Double vision is a common symptom of myasthenia gravis (MG). It can affect daily life in a variety of ways, resulting in a loss of independence. Techniques for managing double vision can include nonsurgical options such as eye patches or prism therapy, as well as medication or surgical intervention.
What is double vision?
Double vision, called diplopia, means seeing two images when there is only one object.
In people living with MG, double vision occurs when communication between the nerves and muscles becomes disrupted. This weakens the muscles around the eyes, and leads the eyes to stop moving together properly. This misalignment is what creates double vision. Blurred vision can also occur.
The symptoms of MG fluctuate, and double vision is no exception. It can occur more often when tired or stressed, and the impact is often most noticeable at the end of the day.
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How does double vision impact quality of life?
Double vision is much more than an annoyance. There are many aspects of life that can be impacted:
- Reading: Text on paper or screens becomes blurred, with words overlapping. This has an impact on professional and personal capacities.
- Driving: Without stable vision, driving is no longer safe.
- Walking: Double vision can interfere with depth and distance perception, making the risk of falling higher. Uneven surfaces or stairs become difficult to navigate.
- Daily activities: Without clear vision, the ability to accomplish simple tasks at home or work become harder.
When so much of daily life is affected, people with double vision can lose independence. This can lead to social isolation, since going to work or driving to meet friends is harder. The resulting emotional impact may include frustration, low mood, depression, feelings of hopelessness and anxiety.
Tips for managing double vision from MG
It is possible to support the eye muscles by avoiding fatigue, taking breaks and adjusting lighting to avoid eye strain. The following techniques have also shown to be effective in some cases:
- Medication: Medication such as anticholinesterase therapy, steroids or immunosuppressants to reduce antibody activity.
- Occlusion therapy: This blocks the vision in one eye by placing a patch over the eye or glasses’ lens, and then alternating the patch to avoid eye strain.
- Strabismus surgery: This corrective surgery is most successful in patients with a large angle of deviation.
- Prism therapy: Eyeglasses with attached or built-in Fresnel prisms can help the brain see one image; however, the fluctuating nature of MG symptoms can pose a problem.
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