What causes double vision and ocular herpes?

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Posted on Tue, 3 Oct 2017 in Brain and Spine
Question: My wife had a problem in her left eye last year,it all started with poor vision and then on eye tests we came to know that she also has diplopia in her left eye,we checked for optic neuritus but the doctors said ,reports seemed fine!she also had ocular herpes after diplopia,for which she was treated.The double vision and sldo her poor vision became fine after a few days on its own.She also had an abrasion on her left cornea ,after 1 month of all this when her eye sight had returned to normal,this was sldo treated with antibiotics and she was fine.NOW AGAIN AFTER 1 year she has had the same abrasion on the same spot on the left eye!The eye sprcialist are clueless,though her eye is fine now,I AM WORRIED AS WHY THIS HAPPENED AND WHAT IS THR CAUSE?please suggest tests and further plan,she also had sensitivity to light when she had the eye problem both the times.
Reports are attached,the first picture is of the prescription,the left side is the current diagnose,and the right the old one!
Please guide?
doctor
Answered by Dr. Erion Spaho 4 hours later
Brief Answer:
Recurrent herpesvirus infection likely.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

I examined the reports you uploaded too.

In your wife's case ocular herpes infection recurrence is the most probable condition.

In cases of recurrence and if trauma together with herpesvirus infection are excluded, other conditions that may result in corneal abrasion include blocked tears glands, granular dystrophy, inheritance, bacterial infections ( trachoma ), diabetes, etc.

In my opinion, treatment with antiviral drugs is necessary too if the final diagnosis will be herpesvirus infection.

Discuss with your wife's Ophthalmologist about these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.

Take care.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Erion Spaho 18 hours later
Sir you mean we dont need to read it from an auto immune disease angel! I was worried if it could be a precursor to some auto immune disease?
doctor
Answered by Dr. Erion Spaho 2 hours later
Brief Answer:
Autoimmune diseases seems unlikely.

Detailed Answer:
Hello again.

Autoimmune diseases such myasthenia gravis may cause double vision, but generally don't cause any corneal abrasion.

In the other hand, there is weakness that is worsened with time, and towards the end of the day.

For now, I think herpesvirus infection is the most probable cause.

If there will be no improvement or any recurrence of the double vision, dropping eyelid, weakness, an evaluation by a Neurologist is necessary.

Hope this helps.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Erion Spaho 20 hours later
One last question sir!
She is feeling excessively sleepy ,she likes to sleep in the day aswell ,hope thats should not be a concern!
doctor
Answered by Dr. Erion Spaho 8 hours later
Brief Answer:
If she sleeps night and day get a brain MRI done.

Detailed Answer:
Welcome back.

Does she sleep enough hours at night? Is her sleep at night undisturbed?

If yes, in such case a brain MRI is necessary to exclude any viral encephalitis.

Discuss with your wife's Doctor about these issues.

Hope I helped you so far.

Kind regards.
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3793 Questions

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