Causes of double vision?

[aspen]

I had double vision for four months -- end of April to third week of August. It cleared up over about a week in fits and starts. My neuro and neuro opthamologist fully expected to see a brainstorm lesion. They did not.

Are there any other causes? I have a sleep disorder but it is treated with cpap and I am sleeping well. I was not taking any new meds when it started. I had other symptoms during this time, most of which resolved around the same time as the double vision. Overlapping my double vision I couldn't smile evenly, whistle or say certain sounds (4 weeks) due to a muscle or nerve on one side of my face not working.

In case it matters, my scans are done on a 1.5 tesla machine.

Could there be another cause for this? I'm in limbo, so can't really blame ms. I've had a whack of rule-out work done .. Including one blood test for myasthenia gravis.

Just curious if some other cause has been identified for someone else here.

Thank you .

[lstrl]

I get double vision as well and my neuro-ophthalmologist was basically telling me my eyes turn inward just a tad bit and normally the brain can compensate for that and get them to focus together, but for some reason, that's not happening anymore. It might not necessarily even be an MS thing. That could be a total coincidence. In my case, I think it is because, aside from the double vision, my eyes are perfect. That might not be what you're looking for, but it made perfect sense to me.

[hsmaldo]

aspen,
my first symptom was also double vision. My neuro as well expected to see a lesion on the brainstem, but one did not appear.

What I HAVE heard from 2 neuros is that brainstem lesions are notoriously difficult to see on MRI's.

My scans were done first on a 1.5 T and then later on a 3.0 T machine.

I hope that you get some answers!

[22cyclist]

Another option is that you may have myasthenia gravis. Even though you may not test positive for it, you can still have it. It often mimics MS, even sensory wise. Go see your eye doctor (MD), or neuro-ophthalmologist if possible to get to the bottom of it. Get your primary to refer you to one.

Good luck,
Lisa

[aspen]

Thanks for weighing in ....

hsmaldo, did a brainstem lesion eventually show up? Perhaps on the 3T machine? This wasn't the only thing going on that made my neuro opthamologist suspect a brainstem lesion. He was surprised not to find one. (There is no 3T access around here, so that's not an option-- they are used for research only).

lstrl, my eyes are fine too normally (other than glasses). It was the eye on the same side of my face that I had smile issues that I couldn't converge with.

Lisa, I do have a neuro opth who saw me during this time. He re-assessed me once things were better in September. He told me initially he was suspicious for MG (based on the referral note from my optometrist), but upon hearing my history he felt ms or neuromyelitis optica. So I'm not sure -- he seemed way more on the ball than my neuro and I think he would have pursued that if he was concerned?

I'm a little concerned because I've started to have a bit of double vision again .. minor, I can correct it ... when I exercise or if I'm overtired. And some sensory stuff (?) with my legs which was minor but ramped up during the night last night ... my gp says a post-surgery "setback".

Thanks again

[Cat Mom]

Has anyone checked for Optic Neuritis? It's easy for an Opth to see, with dilated pupils the inflamed optic nerve is visible. Hope you get to the bottom of this soon!
Jen

[aspen]

Jen, I have not had optic neuritis. I was not assessed when I had severe eye pain in one eye, trouble with contrast, etc. early 2013. I have had a few brief episodes of seeing different colours or more muted colours in one eye, but only for up to 8 hours.

I was told no ON when my eyes were finally assessed 8 months later -- that the damage would still be visible. I saw neuro opth a year and a half later -- he couldn't see signs of ON -- however at this point I only had double vision.

So I don't think so.

[SNOOPY]

Hi aspen,

I have double vision when looking to the right. My left eye does not track. When related to MS the damage would be due to a brainstem lesion, my MRI does not currently show any brainstem damage.

I've had a whack of rule-out work done .. Including one blood test for myasthenia gravis.

I have also had the blood test for MG, it came back negative so I thought MG was off the table. At my follow up appointment I was told a negative blood test for MG does not rule it out So, for me, MG is still on the table as a possible cause for my double vision.

You might discuss this further with your Neurologist.

[hsmaldo]

sorry aspen, I thought I had replied already!

No, I've had at least 3 more brain MRIs and several c-spine MRIs on the 3T machine and none have them have showed lesions on the brainstem.

They diagnosed me with INO when I had the double vision. And although the double vision resolved within about a week or two, the nystagmus and vision/perceptions took much longer to resolve. It tends to get worse when I'm tired, or looking too long at a computer screen as well.

[susa133]

Ocular Muscle Disorder

I lost my vision 4 years ago- i am legally blind - due to this undiagnosed "spontaneous multiple ocular muscle MOVEMENT disorder" - I have not rested my eyes in 4 Years... My disorder, I believe, is stress-induced from years and years of limbo-land - I also have extreme photophobia - i cannot even go outside with sunglasses - everything goes pink under my eye-lids. This disorder, I believe, is going undiagnosed as a stress-induced symptom of not just MS, but many other neuro diseases ...

At daytime, I believe I am going thru an unnoticed ' REM' disorder because the hypothalamus 'believes' that I am asleep due to the constant RAPID EYE Muscle Movement - not eye movement - but the muscles are sending a error feedback loop - so what does the hypothalamus do at night? Well, during REM sleep the hypothalamus shuts down - paralyzes the extremities and conserves temperature to our central core to 5 major organs - so the arms and legs feel numb and really COLD - bone-cold.

The eyes play a major role in MS - regardless of Optic Neuritis or not - there are 6 muscles behind each eye - just imagine the number of possible moves - you'd have a better chance of winning a billion dollar LOTTO than quantifying all of the possible combos of 6 muscles in 1 eye SYNCING with the 6 muscles in the 2nd eye....

Well, I didn't win the Lotto - good luck to you, Susa

I had double vision for four months -- end of April to third week of August. It cleared up over about a week in fits and starts. My neuro and neuro opthamologist fully expected to see a brainstorm lesion. They did not.

Are there any other causes? I have a sleep disorder but it is treated with cpap and I am sleeping well. I was not taking any new meds when it started. I had other symptoms during this time, most of which resolved around the same time as the double vision. Overlapping my double vision I couldn't smile evenly, whistle or say certain sounds (4 weeks) due to a muscle or nerve on one side of my face not working.

In case it matters, my scans are done on a 1.5 tesla machine.

Could there be another cause for this? I'm in limbo, so can't really blame ms. I've had a whack of rule-out work done .. Including one blood test for myasthenia gravis.

Just curious if some other cause has been identified for someone else here.

Thank you .