How to Treat Double Vision: Effective Solutions and Expert Advice

Identifying and Then Treating the Real Problem

Dr. Kalie McCartin

Developmental and Neuro-Optometrist

Owner, Visual Processing Institute

Double vision, also known as diplopia, can be a disorienting and frustrating experience. If you're seeing two images where only one should be, it’s crucial to understand the underlying cause and how to address it. While double vision can sometimes signal a serious health issue, in many cases, it is treatable with the right approach. So, how do you treat double vision? Here's a comprehensive guide to help you understand the causes, treatments, and expert advice on managing this condition.

Step 1: Rule Out Life-Threatening Causes

The first step in treating double vision is to ensure that the cause isn't something more serious. Double vision can be a symptom of various conditions, including neurological or muscular disorders, some of which may be life-threatening. If you're experiencing double vision, seeing a primary care doctor and a neurologist is essential to rule out conditions such as brain tumors, strokes, or degenerative diseases.

Once these serious causes are ruled out, you can focus on addressing the more common, non-life-threatening causes of double vision, which are usually related to issues with eye alignment and coordination.

Step 2: Visit a Neuro-Optometrist

Once life-threatening conditions are ruled out, the next step is to consult with a neuro-optometrist or a developmental optometrist. These specialists are trained to diagnose and treat visual problems related to eye teaming, focus, and alignment. Double vision often results from problems where the eyes don’t work together as they should. There are four main causes of this misalignment:

1. Convergence Insufficiency – When the eyes struggle to work together for close-up tasks.

2. Convergence Excess – When the eyes over-converge, causing them to aim too close.

3. Divergence Insufficiency – When the eyes have trouble focusing on distant objects and don't fully diverge and result in aiming too far inward when they should be aiming fully out.

4. Divergence Excess – When the eyes focus too far outward and aim behind an object.

A neuro-optometrist can help identify which of these conditions (or a combination of them) is contributing to your double vision and recommend the appropriate treatment plan.

Step 3: Vision Therapy and Exercises for How to Treat Double Vision

In many cases, vision therapy is the most effective treatment for double vision. Vision therapy is a structured program of eye exercises designed to retrain the brain and eyes to work together correctly. While some exercises can be done at home, others may require in-office visits with a neuro-optometrist.

It’s essential to understand that pencil push-ups and similar exercises often touted as home remedies are not effective for all types of double vision. For example, a 2008 study showed that pencil push-ups were no more effective than placebo treatments for treating convergence insufficiency. Instead, a neuro-optometrist can provide more tailored exercises that are proven to help align the eyes and reduce double vision symptoms.

Step 4: Targeting Specific Causes

The treatment for double vision depends on the specific cause. Here’s a closer look at how each type of eye misalignment is treated:

• Convergence Insufficiency: This condition is common in people who experience eye strain during near tasks, like reading or using digital devices. The most effective treatment is in-office vision therapy. Your optometrist will guide you through exercises designed to strengthen the eye muscles responsible for focusing on close objects. At-home exercises may also help, but they should be prescribed by your optometrist to ensure they’re effective.

• Convergence Excess: In this case, your eyes tend to over-converge when focusing on nearby objects. Reducing excessive near focus can be helpful. Limiting screen time and incorporating rest breaks can reduce strain on the eyes. Your optometrist may also recommend exercises that retrain the eyes to focus at a more appropriate distance.

• Divergence Insufficiency: This occurs when your eyes struggle to focus on distant objects. It’s often linked to excessive near work, such as prolonged screen time or reading. To treat this, horizon gazing is an excellent practice. By taking breaks throughout the day to look at distant objects, like during a walk with your dog or even just gazing out the window, you give your eyes and brain a break from the close-up work, helping to reset eye coordination.

• Divergence Excess: In this case, the eyes may drift too far outward, especially when focusing on faraway objects. Reducing near-screen time and focusing on exercises that promote proper eye alignment can help treat this condition.

Step 5: Visual Ergonomics and Lifestyle Changes

In addition to specialized eye exercises, maintaining good visual ergonomics can help prevent and manage double vision. This includes setting up your workspace with proper lighting, using screens at the right distance, and taking regular breaks to rest your eyes. These small changes can make a significant difference.

Step 6: Patience and Consistency

Treating double vision requires patience and consistent effort. While the right vision therapy exercises can be highly effective, it’s important to remember that improvement takes time. It’s not uncommon for treatment to span several weeks or even months, depending on the severity of the condition and how diligently you follow your optometrist's recommendations.

Conclusion

If you’re struggling with double vision, the key is to identify the cause and treat it appropriately. By working with a neuro-optometrist to diagnose the type of misalignment you have, you can receive the targeted treatment you need to correct your vision. With the right therapy, exercises, and lifestyle changes, double vision is highly treatable, and you can get back to seeing clearly.

Remember, double vision is a symptom, not a condition. By addressing the root cause with the help of a trained professional, you can correct your vision and restore your quality of life. Don't ignore double vision—seek help and take control of your eye health today!