I can only do that for a few seconds.  The problem is getting progressively worse......both the diplopia and the focus.  It starts earlier and earlier in the day and is worse overall.  Once it starts, I can not read, watch TV or drive.. To date, no one has been able to even come up with a theory as the cause....much less a solution.  No history of such problems at all prior to cataract surgery.  No new medication or other medical conditions.  General health is good.  Age 59.  I'd appreciate any opinions, suggestions or theories.  Thanks in advance for any information you think might of help.

[Nancy T]

Sorry to hear about your problem and that the doctors haven't been able to give you an answer.

Several other people on this forum or on the community eye forum (on the left side of the Medhelp forums page) have also had bilateral monocular diplopia with no reason found. Even the specialists seem to be at a loss to explain it.

Hope you get an answer someday. Please let us know if you do!

Nancy T.

[Michael J Kutryb, MD]

The fact that it is intermittant - almost certainly eliminated any INTRA-ocular cause such as anything to do with implant, retina, etc.  Now this cleary then implicates the cornea as the probable cause and again since it improves then worsens in this vicious cylce, it's probably related to the surface - eg tear film, epithelium, etc.  Would concentrate on rehabilitating the tear film and ocular surface including any lid margin disease.  Restasis, fish and flax oil, punctum plugs, preservative free tears, and glasses that seal around the edges to reduce tear film evaporation and glare.  Just some thoughts.
MJK MD