Doubles in the eyes when looking into the distance. Causes

Vision for a person is one of the important tools for cognition of the surrounding world, obtaining information about it. Therefore, any disturbances in visual function turn into tangible discomfort. If, when looking into the distance, the outlines of objects are fuzzy and double, this is a bright symptom

diplopia (double vision). An ophthalmologist will help to get rid of double vision, because the treatment of diplopia depends on its type and the cause of its appearance.

How does double vision (diplopia) manifest

Diplopia is not considered an independent disease; it is one of the visual changes associated with the appearance of a double image of the objects in question. If a person is healthy, two eyes are involved in the implementation of visual function, and normal vision is binocular. The brain receives individual signals from the eyes, in the process of superimposing them on each other in the brain a single picture is formed, it is its stereoscopicity that helps a person gain confidence in orientation.

Depending on the reasons that caused the images to overlap, the picture can be doubled in different ways, in different planes:

Types of double vision	Horizontal	Overlapping adjacent images
Vertical	Pictures are superimposed one on top of another
Oblique	Diagonal Image Overlay
The main types of diplopia	Monocular	Duality syndrome persists when one eye is closed
Binocular	If you close only one eye, the picture ceases to double.

Types of double vision and their clinical features

Focusing on the symptoms of image layering, there are two main types of double vision - monocular and binocular. It is not difficult to determine the type of diplopia on your own - you need to close one eye with your hand. The disappearance of the double image indicates binocular diplopia. If double vision has not ceased, then the fact of double vision refers to the monocular type.

Monocular diplopia

This type of visual distortion is considered the rarest defect.

It leads to the fact that the picture is projected twice on the surface of the retina due to problems:

• corneal diseases - keratoconus (thinning of the cornea), various types of keratitis, pterygium (proliferation of tissue structures of the inner corner of the eye);
• problems with the lens - cataract (clouding of the lens), as well as astigmatism (curvature of the shape of the eye, cornea, lens);
• double vision when looking into the distance due to insufficient production of tear fluid, which leads to the development of dry eye syndrome.

It is quite rare that neurological disorders become the cause of double monocular vision. They usually develop on the basis of intraocular pathologies that require in-depth ophthalmological diagnostics for a more detailed assessment.

Binocular diplopia

The most common form of double vision in the eyes is associated precisely with the influence of neurological disorders (damage to the optic nerves), which occurs in diabetes and inflammatory processes.

Symptoms of binocular double vision also develop due to high blood pressure (paralysis nerves of the skull), an immune disease (myasthenia gravis), manifested by weakness of the striated muscles. Most often, signs of binocular diplopia are disturbed due to strabismus acquired in childhood.

Temporary diplopia

This type of visual impairment occurs as a result of taking large doses of alcohol or from an overdose of medications. For some time, objects can double after traumatic brain injury, concussion (mild form), intentional (volitional) spasm of the eye muscles. Visual function will recover quickly if the cause of the double vision effect is eliminated.

Volitional diplopia

In the rare case of diplopia, double image syndrome is formed by deliberately defocusing the gaze for cross-tracking. The ability to control the convergence or aversion of the eyes in different directions does not threaten health and life, and sometimes even benefits. For example, to view stereograms.

The main causes of double vision

Doubling of the contours, due to a wide range of reasons, can appear at any stage of life. The deviation that arose in childhood due to strabismus, in most cases, disappears after adulthood due to the ability of the brain to compensate for the influence of acute moments of pathology.

In adults with weakened muscles that control the movement of the eyeball, the appearance of double vision depends on the type of structure affected. The defeat of the oblique muscles leads to the development of vertical double vision, doubling in the horizontal perspective occurs due to problems with the rectus muscles.

After surgery, trauma

Diplopia, accompanied by pain and swelling of soft tissues, appears due to the displacement of the eyeball as a result of an injury to the eye or its surrounding structures. If the walls of the orbit are damaged, the severity of the syndrome may increase, even after the swelling has decreased. The fact of double vision becomes unbearable, and the victim has to close one eye to relieve the headache.

Doubles in the eyes when looking into the distance after operations that relieve cataracts or retinal detachment. After correction of strabismus, patients often suffer from diplopia symptoms caused by the action of anesthetic drugs. Usually double vision of this type does not last long - only a few weeks. Surgical treatment of glaucoma can cause the development of binocular diplopia, and treatment of retinal detachment - temporary layering of the visible image.

With osteochondrosis

Vision problems indicate a violation of internal functions, one of the causes of which are the consequences of cervical osteochondrosis. Symptoms of spinal disease include decreased visual acuity, problems with focusing, headache, and double vision.

The reason is associated with a deterioration in cerebral circulation, pinching of nerve endings. Cervical osteochondrosis primarily affects the nerve receptors of the occiput, which ensure the functioning of the organs of vision.

After suffering a stroke

The symptom of double vision can appear suddenly during the formation of a tumor of the brain structures, the presence of intracerebral aneurysms, as well as in the post-stroke period. The cause of binocular diplopia in this case is explained by the location of the ocular apparatus (skull). In case of impaired blood circulation of the brain, and a stroke is an acute failure of cerebral circulation, its vessels and tissues suffer from subsequent hypoxia, which leads to a decrease in visual acuity.

Astigmatism

Pathology refers to conditions when the uniformity of curvature (sphericity) of the cornea or lens is not observed, as a result of which the visible picture changes. Astigmatism is associated with monocular diplopia and unequal clarity of images seen with both eyes.

The patient sees two overlapping pictures, one of which is true and seen clearly, and the second appears to be its shadow. As a result, there is a feeling of partial overlapping of objects.

Convergence pathologies

The phenomenon of convergence ensures the simultaneous movement of the eyes towards each other, which guarantees the possibility of viewing closely spaced objects. Failure of the convergence mechanism leads to incorrect focusing of objects on the retina, which is the cause of double vision.

The syndrome of layering when looking at distant objects is called convergence kurtosis, which creates the effect of wobbling of the visible object. If closely spaced objects are doubled, the condition is called convergence failure, and the person has a need to rub his eyes.

Accommodation disorders

With this type of ophthalmia, problems arise with the vision of objects located at different distances from the patient. The specificity of accommodative symptoms requires a detailed study of the clinical picture from the doctor, since different types of pathological conditions are accompanied by unequal options and signs diplopia.

It can be poor vision near or impairment of vision of distant objects, as well as bilateral diplopia - double vision of near and distant objects. With all types of accommodation, patients complain of headaches.

Neurological disorders

Since the nervous system (central and peripheral) controls all processes in the human body, failures in its work affect the functioning of the eye apparatus.

The defeat of the muscles responsible for the oculomotor function leads to the development of pathologies accompanied by double vision:

• ocular neuromyotonia interferes with keeping an eccentric gaze;
• intracranial hypertension develops on the basis of various brain lesions;
• with myasthenia gravis, episodes of diplopia are associated with pathological muscle fatigue.

The image of the object in the eyes is doubled if the nerve endings of the organ are affected by pathological changes, because the eye tissues are penetrated by an extensive network of nerves. If the abducens nerve is affected, when looking into the distance, signs of horizontal diplopia appear - doubles when looking at very distant objects. If the lateral nerve is injured, it doubles when the head is tilted down.

Orbital myositis

The development of myositis of the orbit in acute or chronic form is accompanied by diffuse inflammation of the muscles responsible for the oculomotor reflex. Symptoms characteristic of orbital myositis are accompanied by a sudden onset of diplopia. If one eye muscle is affected, the soreness is subtle, but as the inflammation spreads to the rest of the muscles, the pain becomes unbearable.

Thyroid ophthalmopathy

As a result of an autoimmune disease of the thyroid gland, an endocrine disorder develops, the progression of which causes specific lesions of muscle tissue. Since the process of inflammation covers the rectus muscle from below, the pathology is characterized by vertical double vision, which occurs in the position of the raised chin. To select a treatment regimen, ocular dysfunction should be differentiated from orbital myositis.

Taking medications

Long-term therapy with certain drugs can cause specific visual impairment. Symptoms of temporary double vision are caused by antiepileptic and anticonvulsants. Due to the systemic intake of beta-blockers, general fatigue is added to the manifestations of diplopia, and high doses of glucocorticosteroids signal increased drowsiness.

Intoxication

The abuse of alcohol and drugs, as well as drugs for the purpose of suicide, leads to general intoxication, among the specific signs of which is double gaze. In acute poisoning with ethylene glycol, the distortion of the picture is accompanied by the expansion of the retinal veins, a sluggish reaction of the pupils to light. Cocaine overdose is manifested by excessive anxiety against the background of diplopia syndrome.

What does double vision say only when looking into the distance?

The main reason for the visual problem is due to the complexity of the structure of the optical system of the organs of vision. As a result of the correct operation of the eye optics, the rays of light falling on the cornea are refracted, changing its direction, and the picture of the image is obtained due to the focusing (convergence) of the rays on retina. However, in some pathological conditions, there is a doubling of the outlines of objects.

Therefore, the unusual effect of duplicating the shape of visible objects indicates the presence of pathologies of the organs of vision or diseases. Among their manifestations is the development of monocular or binocular diplopia.

Diagnostic procedures

During the initial examination, the ophthalmologist determines which type of diplopia the patient suffers - monocular or binocular.

To prescribe treatment, it is necessary to establish the cause of the split gaze, which will require the results of an ophthalmological examination:

Diagnostic steps	Details
Motor Assessment	Testing the ability of the eyes to move the eyeballs in a coordinated manner (motor skills).
Test system	The range of double vision and the radius of vision are determined, the oculomotor function is assessed, and the presence of myasthenia gravis is checked.
Additional research	MRI, CT, ultrasound of the head are prescribed if there is a suspicion of a neurological or compressive nature of the disorder. Special blood tests will help eliminate thyroid problems.

Methods for treating double vision when looking into the distance

Depending on the established cause of the appearance of diplopia, a specific method of treatment is selected. Correction of double vision in the eyes is performed by the method of surgical intervention, which improves vision therapy, the appointment of glasses with prismatic lenses, as well as medications.

Exercises for diplopia

Doubled in the eyes when looking into the distance is not always with complex pathology, episodes of visual perception are temporary. If, during the course of the diagnosis, a mild form of the disorder is established, in addition to an individual treatment program, the help of specially selected exercises is recommended.

In the case of weakened muscles, doing Bates gymnastics will help restore vision at home. The training complex includes the development of the oculomotor muscles, warm-up of the cervico-shoulder area, as well as palming techniques (palm exposure).

Drops with double vision

Treatment of diplopia with eye drops is justified if there is double vision in the eyes due to severe dryness of the conjunctiva. In this case, solutions from the Artificial Tear series, drops with vitamins for the eyes, as well as on the basis of hyaluronic acid, dexpanthenol, help.

If the double vision syndrome is complicated by additional symptoms, therapy is enhanced by connecting drops of a certain direction:

• to reduce intraocular pressure, Betaxolol is instilled;
• the appearance of bacterial flora is blocked with Levofloxacin;
• with edema and pain symptoms, Diclofenac solution is relevant.

It is important to remember that self-administration of eye drops is unacceptable, since each medication has many contraindications and rather dangerous side effects. Any drug should be prescribed by an ophthalmologist after establishing an accurate diagnosis.

Systemic drugs

Not a single type of diplopia is treated with a specific drug; the direction of conservative therapy depends on the disease that provoked the fact of double vision. The type of the underlying pathology is determined during the diagnosis, if necessary, narrow specialists are involved in the treatment process.

The task of physicians with thyroid ophthalmopathy is to achieve normalization of the thyroid condition with a normal level of thyroid hormones. The tactics of treatment are individual, including the intake of thyroid hormones (synthetic analogs), and other hormonal drugs.

During the treatment of myasthenia gravis, it is necessary to compensate for the influence of the factor that caused the neuromuscular failures. Doctors prescribe therapy with glucocorticosteroids, immunoglobulin G, spironolactone, anticholinesterase agents while taking potassium chloride.

If the cause of double vision is due to refractive errors, vision correction is performed with mechanical devices - wearing glasses or contact lenses (soft). The disturbed convergence is restored by the orthoptic method, and the stable form of diplopia - by prismatic correction.

Surgery

In the absence of positive results of therapy within six months, the inability to cure the underlying disease, a high degree of deviation from the norm, vision correction is performed surgically. An operation to strengthen or weaken the ocular muscles can correct the manifestation of ocular diplopia. Surgery of this type is indicated for adults and children, it is performed on an outpatient basis under local or general anesthesia.

Is it possible to get rid of double vision, in what cases

The unpleasant symptoms of diplopia make life difficult for people, creating problems in everyday life and at work. According to ophthalmologists, ophthalmological pathology can be cured, but the success of the final result depends on the cause of the visual defect.

Diplopia due to alcohol or extreme fatigue or certain medications is considered a short-term disorder. The syndrome does not require treatment and disappears with the cessation of the effect of the irritating factor. In the case of strabismus, when it is impossible to fix the gaze on one object, an operation to tighten the eye muscles relieves from double contours.

A number of systemic diseases that provoke diplopia are difficult or impossible to cure, which excludes the likelihood of getting rid of the defect. Since the outlines of objects in the eyes will not stop doubling, a person will have to adapt to life with a visual defect by wearing prismatic spectacle lenses.

The postoperative loss of clarity when looking into the distance is restored on its own after a few days, they will be required to normalize the functions of the brain and visual system.

Video about the cause of double vision

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