Double Vision Diplopia-What Causes It?



Dr. Jacobs

NJ Ophthalmologist Ivan Jacobs, M.D. explained, “Double vision, which we also refer to as diplopia, generally results from either a misalignment of your eyes or a structural problem with the part or parts of the eye that let light into it.” “There are two types of double vision. The first type is called binocular diplopia. The second type is referred to as monocular diplopia.”

Monocular diplopia can be differentiated from binocular diplopia by a simple test. If the double vision stops when you cover one eye, then you are suffering from binocular diplopia.  If the double vision persists even with one eye covered, that means you are experiencing monocular diplopia.

There are many different causes for diplopia. The problem can arise from the eyes themselves, the surrounding orbit, or the central nervous system. Causes of double vision include corneal infections or scars, cataract, eye muscle weakness from thyroid problems, nerve damage from diabetes or multiple sclerosis, autoimmune disease such as myasthenia gravis, brain tumors or aneurysms, strokes, head trauma, orbital trauma, direct eye trauma and even migraine headaches.

Double vision can occur by itself with no other symptoms. However, depending on the cause other symptoms may be present with diplopia that can include:

• Droopy Eyelids
• Pain with Eye Movements
• Headache
• Nausea
• Misalignment of one or both eyes causing a "wandering eye" or "cross-eyed" appearance
• Weakness of the other muscles in your body  

“Double vision that's new or unexplained requires urgent medical attention. With so many potentially serious causes for diplopia, it's important to discover the reason without delay”, said Dr. Solish. A thorough history and physical examination are critical to localizing a disease process and guiding further tests and studies to identify and treat the cause. If you or someone you know experiences double vision, it is important that they schedule an appointment for an examination. Please feel free to call The Eye Care & Surgery Center at 908-789-8999, visit The Eye Care & Surgery Center or facebook.com/eyecareandsurgerycenter.

The Eye Care & Surgery Center is staffed by a team of Board Certified NJ Ophthalmologists who are subspecialty Fellowship trained New Jersey eye surgeons, Opticians, technical and administrative staff who provide eye examinations for adults and children, surgery for cataracts, intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, diagnosis and treatment of diseases of the retina including diabetes and age related macular degeneration (AMD) and diagnosis and treatment of glaucoma, reconstructive and cosmetic facial surgery including eyelid surgery and facial and skin rejuvenation as well as contact lenses, eyeglasses, eyewear and optical services.

With locations in Westfield and Warren and Iselin, The Eye Care & Surgery Center is a leading NJ eye care practice serving the central and northern New Jersey including Old Bridge, East Brunswick, Sayreville, Milltown, North Brunswick, Kendall Park, Somerset, Dunellen, Bridgewater, Manville, Bound Brook, Raritan, Edison, Colonia, Woodbridge, Metuchen, Avenel, Carteret, Piscataway, Middlesex, Somerville, South Plainfield, North Plainfield, Roselle Park, Garwood, Clark, Kenilworth, Cranford, Gillette, Berkeley Heights, Stirling, Scotch Plains, Summit, Chatham, Watchung, Pluckemin, Rahway, Plainfield, Mountainside, Springfield, New Providence, Basking Ridge, Bedminster, Bernardsville, Millington, Union, Elizabeth, Linden, Jersey City, Irvington, Orange, West Orange, Livingston, Short Hills, Florham Park, Madison, Bloomfield, Montclair, Clifton, Garfield, Wayne, Parsippany, Troy Hills and Paramus, New Jersey.

Fuch’s Dystrophy Information for NJ Patients

Fuch’s Dystrophy is a slowly progressive disease of the cornea that is typically bilateral and is slightly more common in women than men. While it is possible to observe Fuch’s Dystrophy in people in their 30’s and 40’s, it usually does not compromise vision until people are in their 50’s or 60’s. While a precise path of genetic transmission is unclear, a familial predisposition seems to exist among those who are first degree relatives.

Early in the course of Fuch’s Dystrophy patients typically awaken with blurry vision that gets progressively clearer as the day passes. This phenomenon occurs because the cornea normally swells during sleep.  A healthy endothelial pump is necessary in order to restore the cornea to a normal thickness. In Fuch’s Dystrophy, the endothelium removes fluid from the cornea less efficiently.  As the Fuch’s Dystrophy disease worsens, the vision does not clear. Usually we will attempt to help reduce the corneal swelling each day by prescribing hypertonic eye drops and ointments. However, when these measures fail to provide comfort and clear vision, it may be necessary to have a corneal transplant.

If you or someone you know would like to learn more about Fuch’s Corneal Dystrophy please schedule an appointment with New Jersey Corneal Specialist Joel Confino, M.D. at The Eye Care & Surgery Center by calling us at 908-789-8999, visiting The Eye Care & Surgery Center or facebook.com/eyecareandsurgerycenter.

The Eye Care & Surgery Center is staffed by a team of Board Certified NJ Ophthalmologists who are subspecialty Fellowship trained New Jersey eye surgeons, Opticians, technical and administrative staff who provide eye examinations for adults and children, surgery for cataracts, intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, diagnosis and treatment of diseases of the retina including diabetes and age related macular degeneration (AMD) and diagnosis and treatment of glaucoma, reconstructive and cosmetic facial surgery including eyelid surgery and facial and skin rejuvenation as well as contact lenses, eyeglasses, eyewear  and optical services.

With locations in Westfield and Warren and Iselin, The Eye Care & Surgery Center is a leading NJ eye care practice serving the central and northern New Jersey including Old Bridge, East Brunswick, Sayreville, Milltown, North Brunswick, Kendall Park, Somerset, Dunellen, Bridgewater, Manville, Bound Brook, Raritan, Edison, Colonia, Woodbridge, Metuchen, Avenel, Carteret, Piscataway, Middlesex, Somerville, South Plainfield, North Plainfield, Roselle Park, Garwood, Clark, Kenilworth, Cranford, Gillette, Berkeley Heights, Stirling, Scotch Plains, Summit, Chatham, Watchung, Pluckemin, Rahway, Plainfield, Mountainside, Springfield, New Providence, Basking Ridge, Bedminster, Bernardsville, Millington, Union, Elizabeth, Linden, Jersey City, Irvington, Orange, West Orange, Livingston, Short Hills, Florham Park, Madison, Bloomfield, Montclair, Clifton, Garfield, Wayne, Parsippany, Troy Hills and Paramus, New Jersey.

NJ Veterans’ Eye Health & Vision Problems

The Eye Care & Surgery Center gives our thanks to NJ Veterans who individually and together have sacrificed to make our nation a safe and protect our freedom. Our eye physicians and surgeons and staff wish to share some thoughts in order to help military veterans get the best care in order to preserve their eye health and vision. Veterans of the Iraq or Afghanistan wars are more likely than those who served in earlier wars to have vision loss as a result of traumatic brain injury (TBI). Higher rates of TBI in these recent wars can be attributed to two factors: explosive devices have been a major cause of injury, and improved body armor has enabled soldiers to survive more serious injuries. Veterans of the Vietnam, Korean, or early wars are in or entering life stages when eye disorders like cataracts, glaucoma, age related macular degeneration (AMD) and diabetic retinopathy are more likely to occur. Also, like everyone in mid-life and beyond, Veterans may find their near vision decreasing due to Presbyopia or “aging eyes”.

Our eye doctors and out staff will work together with our veterans to make sure they preserve and maintain their eye health and vision in order to take the fullest advantage of the freedom they have provided for all of us. Learn more about eye health and vision at The Eye Care & Surgery Center by calling 908-789-8999, visiting The Eye Care & Surgery Center or facebook.com/eyecareandsurgerycenter.

The Eye Care & Surgery Center is staffed by a team of Board Certified NJ Ophthalmologists who are subspecialty Fellowship trained New Jersey eye surgeons, Opticians, technical and administrative staff who provide eye examinations for adults and children, surgery for cataracts, intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, diagnosis and treatment of diseases of the retina including diabetes and age related macular degeneration (AMD) and diagnosis and treatment of glaucoma, reconstructive and cosmetic facial surgery including eyelid surgery and facial and skin rejuvenation as well as contact lenses, eyeglasses, eyewear and optical services.

With locations in Westfield and Warren and Iselin, The Eye Care & Surgery Center is a leading NJ eye care practice serving the central and northern New Jersey including Old Bridge, East Brunswick, Sayreville, Milltown, North Brunswick, Kendall Park, Somerset, Dunellen, Bridgewater, Manville, Bound Brook, Raritan, Edison, Colonia, Woodbridge, Metuchen, Avenel, Carteret, Piscataway, Middlesex, Somerville, South Plainfield, North Plainfield, Roselle Park, Garwood, Clark, Kenilworth, Cranford, Gillette, Berkeley Heights, Stirling, Scotch Plains, Summit, Chatham, Watchung, Pluckemin, Rahway, Plainfield, Mountainside, Springfield, New Providence, Basking Ridge, Bedminster, Bernardsville, Millington, Union, Elizabeth, Linden, Jersey City, Irvington, Orange, West Orange, Livingston, Short Hills, Florham Park, Madison, Bloomfield, Montclair, Clifton, Garfield, Wayne, Parsippany, Troy Hills and Paramus, New Jersey.

Eyelid Lumps, Bumps & Swelling

Eyelid lumps, bumps and swelling are common eye problems many of us experience. The most common cause of acute lid swelling is an infection of the tiny sweat and oil glands emptying into the margin of the eyelids. Patients who experience an infection of an eyelid sweat gland, commonly known as a “Stye”, usually exhibit diffuse swelling of the lid with a tiny raised nodule on the lid margin that indicates the actual site of involvement. Inflammation of the Meibomian or oil glands in the eyelid will result in what is referred to as an “Internal Hordeolum” that can also result in diffuse lid swelling. With time an Internal Hordeolum may result in the formation of a capsule in the tissue of the eye lid. The patient will then have a firm lump that can be felt through the skin surface of the eyelid. This lump, called a “Chalazion”, is an eruption of the contents of the Meibomian glands into the tissues that results in a granulomatous response with a cystic change. If the initial infection is minimal, a Chalazion may develop without any history of a swollen lid. If the lump does not resolve after treatment with warm compresses and possibly antibiotics we may need to remove it with excision or drainage.

If you or someone you know experiences eyelid lumps, bumps or swelling please call The Eye Care & Surgery Center at 908-789-8999, visit The Eye Care & Surgery Center or facebook.com/eyecareandsurgerycenter to schedule an appointment.

The Eye Care & Surgery Center is staffed by a team of Board Certified NJ Ophthalmologists who are subspecialty Fellowship trained New Jersey eye surgeons, Opticians, technical and administrative staff who provide eye examinations for adults and children, surgery for cataracts, intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, diagnosis and treatment of diseases of the retina including diabetes and age related macular degeneration (AMD) and diagnosis and treatment of glaucoma, reconstructive and cosmetic facial surgery including eyelid surgery and facial and skin rejuvenation as well as contact lenses, eyeglasses, eyewear  and optical services.

With locations in Westfield and Warren and Iselin, The Eye Care & Surgery Center is a leading NJ eye care practice serving the central and northern New Jersey including Old Bridge, East Brunswick, Sayreville, Milltown, North Brunswick, Kendall Park, Somerset, Dunellen, Bridgewater, Manville, Bound Brook, Raritan, Edison, Colonia, Woodbridge, Metuchen, Avenel, Carteret, Piscataway, Middlesex, Somerville, South Plainfield, North Plainfield, Roselle Park, Garwood, Clark, Kenilworth, Cranford, Gillette, Berkeley Heights, Stirling, Scotch Plains, Summit, Chatham, Watchung, Pluckemin, Rahway, Plainfield, Mountainside, Springfield, New Providence, Basking Ridge, Bedminster, Bernardsville, Millington, Union, Elizabeth, Linden, Jersey City, Irvington, Orange, West Orange, Livingston, Short Hills, Florham Park, Madison, Bloomfield, Montclair, Clifton, Garfield, Wayne, Parsippany, Troy Hills and Paramus, New Jersey.

New Jersey Diabetic Eye Disease Awareness Month

The Eye Care & Surgery Center wishes to announce that November is National Diabetic Eye Disease Awareness Month. This is an important time to spread the word about this potentially blinding disease. We need to work to help patients avoid the complications of diabetic retinopathy, which blinds over 8,000 Americans each year. The vision loss from diabetic retinopathy can be prevented if it's caught and treated in time. A recent study found that more than one third of those diagnosed with diabetes do not adhere to vision care guidelines recommending a dilated eye exam every year.

As part of Diabetic Eye Disease Awareness Month we are urging people with diabetes to have a dilated eye exam every year. The longer a person has diabetes, the greater his or her risk for developing diabetic retinopathy. However, diabetic retinopathy does not only affect people who have had diabetes for many years, it can also appear within the first year or two after the onset of the disease.

Patients can help to reduce the risk of developing diabetic eye disease  by not smoking, controlling their cholesterol and lipid profile and blood pressure, as well as working to eat a heart-healthy diet rich in fish, fruit and green leafy vegetables and exercising. 

The key to successful treatment of diabetic retinopathy is early detection and intervention. If you or someone you know suffers from Diabetes please make sure that they are getting regular eye exams to help preserve their eye health and vision. Feel free to call The Eye Care & Surgery Center for an appointment by calling 908-789-8999, visiting The Eye Care & Surgery Center or facebook.com/eyecareandsurgerycenter.

The Eye Care & Surgery Center is staffed by a team of Board Certified NJ Ophthalmologists who are subspecialty Fellowship trained New Jersey eye surgeons, Opticians, technical and administrative staff who provide eye examinations for adults and children, surgery for cataracts, intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, diagnosis and treatment of diseases of the retina including diabetes and age related macular degeneration (AMD) and diagnosis and treatment of glaucoma, reconstructive and cosmetic facial surgery including eyelid surgery and facial and skin rejuvenation as well as contact lenses, eyeglasses, eyewear  and optical services.

With locations in Westfield and Warren and Iselin, The Eye Care & Surgery Center is a leading NJ eye care practice serving the central and northern New Jersey including Old Bridge, East Brunswick, Sayreville, Milltown, North Brunswick, Kendall Park, Somerset, Dunellen, Bridgewater, Manville, Bound Brook, Raritan, Edison, Colonia, Woodbridge, Metuchen, Avenel, Carteret, Piscataway, Middlesex, Somerville, South Plainfield, North Plainfield, Roselle Park, Garwood, Clark, Kenilworth, Cranford, Gillette, Berkeley Heights, Stirling, Scotch Plains, Summit, Chatham, Watchung, Pluckemin, Rahway, Plainfield, Mountainside, Springfield, New Providence, Basking Ridge, Bedminster, Bernardsville, Millington, Union, Elizabeth, Linden, Jersey City, Irvington, Orange, West Orange, Livingston, Short Hills, Florham Park, Madison, Bloomfield, Montclair, Clifton, Garfield, Wayne, Parsippany, Troy Hills and Paramus, New Jersey.

NJ Cornea Specialist on Keratoconus

NJ Cornea Specialist Joel Confino, M.D. explained Keratoconus, a type of corneal dystrophy in which the cornea becomes thin and bulges. “Even though Keratoconus is a relatively rare corneal disease, its impact on vision and overall lifestyle can be quite significant as it progresses,” stated Dr. Confino of The Eye Care & Surgery Center with offices in Westfield, Warren & Iselin, New Jersey. “In the earlier phases of Keratoconus we are often able to provide vision correction for Keratoconus patients with eyeglasses and ordinary contact lenses. In the intermediate phases specialized contact lenses are often necessary to provide good vision and physical tolerance. This may include RGP Contact Lenses for Keratoconus or even a unique hybrid contact lens called SynergEyes®.  As Keratoconus progresses and reaches its later phases, corneal surgery including a cornea transplant may be required in order for patients to conduct normal activities and enjoy normal lifestyles,” explained Dr. Confino.

Keratoconus is generally first diagnosed in young people at puberty or in their late teens and progresses through the third or fourth decade of life. It tends to progress more rapidly in young patients. Keratoconus occurs about equally in men and women. The signs and symptoms of Keratoconus may change as the disease progresses and may include a) blurred or distorted vision b) monocular double vision c) rapidly changing eyeglass prescriptions especially with high degrees of astigmatism d) increased sensitivity to bright light and glare e) problems with night vision f) headaches from eyestrain and in the most severe situation e) hydrops, a painful condition in which the back of your cornea ruptures and fills with fluid, causing a sudden clouding and loss of vision.

If you or someone you know would like to learn more about Keratoconus or the various treatment options please schedule an appointment with New Jersey Corneal Specialist Joel Confino, M.D. at The Eye Care & Surgery Center by calling us at 908-789-8999, visiting The Eye Care & Surgery Center or facebook.com/eyecareandsurgerycenter.

The Eye Care & Surgery Center is staffed by a team of Board Certified NJ Ophthalmologists who are subspecialty Fellowship trained New Jersey eye surgeons, Opticians, technical and administrative staff who provide eye examinations for adults and children, surgery for cataracts, intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, diagnosis and treatment of diseases of the retina including diabetes and age related macular degeneration (AMD) and diagnosis and treatment of glaucoma, reconstructive and cosmetic facial surgery including eyelid surgery and facial and skin rejuvenation as well as contact lenses, eyeglasses, eyewear  and optical services.

With locations in Westfield and Warren and Iselin, The Eye Care & Surgery Center is a leading NJ eye care practice serving the central and northern New Jersey including Old Bridge, East Brunswick, Sayreville, Milltown, North Brunswick, Kendall Park, Somerset, Dunellen, Bridgewater, Manville, Bound Brook, Raritan, Edison, Colonia, Woodbridge, Metuchen, Avenel, Carteret, Piscataway, Middlesex, Somerville, South Plainfield, North Plainfield, Roselle Park, Garwood, Clark, Kenilworth, Cranford, Gillette, Berkeley Heights, Stirling, Scotch Plains, Summit, Chatham, Watchung, Pluckemin, Rahway, Plainfield, Mountainside, Springfield, New Providence, Basking Ridge, Bedminster, Bernardsville, Millington, Union, Elizabeth, Linden, Jersey City, Irvington, Orange, West Orange, Livingston, Short Hills, Florham Park, Madison, Bloomfield, Montclair, Clifton, Garfield, Wayne, Parsippany, Troy Hills and Paramus, New Jersey.

Facts about LASIK & Dry Eyes

Joel Confino, M.D., LASIK Surgeon & Corneal Specialist at The Eye Care & Surgery Center shared facts about LASIK & dry eyes for patients in NJ thinking about LASIK Surgery. “Without much question the most common side effect of LASIK we see is dry eyes,” shared Dr. Confino.”Most patients should probably expect to have some degree of temporary dry eye symptoms after their treatment. The critical thing to know is that LASIK dry eye symptoms should be temporary,” he explained.

Here is what you should know about LASIK and dry eyes. LASIK is corneal surgery. ANY time we do corneal surgery we typically sever some corneal nerves and we often temporarily disturb the delicate cells on the surface of the eye. During cataract surgery and any other eye surgery procedures that involve the cornea we do the exact same types of things. These corneal nerves connect to the Lacrimal Gland which is responsible for producing tears. When the nerves are temporarily interrupted there is a decrease in the amount of tears that are produced-making your eyes feel dry and gritty. To make you more comfortable during the time it takes for the corneal nerves to heal and regenerate we may do one of more of the following for you:

• Prescribe Artificial Tear Eye Drops
• Insert Tiny Tear Duct Plugs
• Prescribe Restasis® Eye Drops
• Prescribe Dietary Supplements with Omega-3 Oils

Each of the above acts to either retain the tears that you have, supplement the tears that are lacking or help you produce more of your own tears so that you will be most comfortable and heal properly. Each person will regenerate the fine corneal nerves at a DIFFERENT RATE and thus will need to use one or more of the above tear helpers for different amounts of time. A very important consideration is how healthy your tear film was BEFORE your surgery. A critical part of your LASIK consultation will be a careful examination of your tear film. Sometimes, in order to make you the most comfortable and make the healing and visual recovery process as quick and easy as possible for you, we may actually prescribe one or more of the above BEFORE your surgery.

If you or someone you know has a question or a concern about LASIK and dry eyes or would like to schedule a Free LASIK Evaluation please call and schedule an appointment at The Eye Care & Surgery Center by calling us at 800-504-1083, visiting The Eye Care & Surgery Center or facebook.com/eyecareandsurgerycenter.

The Eye Care & Surgery Center is staffed by a team of Board Certified NJ Ophthalmologists who are subspecialty Fellowship trained New Jersey eye surgeons, Opticians, technical and administrative staff who provide eye examinations for adults and children, surgery for cataracts, intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, diagnosis and treatment of diseases of the retina including diabetes and age related macular degeneration (AMD) and diagnosis and treatment of glaucoma, reconstructive and cosmetic facial surgery including eyelid surgery and facial and skin rejuvenation as well as contact lenses, eyeglasses, eyewear and optical services.

With locations in Westfield and Warren and Iselin, The Eye Care & Surgery Center is a leading NJ eye care practice serving the central and northern New Jersey including Old Bridge, East Brunswick, Sayreville, Milltown, North Brunswick, Kendall Park, Somerset, Dunellen, Bridgewater, Manville, Bound Brook, Raritan, Edison, Colonia, Woodbridge, Metuchen, Avenel, Carteret, Piscataway, Middlesex, Somerville, South Plainfield, North Plainfield, Roselle Park, Garwood, Clark, Kenilworth, Cranford, Gillette, Berkeley Heights, Stirling, Scotch Plains, Summit, Chatham, Watchung, Pluckemin, Rahway, Plainfield, Mountainside, Springfield, New Providence, Basking Ridge, Bedminster, Bernardsville, Millington, Union, Elizabeth, Linden, Jersey City, Irvington, Orange, West Orange, Livingston, Short Hills, Florham Park, Madison, Bloomfield, Montclair, Clifton, Garfield, Wayne, Parsippany, Troy Hills and Paramus, New Jersey.