Double vision (diplopia) is one of the most troublesome visual disorders a patient can experience. The ability to read, walk and perform common activities is suddenly disrupted. The management of double vision may include prisms, orthoptics, therapy, eye muscle surgery and occlusion. The goal is to establish clear binocular single vision. Double vision management may require any combination of these therapies.Since some patients may recover function over time, surgery may be not be considered initially. Prisms should be used when it aids the patient in eliminating double vision. Press-on prisms may be applied to the patient's lenses toreduce double vision. Orthoptic therapy may be indicated in many cases. When diplopia causes significant discomfort, and is not responsive to other therapies, occlusion may be used. Unfortunately many clinicians are still prescribing black "pirate" patches. These are rarely required. New methods of occlusion are now available.
Double Vision Unresponsive to Orthoptics, Prism and Surgery While the goal is always to reform comfortable, functional binocular vision, this is not always possible. Some patients experience severe functional problems due to constant or intermittement double vision.