Aa
monocular diplopia
Dr. Kutryb, thank-you for your response on May 18th to my post of the same date. I mentioned that I had had cataract surgery for my right eye near the end of April with an Acrysof Toric lens. Before surgery, this eye was -8.50 with -2.11 D of astigmatism.
I can now tell you that my current refraction is -.75 with -.5 D of astigmatism which seems like a very good result for the surgery. The vision is only 20/100, but this is most likely because of an epiretinal membrame. My main concern is still the monocular diplopia. (As mentioned in the previous post, the vertical lines of the Amsler grid are doubled to about 2 feet out (with a beige coloring between the doubled lines. Further out, the horizontal lines (and not the vertical ones) are doubled (with the same beige coloring inbetween). Also, a line of print looks continuous because of the fainter ghosting of letters between the words.)
A few articles I've seen say that monocular diplopia is one of the common symptoms of an ERM. I've read that toric lenses can also cause monocular diplopia - but mainly in people with large pupils, and mine are small.
Are there any tests or specialists who could confirm whether the diplopia is caused by the ERM, or possibly the lens, or something else?
If it is caused by the ERM, would it be a good idea to have the ERM peel done on this eye to see whether this will eliminate the diplopia - before I have the cataract surgery for the left eye?
If I have the cataract surgery on my left eye, is it likely that this eye will also develop monocular diplopia? This eye is very myopic, -12. When I hold an Amsler Grid just beyond where I can focus, both the vertical and horizontal lines are doubled - it looks sort of like plaid.
Is this normal, because of the high myopia, or does this mean that I already have diplopia in this eye?
I'm very concerned because I can't really read with the right eye. Drugstore readers of 3.25 D. do bring the doubled letters together but the vision is "jumpy", not comfortable. If the same thing happens with my left eye, I won't be able to read to any extent at all which would greatly affect my life.
Thank-you very much for your consideration of my situation. I really appreciate your help.
I can now tell you that my current refraction is -.75 with -.5 D of astigmatism which seems like a very good result for the surgery. The vision is only 20/100, but this is most likely because of an epiretinal membrame. My main concern is still the monocular diplopia. (As mentioned in the previous post, the vertical lines of the Amsler grid are doubled to about 2 feet out (with a beige coloring between the doubled lines. Further out, the horizontal lines (and not the vertical ones) are doubled (with the same beige coloring inbetween). Also, a line of print looks continuous because of the fainter ghosting of letters between the words.)
A few articles I've seen say that monocular diplopia is one of the common symptoms of an ERM. I've read that toric lenses can also cause monocular diplopia - but mainly in people with large pupils, and mine are small.
Are there any tests or specialists who could confirm whether the diplopia is caused by the ERM, or possibly the lens, or something else?
If it is caused by the ERM, would it be a good idea to have the ERM peel done on this eye to see whether this will eliminate the diplopia - before I have the cataract surgery for the left eye?
If I have the cataract surgery on my left eye, is it likely that this eye will also develop monocular diplopia? This eye is very myopic, -12. When I hold an Amsler Grid just beyond where I can focus, both the vertical and horizontal lines are doubled - it looks sort of like plaid.
Is this normal, because of the high myopia, or does this mean that I already have diplopia in this eye?
I'm very concerned because I can't really read with the right eye. Drugstore readers of 3.25 D. do bring the doubled letters together but the vision is "jumpy", not comfortable. If the same thing happens with my left eye, I won't be able to read to any extent at all which would greatly affect my life.
Thank-you very much for your consideration of my situation. I really appreciate your help.
MEDICAL PROFESSIONAL
Don't make judgements on the diplopia or ghosting unless you have on the exact proper prescription for glasses for distance and reading. If still present despite the exact prescription then look at OCT scan of macular. If it has a very significant epiretinal membrane present then you may consider surgery for it if you have a definite loss of vision because of it. If you have a normal macula and vision still double with ghosting despite proper glasses, then your situation is much more complex and could involve things like higher order abberations - but we won't go there for now. My impression is that you still need glasses and have some degree of epiretinal membrane.
Michael Kutryb, MD
Michael Kutryb, MD
I should tell you that Dr. Kutryb is on the eye care ask an expert forum. Click on it on the right side of the forum page.
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