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Medical Forum / General / Vision / November 2005Is there any cure for diplopia?
I am a man that has diplopia (binocular) , being affected by that disfunction from 13 years ago (car accident and coma)... Is there any way to cure that illness or am I doomed to have forever this "double sight"? I am waiting for your answers. >I am a man that has diplopia (binocular) , being affected by that > disfunction from 13 years ago (car accident and coma)... > Is there any way to cure that illness or am I doomed to have forever > this "double sight"? > I am waiting for your answers. Diplopia is a symptom, not an illness. Normally, if it's going to clear up, it does so in the first few months after onset. The longer it persists, the less chance of spontaneous improvement. Short of surgery, diplopia is usually treated by using prism in glasses to align the two images. Sometimes, too many muscles are involved, and prism can only make the images single in one direction of gaze. Sometimes an "oblique" muscle is involved, causing the eye to rotate so that vertical lines appear tilted in one eye. This is almost impossible to straighten with glasses and we resort to masking or covering one eye. You didn't say what has been tried already - surely after 13 years you've had an eye exam and asked about treatment? -MT car accident and coma suggests post-traumatic vision syndrome, convergence problems, accommodation problems, possible damage to nerve pathways. what was the diagnosis? certain palsys are going to create incommitance (varying turn size depending on gaze position) and there is no way to resolve this due to paralysed muscles. what do your doctors say? grant On 11/18/05 12:36 PM, in article 1132346185.118366.263260@g43g2000cwa.googlegroups.com, "CatmanX" <grantm@connexus.net.au> wrote: > car accident and coma suggests post-traumatic vision syndrome, > convergence problems, accommodation problems, possible damage to nerve [quoted text clipped - 3 lines] > (varying turn size depending on gaze position) and there is no way to > resolve this due to paralysed muscles. While you may not be able to fix the paralyzed muscles, there is a way sometimes to resolve the incomitance. This is called "matching the defect". You weaken the yoke muscles (the ones that pull in the same direction as the weak muscle) so there is a similar weakening, thereby decreasing (but not necessarily eliminating) incomitance. You can also create "fixation duress" in the other eye by weakening muscles to "goose up" the innervation to the weakened muscles, and reduce innervation to the antagonist muscles that are overacting. > what do your doctors say? > > grant The doctors say (in italian) that my problem is due to an oblique muscle that is paralyzed. Maybe they say other things but I don't remember... Your paralysed muscle will create problems to fix. As David states, there may be a way of reducing the ability of the antagonistic muscle, but it may not work also. One possibility is to use Botox to create a temporary paralysis in the antagonistic muscle and see what happens. grant On 11/19/05 2:39 PM, in article 1132439948.102204.255110@z14g2000cwz.googlegroups.com, "CatmanX" <grantm@connexus.net.au> wrote: > Your paralysed muscle will create problems to fix. As David states, > there may be a way of reducing the ability of the antagonistic muscle, [quoted text clipped - 4 lines] > > grant Actually, if the affected muscle is rather weak, BOTOX does little. It requires that the affected (weakened) muscle has recovered most or all of its strength, and that the primary residual problem is contracture of other (antagonist) muscles. BOTOX works well to relieve contracture, depending on the strength of the recovered muscle to pull on the contractured muscle (now paralyzed by BOTOX) in order to get back to a more normal length-tension relationship. If the paralyzed muscle is still very weak, the eye does not pull over. It may straighten, temporarily, and as the BOTOX weaks of and the strength of the antagonist returns, the eye often goes back to where it started. Therefore, assessment of the recovery of the paralyzed muscle is important. Sometimes it is borderline, and BOTOX may be tried in those cases, but have higher failure rate. On 11/19/05 11:22 AM, in article 1132428139.128513.114950@f14g2000cwb.googlegroups.com, "Diplopia-affected" <blancoypinol@gmail.com> wrote: > The doctors say (in italian) that my problem is due to an oblique > muscle that is paralyzed. > Maybe they say other things but I don't remember... Oblique muscles always have an antagonist muscle, as well as the contralateral yoke to the antagonist muscle. There is a superior oblique (commonly affected) and an inferior oblique (seldom affected). Assuming it is the superior oblique, it may require surgery on the inferior oblique in the same eye, the superior oblique itself (tucking, but tucks are sometimes not done), the inferior rectus in the other eye, or the superior rectus in the same eye. It depends on the alignment pattern, of which there are about 9, plus others depending on the presence or absence of torsion. Hi, I am in a real panic because today i had my eyes tested because of problems in one eye, the eye tester gave me a letter to take to eye casualty but it is shut till Monday and I have no way of finding out what is wrong with my eye and how serious it is. In the letter it says I have Incomitant Deviation and Diplopia and I am very worried that I could lose my sight. Hopefully someone can give me some info on this. Thanks. > On 11/19/05 11:22 AM, in article > 1132428139.128513.114950@f14g2000cwb.googlegroups.com, "Diplopia-affected" [quoted text clipped - 15 lines] > rectus in the same eye. It depends on the alignment pattern, of which there > are about 9, plus others depending on the presence or absence of torsion. >Hi, I am in a real panic because today i had my eyes tested because of >problems in one eye, the eye tester gave me a letter to take to eye [quoted text clipped - 3 lines] >In the letter it says I have Incomitant Deviation and Diplopia and I am >very worried that I could lose my sight. Darren- I'm not a doctor, but I have had exactly what you have, and have had multiple surgeries to deal with it. "Strabismus" is misalignment of the eyes. "Deviation" means that you're eyes are not properly aligned, mechanically. One or both may drift in or out, or up or down. "Incomitant" means that it varies depending on where you look. In other words, the angle of the deviation changes with your 'gaze.' "Diplopa" is double vision. Since your eyes are looking in two slightly different directions, your brain is having trouble "fusing" the two images. This is not uncommon with strabismus. You will likely need some combination of vision therapy, eye patching, prism glasses, or strabismus surgery. In any event you need to be seen by a strabismus ophthalmologist for further evaluation. http://www.nlm.nih.gov/medlineplus/ency/article/001004.htm http://www.strabismus.org/ http://www.aapos.org/  SignatureLive simply so that others may simply live Thank you very much for that, I have read hundreds of websites and government sites and could not understand what they meant but now I do.
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