What Is Vertical Diplopia?

Mary McMahon

Vertical diplopia is a vision disorder where a patient sees a doubled vertical image. This condition can be caused by a number of things including tumors, myasthenia gravis, and cornea problems. It may be evaluated by an ophthalmologist, who can provide recommendations on how to proceed with treatment. The best care option depends on why the patient is having vision problems, and in some cases it may not be possible to resolve the issue.

People who notice vision changes and irregularities should make an appointment with an ophthalmologist as soon as possible.
People who notice vision changes and irregularities should make an appointment with an ophthalmologist as soon as possible.

A broad family of vision problems involve doubled vision in one or both eyes. More commonly, patients see double images side by side, rather than in a vertical orientation; double vision can cause disorientation, headaches, and discomfort. When patients discuss it with a practitioner, they should make sure to describe the frequency of the problem; if it happens all the time, for instance, this is an important clinical clue.

Double vision can cause disorientation and discomfort in patients.
Double vision can cause disorientation and discomfort in patients.

If a case of vertical diplopia is suspected, the patient can be run through a series of vision tests, including exams that will track eye movements. The medical provider may also ask for samples of blood and other fluids to explore possible causes; tumors, for example, can leave tell-tale markers in the blood. Patients may also have problems with their thyroid, nervous system, or cornea.

A patient may need chemotherapy if a tumor is the underlying cause of diplopia.
A patient may need chemotherapy if a tumor is the underlying cause of diplopia.

Treatment of diplopia involves addressing the underlying cause. If the problem is caused by a tumor, for example, the patient might need surgery to remove it, along with chemotherapy and radiation to prevent regrowth. Eye exercises could help develop weak muscles, or special corrective lenses might resolve a problem with the cornea. Sometimes medications help, in the instance of vertical diplopia caused by conditions like myasthenia gravis.

Vertical diplopia can be caused problems with the cornea.
Vertical diplopia can be caused problems with the cornea.

Ongoing monitoring can also help the patient’s medical provider identify any changes. These could indicate a change in the status of the underlying problem; if a patient’s thyroid replacement hormone is no longer working, for instance, vision changes could be an early warning sign. Care may require coordination with a specialist treating another condition to ensure that the patient gets complete treatment for both the vertical diplopia and the root issue.

Patients with vertical diplopia may also experience thyroid problems.
Patients with vertical diplopia may also experience thyroid problems.

People who notice vision changes of any kind should seek medical attention, as changes to the vision can be signs of serious medical conditions; in some cases, vision loss may be irreversible. The more quickly the patient receives treatment, the better the chances of a positive outcome. Vertical diplopia, for example, could onset very rapidly in association with a stroke, which requires prompt care to prevent brain damage.

An ophthalmologist will track a patient's eye movements using special equipment to confirm vertical diplopia.
An ophthalmologist will track a patient's eye movements using special equipment to confirm vertical diplopia.
A broad family of vision problems involve double vision in one or both eyes.
A broad family of vision problems involve double vision in one or both eyes.
In some cases, surgery may be necessary to treat the underlying cause of vertical diplopia.
In some cases, surgery may be necessary to treat the underlying cause of vertical diplopia.

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