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Double vision occurs when a person sees two images where there should only be one. The two images can be side by side, on top of one another, or both. This can affect your balance, movement, and reading ability.

If double vision only occurs when one eye is open, it is monocular. If it occurs when both eyes are open, it is binocular. Monocular double vision is less common than binocular double vision, but some patients have a combination. Treatments depend on the cause and type, but they include eye exercises, specially designed glasses, and surgery.

Causes of binocular double vision

A common cause of binocular double vision is a squint or strabismus. This occurs when the eyes are not properly aligned.

Strabismus means that the eyes look in different directions rather than being pointed at the same object. This might be because the affected eye muscles have the following difficulties:

  • They are paralyzed or weak
  • They have restricted movement
  • They are too strong or overactive
  • The nerves controlling the eyes muscles have abnormalities

Sometimes, this condition can return later in life for people who had strabismus as a child. In some cases, the treatment of a squint can actually cause double vision, despite the individual’s vision being single before. This is because the brain had been suppressing signals from one of the eyes in an attempt to maintain normal vision.

Causes of monocular double vision

If double vision is noted when one eye is covered but not the other, this is referred to as monocular double vision.

The following conditions can cause monocular double vision:

  • Astigmatism
  • Dry eye
  • Keratoconus
  • Retinal abnormalities
  • Cataracts

Other conditions that can cause double vision include:

  • Thyroid dysfunction
  • Stroke or transient ischemic attack (TIA)
  • Aneurysm
  • Convergence insufficiency
  • Diabetes
  • Myasthenia gravis
  • Orbital tumors
  • Multiple sclerosis
  • Trauma
  • Head injury


Depending on the cause, the treatments for double vision vary, but they include:

  • Wearing glasses
  • Eye exercises
  • Wearing an opaque contact lens
  • Botulinum toxin (Botox) injections into the eye muscles, causing them to remain relaxed
  • Wearing an eye patch
  • Surgery on the muscles of the eye to correct their positioning

Call Vision Associates if you have any questions regarding double vision and possible treatments.