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Double vision is usually a temporary issue, but it can also be a sign of more serious health conditions. Health conditions that affect your eyes are the most common diplopia causes.

symptoms and Causes of Diplopia

Diplopia can occur in various forms and is categorized into several types based on different factors. Here are some of the different types of diplopia:

1. Monocular Diplopia:
This type of diplopia occurs when the double vision is present in one eye only. Double vision in one eye typically suggests a problem within the eye itself rather than an issue with the alignment of the eyes. Causes may include astigmatism, cataracts, corneal irregularities, or abnormalities in the lens.

2. Binocular Diplopia:
Binocular diplopia refers to double vision that occurs when both eyes are open. Double vision in both eyes is usually due to misalignment or coordination problems between the two eyes, resulting in the images from each eye not merging properly in the brain. Binocular diplopia can be caused by various conditions such as cranial nerve palsies, muscle weaknesses, strabismus (misalignment of the eyes), or nerve disorders.

3. Horizontal Diplopia:
Horizontal diplopia is characterized by double vision horizontally, where the two images appear side by side. It is often associated with muscle imbalances or weaknesses in the muscles responsible for horizontal eye movement, such as the lateral rectus and medial rectus muscles.

4. Vertical Diplopia:
Vertical diplopia involves double vision vertically, with the two images appearing one above the other. It is commonly associated with imbalances or weaknesses in the muscles responsible for vertical eye movement, such as the superior rectus and inferior rectus muscles. Conditions like thyroid eye disease or trauma to the eye muscles can lead to vertical diplopia.

5. Intermittent Diplopia:
Vertical diplopia involves double vision vertically, with the two images appearing one above the other. It is commonly associated with imbalances or weaknesses in the muscles responsible for vertical eye movement, such as the superior rectus and inferior rectus muscles. Conditions like thyroid eye disease or trauma to the eye muscles can lead to vertical diplopia.

6. Comitant Diplopia:
Comitant diplopia refers to double vision in which the separation between the two images remains constant, regardless of the direction of gaze. It suggests that the misalignment of the eyes is equal in all directions of gaze and typically points to a problem with the eye muscles or their control.

7. Incomitant Diplopia:
Incomitant diplopia occurs when the separation between the two images changes depending on the direction of gaze. The degree of misalignment varies, indicating an underlying condition affecting the extraocular muscles or nerves. Incomitant diplopia can be caused by conditions such as oculomotor nerve palsy, cranial nerve palsies, or orbital disorders.

This is when double vision occurs in only one eye. This means that the doubling does not go away even when you cover the other eye or look in different directions.

Lots of eye problems can cause double vision.

Anything that affects your brain, your eyes or the nerves and muscles that control them can lead to diplopia.

What are the causes?

1. Astigmatism. This is a condition where the front surface of the cornea is abnormally curved hence causing double vision.
2. Keratoconus. Keratoconus is a degenerative condition that causes the cornea to gradually become cone-shaped and thin.
3. Pterygium. This is thickening and hardening of the conjunctiva causing it to extend to the cornea and cause double vision.
4. Dry eyes.The eye dries out too quickly or does not produce enough tears.
5. Retinal abnormalities. For example, in macular degeneration, the centre of the field of vision gradually disappears, and if there’s swelling, double vision can occur in one eye.
6. Cataracts. Cataracts in the eyes can also cause diplopia in one eye.
7. Poorly-fitting glasses or contacts.
8. Migraines.
9. Abnormalities in your iris (the colored part of your eye).
10. Proptosis (bulging eyes).
11. Head injuries.
12. Cranial nerve issues.
13. Nearsightedness (myopia).
14. Farsightedness (hyperopia).

Diplopia risk factors

Anyone can experience double vision, but it’s most common in adults older than 60.

Having certain neurological or other health conditions can increase your risk, including:

• Myasthenia gravis.
• Vertigo.
• Brain aneurysms.
• Strokes.
• Diabetes (including diabetes-related retinopathy).
• Vitamin B1 deficiency.
• Thyroid disease.
• Multiple sclerosis (MS).

Reference:

• amblyoplay.com/what-is-diplopia-or-double-vision
• binettereyecentre.com.au/2019/09/20/what-causes-double-vision