Double Vision in Children: Astigmatism and Treatment Options - Ophthalmology

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Double vision, or diplopia, in children can be a concerning issue for parents, especially when it is accompanied by conditions such as astigmatism. In your case, your 7-year-old child has been diagnosed with high astigmatism in both eyes and is experiencing double vision. It is important to understand the relationship between astigmatism and double vision, as well as the potential need for further evaluation.

Astigmatism occurs when the cornea or lens of the eye is irregularly shaped, causing light to focus on multiple points rather than a single point on the retina. This can lead to blurred or distorted vision. In children, significant astigmatism can indeed contribute to visual disturbances, including double vision, particularly if the astigmatism is uncorrected. However, it is more common for astigmatism to cause monocular (single eye) double vision rather than binocular (both eyes) double vision.

In your child's case, the fact that the double vision resolved with the use of corrective lenses suggests that the astigmatism was a contributing factor. The prescription of glasses with a lower degree of astigmatism correction (150 degrees) appears to have alleviated the double vision, although the child reported that objects appeared wider. This sensation of distortion can occur as the brain adjusts to the new visual input from the corrected lenses. It is not uncommon for children to experience some initial discomfort or visual distortion when they first start wearing glasses, but this typically resolves as they adapt.

Regarding the need for further evaluation, the absence of strabismus (misalignment of the eyes) is a positive sign. Strabismus is often a primary cause of binocular double vision in children. Since your child does not have strabismus and the double vision improved with glasses, it is less likely that there is a serious underlying neurological issue. However, if there are any additional symptoms, such as headaches, changes in behavior, or persistent visual disturbances, it would be prudent to consult with a pediatric ophthalmologist or a neurologist for a comprehensive evaluation.

In summary, while astigmatism can contribute to visual disturbances, the resolution of double vision with corrective lenses is a reassuring sign. Continuous follow-up with an eye care professional is essential to monitor your child's vision and ensure that any changes are addressed promptly. If the double vision returns or if there are any new symptoms, further investigation may be warranted. It is always better to err on the side of caution when it comes to children's health and vision.