“What is the reason for double vision following an accident?”
My husband had a bike accident 3 months back. Although his injuries are healing well, he complains of double vision. What could be the reason behind this? Could it be an internal injury or something to do with the eyes?
20 Answers
See an eye doctor. Could be several reasons from head injury to eye injury
Closed head trauma may be associated with nerve damage to a specific muscle in the eye which then causes oblique or vertical double vision more frequently than horizontal double vision. Seek out a Neuro-ophthalmologist.
If hr hit his head it could be a cranial nerve 4 palsy. Which could improve. He should see a neuroophthalmologist for examine diagnosis and treatment
Hello,
Double vision after an accident can have several causes.
***If he is having any headache or drooping eyelid along with the double vision, he should be seen in the Emergency Room immediately, as this can be part of a very serious condition.***
If your husband hit his head at all, this could be related to a cranial nerve injury or a facial bone fracture. If he has had previous eye surgery, something may have gotten knocked out of place (such as a lens implant from cataract surgery or a corneal flap after LASIK). If the double vision is the only issue and the symptoms have not resolved, I would recommend that he see an ophthalmologist for a thorough exam to evaluate his eye muscles and their movements. This will help to narrow down the possible causes and direct further testing.
Wishing your husband a speedy recovery,
Dr. Lindsey
Double vision after an accident can have several causes.
***If he is having any headache or drooping eyelid along with the double vision, he should be seen in the Emergency Room immediately, as this can be part of a very serious condition.***
If your husband hit his head at all, this could be related to a cranial nerve injury or a facial bone fracture. If he has had previous eye surgery, something may have gotten knocked out of place (such as a lens implant from cataract surgery or a corneal flap after LASIK). If the double vision is the only issue and the symptoms have not resolved, I would recommend that he see an ophthalmologist for a thorough exam to evaluate his eye muscles and their movements. This will help to narrow down the possible causes and direct further testing.
Wishing your husband a speedy recovery,
Dr. Lindsey
If the double vision is relieved with covering either eye, then on of the cranial nerves, which control the eye muscles, may be damaged. If the bones around the eyes were injured, then there could be direct compression of one of the 6 muscles controlling eye muscles. Usually, the inferior rectus muscles can be entrapped by a bone fragment causing double vision in up gaze.
Head trauma following an accident is a major cause of double vision. Also direct Trauma to the eye in an accident can cause double vision
Most likely cause is head injury
Need to see Eye MD
Need to see Eye MD
Nicole K. Renaud
Ophthalmologist
There can be more than one reason for double vision. I would need more details to give a better answer. If this happened within the past week, he needs to see an ophthalmologist immediately (preferably an Oculoplastic surgeon). Otherwise, the tissue can scar down in such a way as to make any repairs difficult, if not with poor results. If he had a blunt injury to his eye, one of his eye muscles could be entrapped. In addition, he could be at risk for secondary glaucoma. If he hit his head, this could be a neurological injury. This is why it is best to be examined immediately by an ophthalmologist or go to the emergency room when the injury occurs.
First and foremost, he must be seen by a qualified ophthalmologist (MD).
There are many aspects of the eye that need to be thoroughly examined
because other parts of the eye may have been injured.
After a bicycle accident 3 month ago (in late June or July) when the rider
was most likely wearing a helmet and sunglasses,I suspect he hit the ground
on the lower side of his face and his glasses were propelled up. This
caused the nose bridge projections (those clear plastic devices on the
inside of the frame) to slam up to the bony orbit and damage the
"Trochlea."
He may have noticed that pressing on the uppermost nasal portion of the
orbital bone would cause pain on the injured side but no tenderness on the
opposite eye upper nasal orbit.
This Trochlea is a pulley that transfers the pulling action of the
"Superior Internal Oblique" ocular muscle to make the eye turn down and in.
If damaged or fractured, the pulley does not function with needed pin point
accuracy. Because each eye is like a video camera and both eyes must
coincide on the same place to not get a blurred image, the DAMAGED Trochlea
causes the eyes to be out of alignment.
After a dilated retinal exam by an MD ophthalmologist, the patient should
be seen by an Ophthalmic plastic surgeon or ocular motility specialist for
possible repair of the condition.
His double vision may encompass both horizontal and vertical elements and
may need to be treated with prism glasses even after surgical repair.
He may find that, when looking at a light in the distance, one eye sees it
above the other and maybe side by side too.
Unfortunately, these double images (medical term: Diplopia) may last a long
time and require prism glasses for correction.
Good luck.
Roger Ohanesian MD
There are many aspects of the eye that need to be thoroughly examined
because other parts of the eye may have been injured.
After a bicycle accident 3 month ago (in late June or July) when the rider
was most likely wearing a helmet and sunglasses,I suspect he hit the ground
on the lower side of his face and his glasses were propelled up. This
caused the nose bridge projections (those clear plastic devices on the
inside of the frame) to slam up to the bony orbit and damage the
"Trochlea."
He may have noticed that pressing on the uppermost nasal portion of the
orbital bone would cause pain on the injured side but no tenderness on the
opposite eye upper nasal orbit.
This Trochlea is a pulley that transfers the pulling action of the
"Superior Internal Oblique" ocular muscle to make the eye turn down and in.
If damaged or fractured, the pulley does not function with needed pin point
accuracy. Because each eye is like a video camera and both eyes must
coincide on the same place to not get a blurred image, the DAMAGED Trochlea
causes the eyes to be out of alignment.
After a dilated retinal exam by an MD ophthalmologist, the patient should
be seen by an Ophthalmic plastic surgeon or ocular motility specialist for
possible repair of the condition.
His double vision may encompass both horizontal and vertical elements and
may need to be treated with prism glasses even after surgical repair.
He may find that, when looking at a light in the distance, one eye sees it
above the other and maybe side by side too.
Unfortunately, these double images (medical term: Diplopia) may last a long
time and require prism glasses for correction.
Good luck.
Roger Ohanesian MD
Depending on how bad an accident it could be a TBI or Traumatic Brain Injury. If it is that it could depend how much damage there was. If it is minor damage then the double vision may be temporary. If the damage was bad it could be permanent double vision. Any type of double vision should be checked out by an Optometrist or Ophthalmologist.
Without a great deal more information and a full eye exam it would be difficult to tell what the problem may be. However head trauma can cause several things that could induce double vision. Brain injury, injury to the bones in the skull around the eye, or damage to nerves or muscles around the eye. Internal eye injuries could also contribute. I would recommend that he be evaluated by an ophthalmologist .
Its related to an internal injury to one of the cranial nerves from the brain that innervates the eye muscles. He should get it checked out as the double vision is frequently correctable by putting a prism in a pair of eyeglasses.
It would be helpful to know more about the accident and the double vision.
Assuming no direct facial trauma, and just a closed head injury, if the double vision were horizontal and at distance, one would think about a 6th nerve palsy, possibly bilateral 6th (in which case the images would get further apart looking both right and left.) If the double were horizontal at near, convergence insufficiency would be high on the list (very common after concussions).
If it were vertical double vision, one would think about 4th nerve palsy or palsies.
If there were direct facial/periocular trauma you would also have to think about orbit fractures with globe displacement and/or muscle entrapment.
In all these cases, it should only be binocular diplopia, i.e. using both eyes together. Covering an eye should resolve the double vision. If the diplopia persists monocularly, then think about a dislocated lens or IOL and rarely a retinal detachement.
Floyd A. Warren, M.D.
Assuming no direct facial trauma, and just a closed head injury, if the double vision were horizontal and at distance, one would think about a 6th nerve palsy, possibly bilateral 6th (in which case the images would get further apart looking both right and left.) If the double were horizontal at near, convergence insufficiency would be high on the list (very common after concussions).
If it were vertical double vision, one would think about 4th nerve palsy or palsies.
If there were direct facial/periocular trauma you would also have to think about orbit fractures with globe displacement and/or muscle entrapment.
In all these cases, it should only be binocular diplopia, i.e. using both eyes together. Covering an eye should resolve the double vision. If the diplopia persists monocularly, then think about a dislocated lens or IOL and rarely a retinal detachement.
Floyd A. Warren, M.D.
He could have internal injuries to his nerves controlling eye movements. He should she a neurologist or ophthalmologist for an examination.
First, you have to determine if the double vision is binocular or monocular. The easiest way to determine this is by closing one eye at a time to see if the double vision goes away. If it does resolve with each eye closed separately, then it is binocular. Accidents typically cause traumatic 4th nerve injuries. This is the nerve that innervates the superior oblique muscle of the eye. They usually resolve, but it's best to see an ophthalmologist to determine the exact cause.
Doubling of vision following head trauma can occur because of destabilization of previously unrecognized tendency for the eyes to get out of alignment; or due to damage to the muscles or nerves that are involved in eye motion. For either of these events, you should make an appointment with a specialist called a Neuro-ophthalmologist who deal with the interaction between the brain and eye function including eye motion.
Diplopia or double vision can be from cranial nerve palsy or ocular muscle involvement. Get your eyes checked for both. Also , sometimes CT/MRI Brain needs to be done for further evaluation.
If he gets double with both eye open and the double goes away when he closes either eye, the problem should be in one of the nerves moving the eye and that happens with a closed head injury. See an ophthalmologist for eye exam.
head injuries can sometimes affect the nerves that balance our eye movements
- recommend evaluation by eye professional
- recommend evaluation by eye professional
It could be nerve damage to the muscles that move the eye, damage to the muscles that move the eye or scar tissue around the eye. It should be evaluated by an ophthalmologist sooner rather than later as some issues need to be resolved ideally within two weeks of the injury
