What are the causes of binocular vision

Double vision

What types of double vision are there?

  1. Monocular double vision: these double images are also seen when one eye is closed. Close one eye first, then the other.
  2. Binocular double vision: these double images are only seen when both eyes are open.
    Binocular double images can appear horizontally, vertically, diagonally offset and tilted.


Rule of thumb: double binocular images can have more serious causes than double monocular images.

How do double images arise?

In principle there are 2 options:

  • If the light rays falling into the eye are refracted to different degrees at different points on the cornea or the lens of the eye, two images of the same object are created on the retina and in the brain (monocular double images).
  • A visual impression is created through each of the two eyes. If the two visual impressions in the brain can no longer be merged into one image, double images occur (binocular double images).

What are the symptoms of double vision?

  • Uncertainty when walking and climbing stairs
  • grab next to it
  • disturbed sense of space, disorientation
  • Dizziness
  • which is the right one and which is the wrong one?
  • Blurred vision

Which symptoms can occur together with double vision?

  • Eye movement disorders
  • Drooping of the upper eyelid (ptosis)
  • visible squint
  • protruding eyes (exophthalmos)
  • Pain when moving the eyes

What are the causes of double vision?

Monocular double vision:

Binocular double vision:

  • Eye muscle paralysis (paresis)
  • Circulatory disorders, e.g. in the case of diabetes or high blood pressure
  • Neurological disease such as stroke, multiple sclerosis, myasthenia, borreliosis
  • Restricted mobility of the eye after an accident or due to a tumor
  • Thyroid disease (endocrine orbitopathy)
  • Inflammation of the muscles in the eyes and the tissues in the eye socket
  • Worsening of a congenital condition, such as a hidden squint, oblique disorder

Ophthalmological examination for double vision

When examining double images, an exact anamnesis, the inclusion of previous findings and several (also time-consuming) examinations are necessary. For this reason, we recommend a so-called double appointment for the initial examination in our ordination.

How are double vision treated?

Monocular double vision: depending on the underlying disease that is causing it, e.g. wearing the right glasses, moisturizing eye drops, cataract surgery and treatment of the retinal disease are possible.

Binocular double vision
: In addition to treating the underlying cause, balancing the double images with prisms is an option. Prism foils are available for this, which are glued to the lens or prisms ground into the lens. (The prism deflects the rays of light falling into the eye so that again only one image is seen.)
In some cases, in which the double vision cannot be compensated for, a matt film on the lens or an eye patch can bring relief.
If the double vision persists for a long time, squint operations are also possible.

The compensation of double vision contributes to the improvement of the quality of life.

Can I drive a car with double vision?

No, it is not allowed to drive a car with double vision.
Operating machines or other activities that could injure yourself or others should also be avoided.

Please keep in mind that the examination of strabismus is time-consuming and therefore requires several appointments.