Double vision after cataract can have many causes, surgeon says

Careful history-taking can help surgeons distinguish surgically induced diplopia from conditions that existed before cataract surgery, said Mitchell B. Strominger, MD. Existing neuro-ophthalmic conditions may have gone unrealized because of the lens opacity, he said "I feel that double vision in adults is neuro-ophthalmic until proven otherwise because those are the really serious problems," Dr. Strominger said.

Neurologic or myogenic problems tend to be paretic in nature, while in more common problems eye movement tends to be physically restricted, he said. Unrecognized systemic disorders may account for up to one-third of post-cataract diplopia cases, Dr. Strominger said.

"The medical history is actually important," he told Ocular Surgery News. "Rule out compressive optic neuropathy. Check their visual acuity, color, pupil examination and look at their visual fields."

Other causes can include loss of fusion in patients with strabismus or acquired double vision from the surgical procedure itself. Diplopia can also result from damage to either the superior or inferior rectus muscles from the bridle suture or the anesthetic needle, he said. For more about diplopia, possible causes and prevention methods, see the full story in the June 15 issue of Ocular Surgery News U.S. Edition.