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Got hit on eye. Having blurred and double vision. What should be done?

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My son was punched in the eye last night. He complains of blurry vision and double vision when looking out of both eyes but seems to be able to see if looking out of one with the other covered. What should I do?
Posted Sat, 23 Mar 2013 in Vision and Eye Disorders
Answered by Dr. Naseem 51 minutes later
Hi there. Thanks for posting your query here.

Firstly, you need to be sure there is no double vision when the eyes are checked separately since the causes change depending on that important finding.

The reasons for double vision or diplopia with both eyes open following trauma such as the one your son experienced may be a bruising of the eye muscles of the left eye, damage to the muscle fibres or damage to the nerves supplying those muscles.

Which muscle or muscles are affected is difficult to determine without an examination of the movements of the eye.

Make sure there is no displacement of the position of the eye. That means both eyes are looking straight. Also, does he have any other injury on his face, swelling or tenderness around the eye and eyebrow area? Was the injury severe enough to cause any bone damage?

If not, the cause of double vision could be a muscle swelling or bruising that is most often temporary and needs ice packs to be applied for a day or two a couple of times a day. He may also be given antiinflammatory medication orally like Paracetamol to combat inflammation. This often works and the double vision goes away more often than not.

If there is any nerve damage, the movement of extraocular muscles need to be evaluated to determine which muscle nerve complex is affected.

Typically, you may wait for 2 to 3 days for symptoms to subside.
Any deterioration and he needs to be evaluated further.

Do revert with anything further you may need.

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