Strabismus and Diplopia: A 23-Year-Old's Inquiry - Ophthalmology

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Strabismus, commonly referred to as "crossed eyes," is a condition where the eyes do not properly align with each other when looking at an object. This misalignment can lead to various visual problems, including diplopia, or double vision. Your inquiry about the relationship between strabismus and diplopia, especially in the context of your personal history, is quite pertinent.

From your description, it seems you have developed a preference for using your right eye due to the internal strabismus (esotropia) affecting your left eye. This is a common adaptive response in individuals with strabismus, where the brain suppresses the input from the misaligned eye to avoid double vision. This suppression can lead to amblyopia, or "lazy eye," particularly if it occurs during the critical period of visual development in childhood. Since you mentioned a family history of conditions like high blood pressure, diabetes, and thyroid disease, it’s essential to consider these factors as they can influence overall health, including eye health.

Regarding your specific questions:
1. Understanding Diplopia: Diplopia can be classified into two types: monocular and binocular. Monocular diplopia occurs when double vision is present in one eye, regardless of the position of the other eye, often due to issues like astigmatism or cataracts. Binocular diplopia occurs when both eyes are open and is typically due to misalignment, such as that seen in strabismus. Given your description, it sounds like you are experiencing binocular diplopia when trying to use both eyes together, particularly when looking at distant objects. This is likely related to your strabismus.

2. Strabismus and Amblyopia: The fact that you have a history of strabismus and a preference for using one eye suggests that amblyopia could be a concern. Amblyopia occurs when one eye does not develop normal vision, often due to strabismus or significant refractive errors that are not corrected. Since you mentioned that you have myopia (nearsightedness) and astigmatism, it’s crucial to ensure that both eyes are adequately corrected with glasses to promote proper visual development.

3. Impact of Glasses: Wearing corrective lenses should help improve your vision, but if the strabismus is significant, it may not fully resolve the misalignment. This misalignment can lead to difficulties in using both eyes together, resulting in the need to switch between eyes to see clearly. The use of prism glasses, as suggested by your eye doctor, can help align the images seen by both eyes, potentially alleviating some of the diplopia.

4. Surgical Options: If the strabismus is not adequately managed with glasses or prisms, surgical intervention may be considered. Surgery can help realign the eyes, which may improve binocular vision and reduce or eliminate diplopia. However, the decision for surgery should be made in consultation with an ophthalmologist who specializes in strabismus.

5. Follow-Up Care: It’s great that you have plans to see a specialist at a larger hospital. Be sure to discuss all your symptoms, including the diplopia and your history of amblyopia, during your appointment. A comprehensive eye examination will help determine the best course of action for your specific situation.

In summary, your condition appears to involve binocular diplopia related to strabismus, and it’s essential to address both the alignment of your eyes and the refractive errors. Early intervention is key, especially considering your history of amblyopia. Continue to seek professional advice and follow up with your eye care provider for the best outcomes.