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Double vision
Category: Head, Eyes, Ears, Nose & Throat · All head & senses symptoms
What it can feel like
Double vision (diplopia) means seeing two images of a single object — side by side or stacked — when both eyes are open. It usually means the eyes are not aligning properly, because the muscles that move them, or the nerves and brainstem circuits controlling them, are not working together.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Double vision can be associated with squint (strabismus) that decompensates with tiredness, with severe dry eye or cataract problems (these usually cause ghosting in one eye only, which persists when the other eye is closed).
Other possible causes
New double vision with both eyes open can be associated with diabetes or blood-pressure damage to an eye-movement nerve, with thyroid eye disease, with myasthenia gravis (worse with fatigue), and with stroke or other conditions in the brainstem — new double vision is always assessed promptly.
Red flags — when to seek help promptly
- New double vision — assess the same day
- Double vision with weakness, speech problems, severe headache or unsteadiness — emergency
- Double vision with a droopy eyelid and enlarged pupil
- Double vision after a head injury
- Double vision with bulging eyes or eye pain
What a clinician may do
A clinician will first confirm whether it vanishes when either eye is covered (binocular, alignment problem) or persists in one eye (optical problem), then test eye movements, pupils and the rest of the nervous system. Blood tests and brain imaging follow most new binocular cases.
Related guides on MedicalVideos.com
Frequently asked questions
Why does covering one eye matter?
If doubling disappears when either eye is covered, the problem is alignment — the two eyes point differently. If it persists in one eye with the other covered, the problem is inside that eye (lens, cornea, macula). This one test halves the diagnostic list.
Can double vision be 'just' diabetes?
Diabetes and hypertension can injure the small nerves moving the eye and cause double vision that recovers over weeks to months. But because stroke and other brain causes look identical at first, new cases are assessed urgently and usually scanned.
Related symptoms — Head, Eyes, Ears, Nose & Throat
Browse the D section of the A–Z list or return to the Symptoms A–Z hub.