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.Most children over the age of 12 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 surgeryis another possible option for treating astigmatism, but it's not usually available free of charge on the NHS.

If you have cataracts in both eyes, you'll have them removed on separate occasions to give the first eye time to heal and 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.


A prism is a wedge-shaped piece of glass or plastic that bends thelight thatshines 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 (Botox)injections are sometimes used to treat eye movement disorders, such as squints.

The botulinum toxin is injected into one of the muscles controlling 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 your eyesare not aligned properly this can meanyour eye "drifts" slightly, and appears as if one eye is looking up or in the opposite direction
  • worse double vision

As the botulinum toxin wears off, you may be able to control the position of your eyes for a period of time. However, this timeframe can vary and further injections may be necessary.

Surgery on your eye muscles

Ifyourdouble vision is caused by a squint, surgery on youreye 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.

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
  • having a poor result from the operation, which could mean you need further squint surgery this is estimated toaffect around 1 in 10 people who have squint surgery
  • in rare cases, damaging the eye or your vision this is estimated to affect1 in 2,400 people who have 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 treatments 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 and replacing it with an implant.

Although it's considered a safe procedure, there are risks associated with having an opaqueintraocular lensfitted. 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

Before having anopaqueintraocular lensimplant, you should discuss the implications of the procedure with your eye specialist. The procedure is irreversible, and removing the implant would involve significant risk of damaging your eye and impairing your vision.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 22 Aug 2016