"Where the mind is without fear and the head is held high; Where knowledge is free; Where the world has not been broken up into fragments by narrow domestic walls; Where words come from the depth of truth; Where tireless striving stretches its arms toward perfection; Where the clear stream of reason has not lost its way into the dreary desert sand of dead habit; Into that heaven of freedom it should be our intent. ( my adaption from Rabindranath Tagores famous lines)

Monday, June 13, 2005

Double Vision 2

Double Vision (Diplopia)
A few days back I had the misfortune of being confronted with this eye problem of double vision, also called Binocular diplopia. Diplopia causes a person to see two images of a single object. There are two types of double vision: monocular and binocular. Monocular diplopia is double vision in only one eye. The double vision continues in the affected eye even when the other eye is covered. The doubling does not go away when you look in different directions. What I have is Binocular diplopia - double vision related to a misalignment of the eyes. Binocular diplopia, however, does go away when either eye is closed. I see a double vision when I open both eyes. However if I closed one eye, I clearly see a single image, near or far. Any problem that affects one or more of the muscles around the eyeball that control the direction of the gaze can cause binocular diplopia. Besides, nerves can be injured by brain damage caused by infection, multiple sclerosis, stroke, head trauma or a brain tumor. If the specialist, after his examination feel that further investigations are required you may need to have a magnetic resonance imaging (MRI) or (CT) scan, etc. Fortunately my Super Neuro Ophthalmologist was of the opinion that as a result of my medical history ( previously having had a Stroke and Heart attack ) and age (77 yrs) and his tests , that the indications were a muscle dysfunction or a mild paralysis of this or the cranial nerve, and it should resolve itself in 8 weeks to 6 months. Presently I am wearing a patch over one eye to prevent visual confusion till the new prism lens arrives. This is for distance vision. The Neuro Ophthalmologist, by holding my head in his hands and moving it in different directions was able to prescribe the Prism Lens ( #4, in this case) to be incorporated in my new spectacles. However in near vision I will have to close the weaker right eye.
I will relate to you how it happened but I give below some sketches made by me after the specialist examined my eyes.

Double Vision

On June 4th 2005 I was having several bouts of headache, some dizziness/ giddiness and an uncomfortable feeling. I kept treating this with CROCIN (Paracetomol). It became really worse the next day. So I took my BP with my home Omron Digital Blood Pressure Monitor. It was 90/50 with pulse at 45 bpm. PANIC. Decided to see my Cardiologist and he measured it as 100/50/50. ECG was done. No significance. Told to discontinue BP medicines except Aspirin. Asked for investigations for Blood Sugar, Blood Urea, Blood Picture, Creatine and Lipid profile. As tests were to be done on an empty stomach they were done next day. Results were normal - nothing significant.
But BP had returned to 120/90 with pulse 55 bpm. However, now there no dizziness now but was having Double vision. (It may have been there earlier but was lost in my dizziness!). The Cardiologist referred me to an expert Ophthalmologist who found I had Binocular diplopia that would in time heal itself. Not being convinced I went to an Eye Institute and was examined by another expert Ophthalmologist, who, to make sure referred me to an in-house Neuro Ophthalmologist whose examination and results I have already given. Time for self-healing was 8 weeks to 6 months. No medicines or eye exercises were prescribed. Advised to keep hypertension in check and not to search for double images. He had the courage and confidence of his diagnosis that he did not ask for a MRI and CT scans to get additional information.

Now what caused this? Well, I have had a history of “blood thickening” in that I had a stroke 15 years back when I lost my voice for 10 days, a heart attack 5 years back and a “temporary loss of vision” for almost a minute 2 years back. I am by nature very excitable and suffer from hypertension. I had cataract surgery and lens replacement for both eyes a few years back. Fortunately I have no diabetes and I am 77 years young. Again! What caused this? During the first week of June I was reading, as usual newspapers for 1.5 hours in the morning, then watching TV for 5 hours per day (French Open), followed up with a 2 hour session on the computer where I was trying to figure out the relationship of the now famous puzzle Sudoku and its relationship with Euler’s work on magic squares and the algorithms for programming such, etc, apart from solving these puzzles for another hour. I continue to work on the computer and continue studying the subject of Eulerian squares to invent another Mindgame !Was this really such a strain on the eyes to result in double vision or was it a coincidence or was it a random age related problem?