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Experiencing horizontal and vertical diplopia, vision is loosing and feeling dizzy. Had MRI and diabetic. Suggest?

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Practicing since : 2003
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Dear Doctor,

I am 58 year old man experiencing “horizontal and vertical diplopia”. For approximately 3 consecutive weeks now, I am very worried as my vision is losing for a couple of minutes (sometimes almost 5 minutes). This actually happens every other day and this makes me feel dizzy.

I have already consulted a specialist and undergone MRI, too, but no findings. My health status is merely not good now. I have diabetes but it’s under controlled.

I would want a second opinion with brain and eyes specialist to have conclusion regarding my status.

Looking forward to your immediate advise.
Posted Sun, 29 Sep 2013 in Vision and Eye Disorders
Answered by Dr. Dadapeer K 3 hours later
Brief Answer:
Intermittent diplopia

Detailed Answer:
Welcome to Health Care Magic

Diplopia means perceiving two images of a single object. The causes for diplopia depends on whether it is

Binocular meaning diplopia present with only one eye being kept open or
Monocular meaning diplopia present even with one eye being kept open

Constant meaning present at all the times
or intermittent meaning present only at some times

Associated with restricted eye movements or not

Since you have told in the history that the diplopia is intermittent and you have been diagnosed with diabetes, my opinion is as follows:

The common causes for intermittent diplopia are myasthenia gravis, thyroid eye disease, multiple sclerosis, chronic fatigue, deblitated health status...

I need to rule out chronic fatigue and deblitated health status as a cause in your case, if that is not the case then tests should be done to rule out myasthenia gravis, thyroid eye disease and multiple sclerosis.

Myasthenia gravis and thyroid eye disease will have normal MRI findings which you have undergone already. Diabetes is also known to cause constant diplopia because of microvascular disease affecting the nerves supplying the extraocular muscles.

If you have already done the tests, can you upload the test reports. If not then I will suggest you to consult your physician regarding these tests.

Thank you
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