You are reading a document, and suddenly some text appears to split into two. Or perhaps a familiar face seems to have a faint “ghost” beside it. Double vision can be unsettling, especially because it may appear suddenly and interfere with driving and reading. While some causes are minor and treatable, others can point to nerve, muscle or brain-related problems that need prompt attention.
This blog explains what double vision is, its main causes and when you should consult an eye specialist.
Double vision, medically called diplopia, means seeing two images of a single object. It may be constant, intermittent, vertical, horizontal, or diagonal, and it can affect one or both eyes. An eye specialist can accurately assess the pattern of these visual changes.
The key distinction is whether the double image disappears when one eye is covered:
| Type | What it means | Common source |
| Monocular diplopia | Doubling continues when one eye is covered | Problem within that eye, such as dry eye, astigmatism, cataract, or retinal surface changes |
| Binocular diplopia | Doubling disappears when either eye is covered | Misalignment between the two eyes, often involving eye muscles or the nerves controlling them |
Double vision is a symptom which can be caused by an easily corrected refractive error or a neurological cause. There are many causes of double vision such as:
Less commonly, double vision may be linked with migraine, stroke, brain tumours or multiple sclerosis. They may increase pressure inside the skull or cause giant cell arteritis. Because these causes can affect the brain, nerves or blood vessels, double vision requires prompt assessment from an eye doctor.
Any new, persistent or recurring double vision needs a professional eye assessment, even if it improves on its own. Seek emergency care from an eye specialist immediately if double vision occurs with any of the following:
An eye doctor will usually begin with a detailed history: when the doubling started, whether it is constant or intermittent, whether it affects one or both eyes and whether it is associated with headaches, trauma, diabetes, thyroid disease or muscle weakness.
A typical eye assessment may include:
Double vision should be assessed cautiously because it can stem from something as simple as astigmatism or as significant as a nerve- or brain-related condition. A useful first clue is whether the doubling remains when one eye is closed, but only a comprehensive examination can identify the true cause. If the symptom is new, persistent, or accompanied by headache, pain, drooping eyelid, weakness or difficulty speaking, seek urgent medical care from an eye specialist.
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