Treating double vision

If you have double vision, your treatment will depend on whether you have double vision in
one eye (monocular) or both eyes (binocular) and the underlying cause.
Underlying conditions may be treated separately. Read more about the causes of double vision.
Double vision in one eye

If you are diagnosed with monocular double vision, treatment will depend on the underlying
condition causing the problem.
Astigmatism
If you have monocular double vision caused by astigmatism (an abnormally curved cornea), you
may be prescribed corrective lenses, such as glasses or contact lenses. Most children over 12
years of age are able to wear contact lenses.
Corrective lenses compensate for the uneven curve of the cornea so the incoming light that
passes through the corrective lens is properly focused on the retina.
Laser surgery is another possible option for treating astigmatism, but it is not usually available
free of charge on the NHS.
Read more about treating astigmatism.
Cataracts
If you have monocular double vision caused by cataracts (clouding of the lens), you may need
cataract surgery to remove them. If you have cataracts in both eyes, you will have them removed
on separate occasions to give the first eye time to heal and to allow your vision to return.
Cataract operations are common procedures, usually performed as day surgery, which means you
should be able to go home shortly afterwards.
Read more about cataract surgery, including how it is carried out and your recovery.
Double vision in both eyes

Treatment for binocular double vision also depends on the underlying cause. Read more about
the causes of double vision.
Possible treatment options include:
 wearing glasses
 doing special eye exercises
 fixing prisms on your glasses
 wearing an eyepatch over one eye
 wearing an opaque (not see through) contact lens in one eye
 having botulinum toxin injections into an eye muscle
 having surgery on your eye muscles
Sometimes, children are able to ignore double vision because their brain deals with the problem
by ignoring, or ‘suppressing’, one of the two images.
Most squints in children (when the eyes are pointing at different angles) are successfully
treated, if condition is detected and treated early. Read more about treating squints.
Prisms
A prism is a wedge-shaped piece of glass or plastic that bends the light that shines though it.
Special prisms called Fresnel (pronounced frennel) prisms can be attached to your glasses and
are an effective way of treating double vision.
Fresnel prisms are thin, see-through sheets of plastic. One side sticks to the lens of your glasses
and the other side has special grooves in it that change the way the light enters your eye.
You may need to wear prisms for several months. The strength can be adjusted to suit your eyes.
If the Fresnel prisms are successful, you can have glasses made with prisms built in.
Botulinum toxin
Botulinum toxin injections are sometimes used to treat eye movement disorders, such as squints.
Botulinum toxin is a poison, but in very small doses it is used to treat a range of different health
conditions.
The botulinum toxin is injected into one of the muscles that controls the movement of your eye.
It blocks the chemical messages sent from the nerves and causes the muscle to relax. This means
the muscle can no longer move your eye and the other muscles take over and straighten the eye.
After the injection, you may experience some temporary side effects such as:
 a droopy eyelid (ptosis)
 overcorrecting the position of your eye so that your eyes are not aligned
properly, which can mean your eye "drifts" slightly and appears as if one eye is
looking up or in the opposite direction
 worse double vision
Surgery on your eye muscles
If your double vision is caused by a squint, surgery on your eye muscles can correct the position
of your eyes. Any decision to have surgery is made on the basis that the benefit offered by the
surgery (usually to align your eyes) is bigger than any risks of the surgery.
There are six muscles controlling the position of each eye. Each muscle can be weakened,
strengthened or moved. Depending on your particular squint, surgery can be carried out on the
eye muscles to change the position of your eyes and realign them.
The risks of squint surgery include:
 making any double vision worse
 damaging the eye or your vision
 having a poor result from the operation that could mean you need further squint
surgery
Your eyecare team will discuss the risks and benefits with you.
Opaque intraocular lens
For some cases of double vision, a surgical procedure known as opaque intraocular lens (IOL)
may be an option. However, this procedure is only recommended when other treatment methods
have been unsuccessful.
An opaque intraocular lens can only be used to treat people with binocular double vision (both
eyes). The procedure usually involves removing the lens of the eye, either under local
anaesthetic or general anaesthetic, and replacing it with an implant.
Although it is considered to be a safe procedure, there are risks associated with having an
opaque intraocular lens fitted. These include:
 the intraocular lens breaking after it has been inserted
 damage to the natural lens of the eye (if it is not removed)
 inability to examine the back part of the eye (retina)
 reduced visual field
Therefore, before having an opaque intraocular lens implant, you should discuss the implications
of the procedure with your ophthalmologist (eye specialist). The opaque intraocular lens
procedure is irreversible and removing the implant would involve significant risk of damaging
your eye and impairing your vision.