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What Neurological Conditions Cause Double Vision?


4 min


what neurological conditions cause double vision

Double vision, also known as diplopia, is a condition where a single object appears as two distinct images. While this occurrence can be attributed to various factors, some of them belong to neurological conditions. In this blog post, we’ll explore what neurological conditions can cause double vision.

Cranial Nerve Palsy

Third Nerve Palsy (Oculomotor Nerve)

The oculomotor nerve controls several eye muscles, including the superior rectus, inferior rectus, and medial rectus muscles. Damage to this nerve can result from an aneurysm, trauma, or compression, leading to the affected eye deviating outward and downward, causing double vision.

Fourth Nerve Palsy (Trochlear Nerve)

The trochlear nerve controls the superior oblique muscle, which helps with downward and inward eye movements. Damage to this nerve, often due to head trauma, can cause double vision, particularly when looking down or inwards.

Sixth Nerve Palsy (Abducens Nerve)

The abducens nerve controls the lateral rectus muscle, responsible for moving the eye outward. Damage to this nerve can result in double vision, especially when looking towards the affected side. Causes include head trauma, infections, or tumors.

Multiple Sclerosis (MS)

Multiple Sclerosis is a chronic autoimmune disease that affects the central nervous system, causing damage to the protective covering of nerve fibers.

As a result, signals between the brain and the eyes can become disrupted, leading to a misalignment of the eyes and subsequent double vision. The severity and duration of diplopia in MS can vary, often appearing as a transient symptom during relapses.

Internuclear Ophthalmoplegia (INO)

INO involves a disruption in the medial longitudinal fasciculus (MLF), a pathway in the brainstem that coordinates eye movements. When the MLF is affected, communication between the eyes is impaired, leading to difficulty moving one eye horizontally. INO can be associated with conditions such as multiple sclerosis.

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Myasthenia Gravis

Myasthenia Gravis is a neuromuscular disorder characterized by weakness and fatigue of voluntary muscles.

In the case of the eyes, the muscles responsible for controlling eye movement and alignment may weaken, causing double vision. Symptoms can fluctuate throughout the day and may be exacerbated by prolonged use of the muscles, such as reading or driving.

Brain Tumors

Tumors in the brain, especially those affecting the nerves responsible for eye movement and coordination, can result in double vision.

The pressure exerted by a growing tumor can disrupt the normal functioning of these nerves, leading to misalignment of the eyes. Prompt diagnosis and treatment are crucial in managing double vision associated with brain tumors.

Brain tumors can cause double vision.


A stroke occurs when there is a disruption of blood supply to the brain, leading to damage of brain tissue. Depending on the area of the brain affected, stroke survivors may experience a range of symptoms, including double vision.

The impact on the nerves controlling eye movement can result in the eyes not working together seamlessly, causing diplopia, which may be temporary or affect only one eye, or in severe cases, both eyes.

Head Trauma

Trauma to the head can cause damage to the nerves controlling eye movements or the structures in the brainstem. This damage may result in misalignment of the eyes and double vision. The severity and specific symptoms depend on the nature and location of the head injury.

Brainstem Lesions

Lesions or damage to the brainstem, which contains the nuclei of several cranial nerves involved in eye movements, can result in double vision. Causes include strokes, tumors, or inflammatory conditions affecting the brainstem.

Thyroid Eye Disease (Graves’ Disease)

An autoimmune condition, thyroid eye disease is often associated with an overactive thyroid gland. In this disorder, the muscles and tissues around the eyes can become inflamed, leading to double vision. The condition may also cause protrusion of the eyes (exophthalmos) and other ocular symptoms.


People with diabetes may develop double vision due to nerve damage, a condition known as diabetic neuropathy. The nerves controlling eye movement can be affected, leading to misalignment of the eyes. Managing blood sugar levels is crucial in preventing and mitigating the impact of diabetes-related double vision.

Conclusion: What Neurological Conditions Cause Double Vision

Double vision is a complex symptom linked to various neurological conditions. Recognizing the causes is key for proper diagnosis and treatment. If you or someone you know experiences persistent double vision, seeking timely medical attention is vital. Consulting with a healthcare professional helps identify the root cause and develop an effective plan. Early intervention significantly improves outcomes, offering a better quality of life for those dealing with neurological conditions associated with double vision.

Frequently Asked Questions

What is double vision, and how does it occur?

Double vision, or diplopia, is a visual anomaly where a person sees two images of a single object. It can occur when the eyes are misaligned or when there is a disruption in the normal functioning of eye muscles or nerves, leading to an inability to coordinate the movement of both eyes.

How are neurological causes of double vision diagnosed and treated?

Diagnosis involves a thorough medical examination, including a neurological assessment and, in some cases, imaging studies. Treatment varies depending on the underlying cause and may include medications, surgery, or other targeted interventions aimed at addressing the specific neurological condition contributing to double vision.

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