Seeing double after a head injury in a crash
How a neuro ophthalmologist and an orthoptist approach double vision
A crash can leave you seeing double for several reasons. An eye muscle may get trapped. A nerve that moves the eye may be hurt. Something else may be affecting the eye or the brain. The two images can sit side by side, one on top of the other or at a slant. [1]
A swollen face doesn’t account for every case. Some double vision from a nerve injury shows up along with a drooping lid or an unusual pupil. Your doctor needs to hear about these details. [1]
Describe exactly what you see
Tell the team when the double vision started. Say which way you look when it gets worse. Does the extra image go away when you cover either eye? A yes points to eyes that aren’t lined up. If the extra image stays with only one eye open, the problem may be inside that eye. [1]
The exam checks your sight, pupils and eye movements, along with the bones around the eye. After a head injury, you may need imaging. [1]
Find the cause first, then ease the symptoms
The first step in treatment is to rule out an urgent injury to the brain, nerves or eye socket. After that, some people find daily tasks easier with a temporary cover over one eye or a prism lens. Checkups track whether your eyes are lining up better or holding steady. [1]
Do not drive while seeing two images makes distances hard to judge. Ask how to handle stairs, reading and work safely. [1]
When double vision is an emergency
Get emergency care if new double vision comes with a severe headache, new weakness or confusion. The same is true if it comes with a drooping eyelid and a large pupil, or sudden vision loss. After a blow to the face, an eye that hurts and won’t move freely also needs an urgent check. [1]
Questions about your double vision
- Is the problem in my eye, eye socket, a nerve or my brain?
- Which tests do I need since this came after an injury?
- What can help me read and get around safely while I heal?
Note when the images split
Jot down when the two images pull apart. Also note whether covering one eye makes the double vision go away. [1]
Sources and further reading
General education from neuro ophthalmology and orthoptics. Double vision that starts after an injury needs a timely exam. The cause could lie in the eye socket, the eye muscles, the nerves or the brain.
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