May 16, 2023 - Double Vision (Strabismus)
I receive more e-mails from followers who suffer the dilemma of seeing two objects instead of one—which we call Double Vision. Also known as diplopia, the condition is a visual phenomenon in which a person sees two images of a single object instead of a single, clear image. These two images may appear side by side, overlapping, or vertically separated. Double Vision can occur in one or both eyes and be constant or intermittent, depending on the underlying cause. One of the solutions is eye muscle surgery to correct the Double Vision.
Here are the potential challenges and limitations associated with this surgical procedure.
1. Incomplete Correction: Strabismus surgery aims to align the eyes to reduce or eliminate double vision. However, achieving perfect alignment can be challenging, and the surgery may not correct the misalignment. In some cases, residual misalignment may persist, leading to persistent or recurrent double vision.
2. Overcorrection or under-correction: There is a risk of overcorrection or under-correction during strabismus surgery. Overcorrection occurs when the eyes are over-adjusted and may result in a new form of misalignment. Under-correction happens when the eyes are not adequately aligned, and double vision persists. More surgery is required to address these issues.
3. Need for Multiple Surgeries: In some cases, single strabismus surgery may not achieve the desired alignment, and patients receive more surgery. Multiple surgeries can increase the overall risk and may require a longer recovery.
4. Risks and Complications: Strabismus surgery carries inherent risks like any surgical procedure. These include infection, bleeding, scarring, and adverse reactions to anesthesia. Although rare, complications can occur and may impact the outcome and the presence of double vision.
5. Limited Success in Some Cases: Some underlying conditions or factors, such as certain neurological or systemic diseases, may limit the success of the surgery. In such cases, I would offer vision therapy.
One of the clinical observations I have made is that strabismus surgery only gives a temporary cosmetic solution. The eyes look straight, but they don’t function any better together. The surgery creates more confusion in the person because they have not improved the muscle control of the eyes. The most important principle is that the brain controls the eye muscles. This skill is learned and developed. In surgery, the brain loses its organic ability to control the eye muscles. This surgery creates permanent confusion as if someone cannot trust their Vision. Later in this article, I will offer a treatment modality that works much better.
There are two types of Double Vision: binocular and monocular.
1. Binocular Double Vision occurs when both eyes are open and functioning correctly. Each eye sees a slightly different image, and the brain combines these images to create a single, three-dimensional perception. However, when the eyes are not aligned properly, or there is a problem with the eye muscles or nerves, the brain receives conflicting information from each eye, resulting in Double Vision.
2. Monocular Double Vision: This type is when Double Vision is when one eye is closed. It typically indicates a problem within the eye, such as cornea, lens, or retina abnormalities. Monocular Double Vision is often present in only one specific position or direction of gaze.
Unlike binocular Double Vision, which involves a misalignment of the eyes, monocular Double Vision typically arises from abnormalities within the eye itself.
Here are some common causes of monocular Double Vision:
1. Refractive errors: Uncorrected or inadequately corrected refractive errors, such as nearsightedness (myopia), farsightedness (hyperopia), or astigmatism, can lead to monocular Double Vision. These conditions cause the incoming light to focus improperly on the retina, resulting in distorted or blurred vision.
2. Corneal abnormalities: The cornea is the transparent front surface of the eye. Irregularities in the shape or structure of the cornea can cause monocular Double Vision. Conditions like astigmatism (irregular corneal curvature) or keratoconus (cone-shaped cornea) can distort the eye’s light, leading to Double Vision.
3. Cataracts: Cataracts involve the clouding of the eye’s natural lens, which can lead to blurred Vision and, in some cases, Double Vision. Cataracts scatter light as it passes through the lens, causing visual disturbances.
4. Retinal abnormalities: The retina is the light-sensitive tissue at the back of the eye. Any condition that affects the retina’s normal functioning can result in monocular Double Vision. Examples include macular degeneration (damage to the central part of the retina), retinal detachment, or retinal abnormalities caused by diabetes.
5. Eye trauma or surgery: Injuries to the eye or previous eye surgeries can cause monocular Double Vision. Damage to the structures within the eye, such as the cornea, lens, or retina, can disrupt the normal visual pathway and lead to Double Vision.
6. Dry eye syndrome: Insufficient tear production or poor tear quality can result in dry eye syndrome. When the cornea lacks proper lubrication, it can cause blurry or distorted Vision, which may manifest as monocular Double Vision.
7. Abnormalities in the visual pathway: Certain conditions affecting the optic nerve or higher visual processing centers in the brain can lead to monocular Double Vision. Diseases include optic nerve disorders like optic neuritis or optic nerve compression.
Here are some common causes of binocular Double Vision:
• Strabismus: A misalignment of the eyes, where they point in different directions.
• Refractive errors: Uncorrected nearsightedness, farsightedness, or astigmatism can cause Double Vision.
• Cataracts: Clouding of the eye’s lens, leading to distorted Vision.
• Corneal abnormalities: Irregularities in the shape of the cornea, such as astigmatism or keratoconus.
• Nerve damage: Conditions like cranial nerve palsies, multiple sclerosis, or diabetic neuropathy can affect the nerves controlling eye movement.
• Trauma: Head injuries or damage to the eye muscles can result in Double Vision.
• Systemic diseases: Myasthenia gravis, thyroid disorders, or autoimmune diseases may cause Double Vision.
Whole-Body Physical Eye therapy, o is a specialized therapy to improve and reprogram how the eyes, brain, and body work together. It involves a series of awareness-based exercises and activities designed to reprogram the coordination between the eyes, the eye muscles, and the visual system with the brain and body. Vision therapy can be beneficial in treating various visual conditions, including Double Vision or diplopia.
Vision Therapy reduces Double Vision.
Here are some ways in which vision therapy may help treat Double Vision:
1. Eye Muscle Control: Vision therapy can target the muscles responsible for eye movement and coordination. Through various exercises, such as eye tracking and fixation tasks, the treatment aims to improve the ability of the eye muscles to work together effectively, reducing or eliminating Double Vision.
2. Binocular Vision: Double Vision often arises from a misalignment or imbalance in the eyes, leading to disparate images. Vision therapy can help improve binocular Vision, allowing the eyes to work together to fuse the images into a single, clear image.
3. Visual Processing: Vision therapy can also address issues related to visual processing, which is the brain’s ability to interpret and make sense of visual information. By training the brain to process visual input more efficiently, vision therapy can help reduce the occurrence of Double Vision.
4. Accommodation and Convergence: Accommodation refers to the eye’s ability to focus on near objects, while convergence is turning the eyes inward to maintain a single Vision. Vision therapy exercises can target these skills, enhancing the ability to maintain clear and single VisionVision and reducing Double Vision.
5. Craniosacral Therapy can help reduce Double Vision. Craniosacral therapy (CST) is a form of complementary and alternative therapy that focuses on the craniosacral system, which consists of the membranes, cerebrospinal fluid, and the central nervous system (brain and spinal cord). Gentle manipulation of the craniosacral system can promote the eye-brain body’s self-healing abilities and restore balance.
During a craniosacral therapy session, the practitioner uses light touch and gentle techniques to assess and manipulate the craniosacral rhythm, stimulating the cerebrospinal fluid’s subtle movement as it flows around the brain and spinal cord. The practitioner may apply gentle pressure and manipulation on specific body areas, such as the skull, spine, and pelvis, to release any restrictions or tensions in the craniosacral system.
6. Several nutritional ingredients have been studied for their potential beneficial effects on neurological brain health. While it’s essential to maintain a balanced and varied diet for overall brain health, here are some specific nutrients that have shown promise:
Omega-3 Fatty Acids: Omega-3 fatty acids, particularly EPA and DHA found in fatty fish like salmon, mackerel, and sardines, have been associated with improved cognitive function and a reduced risk of age-related cognitive decline. Omega 3 helps in eye-brain development, neuroplasticity, and reducing inflammation.
Antioxidants: Antioxidants, such as vitamins C and E, beta-carotene, and other phytochemicals, help protect brain cells from oxidative stress and damage caused by free radicals. Foods rich in antioxidants include berries, citrus fruits, leafy green vegetables, nuts, and seeds.
B Vitamins: B vitamins, including vitamins B6, B12, and folate, are involved in various brain functions, such as producing neurotransmitters and maintaining brain health. Good sources of B vitamins include whole grains, legumes, leafy greens, eggs, and lean meats.
Curcumin: Curcumin is the active compound in turmeric and has shown potential neuroprotective effects. It exhibits antioxidant and anti- inflammatory properties, and some research suggests it may improve memory and cognitive function.
Vitamin D: Vitamin D plays a role in brain development, neurotransmitter synthesis, and neuroprotection. Adequate sun exposure and dietary sources such as fatty fish, fortified dairy products, and egg yolks can help maintain vitamin D levels.
Green Tea: Green tea contains polyphenols, such as catechins and epigallocatechin gallate (EGCG), which have antioxidant and anti-inflammatory properties. Green tea consumption may enhance cognitive function and protect against neurodegenerative diseases.
Resveratrol: Resveratrol is a compound found in grapes, berries, and red wine. It exhibits antioxidant and anti-inflammatory effects and shows potential neuroprotective properties.
It’s important to note that the success of vision therapy in treating Double Vision depends on the specific cause and individual factors. The more stress, trauma, inflammation, and body toxicity, the longer it can take to reduce Double Vision.
Patience is necessary in the process. Patience, as it relates to improving your double vision, refers to the ability to remain calm, persistent, and understanding while recovering or enhancing one’s health. It involves accepting that healing and progress often take time and embracing a long-term perspective.
When facing double-vision challenges, patience plays a crucial role in several ways:
Recovery Process: Patience recognizes that the healing journey is often gradual and may involve setbacks. It acknowledges that the eyes and body need time to heal, regenerate, and adapt to changes. Patience helps individuals stay committed to their treatment plans and allows for realistic expectations regarding the pace of improvement.
Treatment Adjustments: Patience encourages individuals to work closely with the understanding that finding the most effective treatment or management approach may require time and experimentation. It involves trusting the process and being open to adjustments, even if immediate results are not apparent.
Lifestyle Changes: Improving double vision involves making sustainable lifestyle changes, such as adopting a healthier diet, increasing physical activity, managing stress, or improving sleep habits. Patience recognizes that these changes may yield little results and that consistent effort and time are needed to see the benefits.
Emotional Resilience: Patience helps individuals navigate the emotional challenges that may arise during the double vision process. It supports the development of resilience, acceptance, and the ability to stay positive and hopeful even during difficult times. Patience allows individuals to practice self-compassion and avoid unnecessary stress or frustration.
It’s important to note that patience does not imply passivity or inaction. Instead, it involves an active and engaged approach to health while understanding that progress may take time. It encourages individuals to advocate for their well-being, seek appropriate medical care, and maintain a proactive attitude while embracing the inherent uncertainties of the healing process.
Developing patience in the context of eye health requires self-awareness, self-care, and a supportive network. Engaging in mindfulness practices, seeking emotional support, and maintaining open communication with healthcare professionals can contribute to cultivating patience and resilience on the path to wellness.