Double vision is when you see two overlapping images instead of a single normal image. Double vision can be sudden and cause nausea, dizziness and headaches.
11 most common cause(s)
Double vision symptoms
Double vision means you are seeing two overlapping images instead of a single normal image. These images may overlap on top of each other or may appear side to side. Double vision is also known as diplopia or ocular misalignment.
Common characteristics of double vision
If you're experiencing double vision, it can likely present with the following.
- Squinting
- Trying to look sideways at objects
- Covering one eye with a hand
- Eyes that "wander": Appearing misaligned as though looking in different directions
- Eyes that appear to be crossed
- One or both eyes: It may occur only in one eye (monocular) or in both eyes (binocular).
- Slightly distorted: With monocular double vision, your images may "ghost" and appear to be only slightly separated.
Duration of symptoms
Depending on the cause, your double vision:
- May come and go or be constant
- May happen only when looking in a particular direction
- May resolve on its own
Who is most often affected by double vision symptoms?
This condition can happen to anyone at any age. Even young children can have double vision symptoms.
Are double vision symptoms serious?
Double vision interferes with quality of life. It can make some activities such as driving very hazardous. In rare cases, double vision may be a symptom of a brain injury, stroke, or tumor. All of these are good reasons to have any episodes of double vision checked by a medical provider.
Causes of double vision
Many conditions can have double vision as a symptom. The most common are those involving weakened nerves or muscles within both eyes, or abnormalities of your retina or cornea within a single eye.
Binocular double vision causes
Binocular double vision is the most common type. This means both eyes are involved. If either eye is closed or covered, your double vision goes away until they eye is opened or uncovered again.
- Weakened or damaged nerves or muscles: These may allow your eyes to point in slightly different directions. Your brain is unable to resolve the two images and sees double instead.
- Neurologic causes: In some cases, binocular double vision can have a serious neurologic cause.
Monocular double vision causes
Monocular double vision is less common. This means that only one eye is involved. If that eye is closed or covered but not your other one, your double vision goes away until the eye is opened or uncovered again. This may be due to the following, however, monocular double vision almost never has a serious cause.
- Nearsightedness within one eye
- Farsightedness within one eye
- Abnormalities of your cornea in one eye
- Abnormalities of your retina in one eye
Physiological double vision causes
This is the rarest type of double vision. Objects in the background, out of your field of focus, may appear double.
Causes of double vision due to injury
The following injuries may result in double vision.
- A severe head injury: Such as one caused by a fall or an automobile accident, may damage the nerves, muscles, or alignment involving one or both of your eyes
- A black eye, or injury to your face that causes bruising around your eye: This is a common sports injury and may cause double vision in your injured eye.
This list does not constitute medical advice and may not accurately represent what you have.
Type 2 diabetes
Type 2 diabetes is also known as adult-onset diabetes, because it is the result of lifestyle and is not hereditary. Diabetes of any type is the condition where the body does not produce enough insulin to process the sugars in food.
Risk factors include obesity, overeating high-carbohydrate foods, lack of exercise, pregnancy, and polycystic ovary syndrome (PCOS.)
Early symptoms include increased thirst; frequent urination; weight loss despite increased appetite; blurred vision; infections that are slow to heal; and blood sugar somewhat higher than normal.
It is important to get treatment at the first sign of these symptoms, because the high blood sugar levels can cause serious organ damage. Heart disease, neuropathy, kidney damage, and blindness can all result from untreated diabetes.
Diagnosis is made through a series of blood tests to measure blood sugar levels.
Type 2 diabetes cannot be cured, but it can be managed through lifestyle changes. A diet which eliminates refined carbohydrates and controls calories; regular exercise; regular blood sugar monitoring; and sometimes insulin or other medications will all be recommended.
Traumatic brain injury
A traumatic brain injury (TBI), or concussion, happens when a bump, blow, jolt, or other head injury causes damage to the brain. This can happen commonly as a result of falls, sports injuries, and car or bike accidents. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that people must go to the hospital, and the worst injuries can lead to permanent brain damage or death.
You should call an ambulance to go to the hospital immediately. There, doctors will examine you and may take images of your head (like a CT scan) to see if there's any bleeding.
Rarity: Common
Top Symptoms: new headache, irritability, clear runny nose, vision changes, general numbness
Symptoms that always occur with traumatic brain injury: head injury
Urgency: Emergency medical service
Stroke or tia (transient ischemic attack)
Transient ischemic attack, or TIA, is sometimes called a "mini stroke" or a "warning stroke." Any stroke means that blood flow somewhere in the brain has been blocked by a clot.
Risk factors include smoking, obesity, and cardiovascular disease, though anyone can experience a TIA.
Symptoms are "transient," meaning they come and go within minutes because the clot dissolves or moves on its own. Stroke symptoms include weakness, numbness, and paralysis on one side of the face and/or body; slurred speech; abnormal vision; and sudden, severe headache.
A TIA does not cause permanent damage because it is over quickly. However, the patient must get treatment because a TIA is a warning that a more damaging stroke is likely to occur. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through patient history; physical examination; CT scan or MRI; and electrocardiogram.
Treatment includes anticoagulant medication to prevent further clots. Surgery to clear some of the arteries may also be recommended.
Rarity: Common
Top Symptoms: dizziness, leg numbness, arm numbness, new headache, stiff neck
Symptoms that never occur with stroke or tia (transient ischemic attack): bilateral weakness
Urgency: Emergency medical service
Post-concussion syndrome
Concussion symptoms tend to last for a few days to weeks. Sometimes, symptoms are long term, lingering for several months or even years. This is known as post-concussion syndrome (PCS). Some of the most common PCS symptoms include headaches and confusion. Memory problems and difficulty concentrating may also occur.
You should consider visiting a medical professional in the next two weeks to discuss your symptoms. A doctor can evaluate PCS with a review of your symptoms and an MRI. Once diagnosed, treatment depends on your specific symptoms but often focuses on letting the brain rest and recuperate. You may be asked to temporarily stop sports and exercise until you are cleared to return.
Overactive thyroid
Overactive thyroid, or hyperthyroidism, means that the thyroid gland in the neck produces an excess of the hormone thyroxine and causes a metabolic imbalance.
Hyperthyroidism can be caused by autoimmune disorders such as Graves' disease; by benign growths in the thyroid; or by inflammation of the gland, called thyroiditis.
The condition may run in families. Women seem to be more commonly affected than men.
Hyperthyroidism causes very high metabolism with sudden and unexplained weight loss, rapid and irregular heartbeat, sweating, nervousness, and anxiety.
Goiter, or swelling of the thyroid gland, may appear at the base of the neck. The eyeballs can protrude and become irritated, a condition called Graves' ophthalmopathy.
If not treated, hyperthyroidism can lead to serious heart rhythm abnormalities and osteoporosis. An endocrinologist can diagnose the condition through a physical examination and simple blood test.
Treatment is done with anti-thyroid medications and sometimes radioactive iodine. Surgery to remove part of the thyroid gland may be done. The condition usually responds well to treatment and monitoring, and to improved diet, exercise, and stress reduction.
Hypertensive crisis
Hypertensive crisis, also called malignant hypertension, means there has been a sudden increase in blood pressure to dangerously high levels. Any reading higher than 180/120 is enough to cause serious health problems.
High blood pressure, or hypertension, can be due to stress, poor diet, lack of exercise, obesity, sleep apnea, or use of illegal drugs. Untreated hypertension can lead to a hypertensive crisis.
Symptoms of dangerously high blood pressure can include chest pain, severe headache, blurred vision, nausea and vomiting, shortness of breath, and blacking out.
Blood pressure at these high readings, with these symptoms, can damage blood vessels and cause a stroke. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through physical examination and blood pressure measurement.
Treatment involves oral medication to reduce the blood pressure. Hospitalization is usually not required unless the medication is not effective, in which case intravenous medicine will be used.
The best prevention involves proper use of blood pressure medication along with lifestyle changes to reduce stress and improve physical fitness.
Concussion (mild traumatic brain injury) needing imaging
A concussion is also known as traumatic brain injury or TBI.
Concussion is the result of being struck in the head. In some cases, especially with infants, being violently shaken so that the head whips back and forth can also cause a concussion.
Most susceptible are those playing contact sports. However, concussion is often the result of an automobile accident or simple fall and can happen to anyone.
Symptoms include headache; loss of balance and coordination; difficulty with memory and concentration; and sometimes, but not always, loss of consciousness.
If symptoms do not clear within a few hours, or seem to get worse, take the patient to the emergency room or call 9-1-1.
Diagnosis is made through patient history and physical examination. A mild concussion does not show up on imaging because there is no bleeding or swelling in the brain. Mild concussion is entirely a disruption in brain function, with nothing to see on an image.
A concussion does not usually need treatment, but head injuries can result in more serious complications, like bleeding in the brain, you should be seen for an evaluation today, just to be sure. The health care provider will determine if imaging of your head, like a CT scan, is necessary. If your symptoms change or worsen, go to the ER immediately.
Rarity: Common
Top Symptoms: nausea or vomiting, dizziness, difficulty concentrating, sensitivity to light, frequent mood swings
Symptoms that always occur with concussion (mild traumatic brain injury) needing imaging: head or face injury
Urgency: Hospital emergency room
Chronic carbon monoxide poisoning
Chronic carbon monoxide poisoning means there has been very low-level exposure to carbon monoxide gas over a long period of time.
Carbon monoxide is a deadly, invisible gas that has no smell and causes unconsciousness and death very quickly. It is usually produced from a faulty furnace or from using a generator or charcoal grill indoors.
In chronic cases, the most likely cause is a gas, oil, or coal furnace that is improperly ventilated.
Carbon monoxide replaces oxygen in the bloodstream, causing suffocation.
Symptoms include headache; fatigue; body aches; nausea and vomiting; chest pain; dizziness; incoordination; and mental confusion.
These symptoms are often mistaken for other illnesses such as influenza, chronic fatigue syndrome, depression, or dementia. But there is a risk of permanent damage and death if carbon monoxide poisoning is not treated.
Diagnosis is made with a blood test to measure the oxygen content.
Treatment involves first correcting the source of the carbon monoxide. Next is daily sessions of breathing pure oxygen, and possibly time spent in a hyperbaric oxygen chamber.
Cataract
In older adults and sometimes in people who aren't all that old, blurry vision is due to cataracts or clouding of the lens of the eye. This can be due to damage from the sun and radiation, as well as genetic causes. This is a key reason to keep up with routine eye exams, especially after the age of 65, as this can be readily treated with surgery.
Brain tumor or mass
In medical terms, "mass" and "tumor" mean the same thing: the unexplained, out-of-place growth of tissue anywhere in the body, including the brain.
The cause of any sort of brain tumor is unknown. Some originate in the brain, while others spread from cancers growing in other parts of the body.
Symptoms may include increasing headaches; nausea and vomiting; blurred or double vision; loss of sensation in an arm or leg; loss of balance; confusion; speech difficulties; or seizures.
If symptoms persist, it is important to see a medical provider so that any treatment can begin as soon as possible.
Diagnosis is made through neurological examination, CT scan, and/or MRI.
If the mass or tumor is found to be benign, that means it is not cancer and not harmful. It may or may not be treated.
If it is malignant, that means it is cancer and must be treated. This will involve some combination of surgery, radiation therapy, and chemotherapy, followed by specialized therapy to help with recovery.
Age-related macular degeneration
Age-related macular degeneration is a disease of the macula, which is the part of the eye responsible for seeing objects clearly. It is the leading cause of vision loss in the United States.
You should visit your primary care physician within a few weeks to discuss your symptoms. The diagnosis will be made via eyesight tests.
Concussion not needing imaging
A traumatic brain injury (TBI), or concussion, happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that people must go to the hospital, and the worst injuries can lead to permanent brain damage or death.
Rarity: Common
Top Symptoms: dizziness, irritability, depressed mood, difficulty concentrating, trouble sleeping
Symptoms that always occur with concussion not needing imaging: head or face injury
Symptoms that never occur with concussion not needing imaging: recent fall from 6 feet or higher, severe vomiting, posttraumatic amnesia over 30 minutes, slurred speech, fainting, moderate vomiting
Urgency: Primary care doctor
Myasthenia gravis (over 50)
Myasthenia Gravis is an autoimmune disease, where the immune system attacks the connection between nerves and muscles.
Rarity: Rare
Top Symptoms: weakness, general weakness, trouble swallowing, voice change, double vision
Urgency: In-person visit
Double vision treatments and relief
When double vision is an emergency
Seek immediate treatment in the emergency room or call 911 if double vision symptoms are accompanied by:
- Memory loss
- Seizures
- Loss of sensation or movement in your arm or leg
- Loss of consciousness
- Inability to move one or both eyes
- Vision loss
- Blood appearing just beneath the surface of your eye
- In rare cases, double vision can be a symptom of a brain injury, tumor, or skull fracture
When to see a doctor for double vision
Schedule an appointment with an ophthalmologist (eye specialist) if double vision symptoms are accompanied by the following combinations of symptoms.
- Fogged vision and difficulty with glare
- Swelling and protrusion of your eyes
- Eye pain, headache, nausea and vomiting, and seeing halos around lights
- A blind spot in the center of your field of vision
- Numbness and tingling in one arm, with speech difficulties
- Fatigue, increased thirst, and increased urination
- Severe headache with nausea, vomiting, and anxiety
- Fatigue, weakness, dizziness, and incoordination
- Headaches with eye strain
- For glasses: A specialist can prescribe eyeglasses that compensate for double vision, as well as glasses to correct any other factors.
- Surgery: This may be needed to remove cataracts, correct misalignment of your two eyes, or treat other conditions.
- Medication: In some cases, medication may be needed to correct the underlying cause of your double vision symptoms.
At-home treatments for double vision
Double vision remedies that you can try at home include:
- Eye exercises: These may help strengthen your ocular muscles. Consult your eye doctor for other practices to help limit eye strain and fatigue.
- Give your eye a rest: You may choose to wear an opaque contact lens or an eyepatch over the eye that is most affected by double vision symptoms.
Here are some over the counter treatment that might help:
- Lubricating Eye Drops: Dry eyes can exacerbate symptoms. Consider using over-the-counter lubricating eye drops to keep your eyes moist.
- Magnesium Supplements: Some studies suggest magnesium can improve nerve function, which could potentially benefit those with nerve-related eye issues.
FAQs about double vision
What causes double vision?
Double vision, or diplopia, is caused by dysfunction of the muscles that move the eye. There are many types of diplopia that correspond to dysfunction of different muscles of the eye. There are two types of double vision: double vision in which the images are side by side and double vision in which the images are on top of each other. Side by side images are are caused by poorly functioning muscles along the inside of the eye. Images above each other are caused by a poorly functioning medial or lateral rectus muscle. Please also see the list of diagnoses in the sections above.What is monocular double vision?
What is monucular double vision?
Monocular double vision or monocular diplopia is due to an abnormality within one eye rather than the eye muscles. Usually, it is caused by an error in light refraction caused by abnormalities in the iris, lens, or fluid within the eye. It is best evaluated by an ophthalmologist and can be corrected with corrective lenses in some cases, surgery in other cases, and rarely, not at all.
What is binocular double vision?
Binocular double vision is caused by a defect in the muscles of the eye. It is split into roughly two categories, horizontal and vertical diplopia in which the muscles that move the eye in different directions cease to function adequately and the eyes do not align so their respective fields of vision are not complementary. This shows up as a break in the field of vision and two images next to each other in an individual's view.
Is nausea common when experiencing double vision?
Nausea can occur, but if double vision is chronic or long term it is uncommon. Usually diplopia from an imbalance in the inner ear or inability to coordinate eye movements may also cause nausea, however the nausea is not caused by diplopia.
When is double vision a sign of an eye disorder?
Double vision can occur following a blow to the eye that stuns the eye or the muscles of the eye. Usually this is transient and will disappear shortly after the injury. If double vision is persistent or accompanied by pain or blurry vision it may be a sign of an eye disorder. If there are bruises around the socket of the eye, blood within the eye, or a change in the arrangement of the iris (colored ring around the eye) or pupil (black center of the eye), then you should seek immediate medical care.
Questions your doctor may ask about double vision
- Does light bother your eyes more than usual?
- Are you experiencing a headache?
- Have you ever been diagnosed with diabetes?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
- Focal Points - Excerpt: Evaluation and Management. American Academy of Ophthalmology. Published 2018. AAO Link.
- Alves M, Miranda A, Narciso MR, Mieiro L, Fonseca T. Diplopia: A Diagnostic Challenge with Common and Rare Etiologies. The American Journal of Case Reports. 2015;16:220-223. NCBI Link.
- Tan A, Faridah H. The Two-Minute Approach to Monocular Diplopia. Malaysian Family Physician. 2010;5(3):115-118. NCBI Link.
- Margolin E, Lam CTY. Approach to a Patient with Diplopia in the Emergency Department. Journal of Emergency Medicine. 2017;54(6):799-806. NCBI Link.
- Binocular Diplopia. American Academy of Ophthalmology. Published 2018. AAO Link.