Ask Dr. Driscoll: Monocular Diplopia in EDS

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Dear Dr. Driscoll,

My daughter has hypermobility joint disorder and MCAS. Recently she developed monocular double vision with far objects being double. She has had one ophthalmologist and two optometrists tell her that her eyes look healthy. She has had two MRIs which appear normal according to the neurologist and radiologist. Could this be ciliary muscle spasm? She has been under great distress due a family member who was ill and passed away. One more note regarding my daughter, Emily. The neurologist who reviewed her MRI and case referred her to a neuro-ophthalmologist. After a month of waiting to hear from their office they’ve told her she has to see another Ophthalmologist who will decide if she can see the doctor. This will be her second Ophthalmologist seeing her as the first one said her eyes were healthy. As her eye worsens, we fear she’s being brushed off because people don’t understand her conditions.

-Carol

Dear Carol,

I’m sure this is frightening for you, and I’m so sorry that you and your daughter are struggling for answers. I may be able to give you some guidance.

Monocular diplopia (double vision out of one eye) is structural – something is interfering with the image itself on the retina (the back of the eye). Monocular diplopia is NOT neurological, so you can take a deep breath. It is more likely that the doctors just want to be sure they aren’t missing anything – or perhaps they are confused by the mast cell issue or the signs of connective tissue problems (hypermobility).

The evaluation for monocular diplopia includes ruling out problems in every layer of the eye – from the cornea to the retina – to figure it out. Your doctors will consider the ocular surface first (tear film and cornea). They will need to rule out an irregular surface (something like keratoconus needs to be ruled out), then they will go to the lens of the eye (ruling out lens dislocation), etc. Some issues are more common in patients with connective tissue disorders. If you don’t have a copy of my book “Your Eyes and EDS”, please call my office and we’ll make sure you get a copy! I think everything you need is in there.

Hugs to you both,

 

Diana Driscoll, OD

 

Founder, Clinical Director at POTS Care

 

Dr. Diana Driscoll, an Optometrist, is the President of Genetic Disease Investigators, LLC – a research corporation devoted to helping people affected by “invisible illnesses”. Read more…

 

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