and Managing Double Vision and Astigmatism Issues

Q: and Managing Double Vision and Astigmatism Issues

Hello： Based on your situation, I will address your concerns as follows： <br>1. <br>The significant difference in astigmatism measurements may be due to multiple factors. <br>It could be attributed to variations in measurement techniques or differences in the location of the corn

Diplopia

Hello Doctor, I have been wearing glasses since middle school, but in recent years, I have been experiencing double vision, where I see overlapping images above what I am looking at.
I have undergone many tests, but nothing conclusive was found.
Eventually, the doctor determined that it was caused by astigmatism.
However, when I tried on glasses during the refraction test, the symptoms of vertical double vision were reduced, but I could still see the overlapping images.
Currently, my left eye has a myopia of -3.50 diopters and astigmatism of -2.50 diopters, while my right eye has a myopia of -2.50 diopters and astigmatism of -2.75 diopters.

One issue I have is that I need to get new glasses, and in a short period (within a month), I have had several refractions where the astigmatism measurements have varied significantly.
Sometimes, the left eye's astigmatism is measured at -1.50 diopters and the right eye at -2.00 diopters; other times, the left eye is -2.50 diopters and the right eye -2.75 diopters, with the astigmatism in one eye exceeding -1.00 diopter! Doctor, why is there such a strange phenomenon with my astigmatism measurements? In contrast, my myopia measurements are consistently accurate, with at most a 0.25 diopter difference, and only once did I have a 0.25 diopter difference.
The myopia measurements have very little variation, but the astigmatism measurements are so inconsistent that I don't know how to prescribe the astigmatism correction in my glasses.

1.
The astigmatism issue affects my daily life, as I see one object as two, with all objects appearing as overlapping images, making driving very dangerous! Currently, my glasses are only correctly prescribed for my myopia, but due to the large discrepancies, I have not been able to get the astigmatism corrected.
Doctor, how should I handle this situation?
2.
I am also experiencing frequent dryness and itching in my eyes.
I often use a towel to wipe around my eyes and then dry it with tissue paper, but the skin around my eyes feels increasingly itchy.
What should I do about this?
3.
Please provide me with some eye care tips.
Thank you.
I appreciate your time in responding.
Thank you.

Jason, 20~29 year old female. Ask Date: 2024/02/28

Dr. Gao Pilin reply Ophthalmology

Hello: Based on your situation, I will address your concerns as follows:
1.
The significant difference in astigmatism measurements may be due to multiple factors.
It could be attributed to variations in measurement techniques or differences in the location of the cornea being measured, which can yield different results.
Particularly, in cases of high astigmatism, the cornea may be irregular; thus, measurements taken from different locations can result in varying degrees.
Therefore, it is advisable to try several measurements to determine the best condition.
2.
Dry and itchy eyes may be caused by surface dryness or allergies.
It is recommended to avoid wiping your eyes with a towel, as towels may introduce bacteria and lead to infection.
You can use saline solution or artificial tears to moisturize your eyes and should avoid eye drops that contain irritating substances.
If symptoms persist, it is advisable to consult an ophthalmologist for an examination to determine the cause and receive appropriate treatment.
3.
Vision care methods include:
- Regular eye examinations to ensure normal vision.
- Taking a break every 20 minutes when using electronic screens to focus on a distant object.
- Maintaining good lighting and avoiding prolonged use of electronic devices in dim environments.
- Eating a balanced diet with sufficient vitamins and minerals.
- Avoiding prolonged fixation on a single point, and blinking regularly to prevent eye strain.

Reply Date: 2024/02/28

More Info

Double vision, or diplopia, can be a frustrating and concerning issue, particularly when it affects daily activities such as driving or reading. Your experience with double vision, especially the overlapping images you see, suggests that there may be underlying issues related to astigmatism or other refractive errors. Let's break down your concerns and explore potential solutions and management strategies.

Understanding Your Condition
1. Astigmatism and Double Vision: Astigmatism occurs when the cornea (the front surface of the eye) is irregularly shaped, causing light to focus on multiple points in the eye rather than a single point on the retina. This can lead to blurred or distorted vision, which may manifest as double vision. The fact that you have been diagnosed with astigmatism and are experiencing overlapping images indicates that your current corrective lenses may not be adequately addressing your visual needs.

2. Variability in Measurements: The fluctuations in your astigmatism measurements can be attributed to several factors:
- Measurement Technique: Different instruments or techniques used during refraction can yield varying results. It's essential to ensure that the same method is used consistently.

- Eye Fatigue: If your eyes are tired or strained during the examination, this can affect the accuracy of the measurements. It’s advisable to have your eyes rested before a refraction test.

- Changes in Eye Health: Conditions such as dry eye syndrome or other ocular surface issues can also impact how your eyes respond during testing.

Recommendations for Management
1. Comprehensive Eye Examination: Since your symptoms are persistent and affecting your quality of life, it is crucial to undergo a thorough eye examination by an ophthalmologist or optometrist. They can assess not only your refractive error but also check for other potential causes of double vision, such as muscle imbalances or neurological issues.

2. Corrective Lenses: Once a consistent and accurate measurement of your astigmatism is obtained, it is vital to have a pair of glasses specifically tailored to your needs. If traditional glasses do not provide relief, consider discussing options such as toric lenses, which are designed to correct astigmatism more effectively.

3. Managing Dryness and Irritation: The dryness and itching you are experiencing around your eyes may be related to dry eye syndrome, which is common among individuals who wear contact lenses or spend long hours in front of screens. Here are some strategies to alleviate these symptoms:
- Artificial Tears: Use preservative-free artificial tears to lubricate your eyes throughout the day.

- Warm Compresses: Applying warm compresses can help soothe irritation and improve tear quality.

- Avoid Rubbing: Try to avoid rubbing your eyes, as this can exacerbate irritation and lead to further discomfort.

4. Vision Care Tips: To maintain eye health and improve your overall vision, consider the following:
- Regular Breaks: Follow the 20-20-20 rule: every 20 minutes, take a 20-second break and look at something 20 feet away to reduce eye strain.

- Proper Lighting: Ensure that your workspace is well-lit to minimize glare and strain on your eyes.

- Healthy Diet: Incorporate foods rich in omega-3 fatty acids, vitamins A, C, and E, and zinc to support eye health.

5. Follow-Up Care: Regular follow-up appointments with your eye care professional are essential to monitor your condition and make necessary adjustments to your treatment plan.

Conclusion
Your experience with double vision and fluctuating astigmatism measurements is not uncommon, and with the right approach, it can be managed effectively. Prioritize a comprehensive eye examination to obtain accurate measurements and explore appropriate corrective lenses. Additionally, addressing dry eye symptoms and adopting healthy vision habits will contribute to your overall eye health. If symptoms persist or worsen, do not hesitate to seek further medical advice. Your vision is vital, and taking proactive steps can lead to significant improvements in your quality of life.

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