Can Dry Eyes Cause Double Vision?

If you’ve been experiencing double vision, you may wonder if it could be connected to a common eye condition like dry eye. The answer is yes — dry eye can, in some cases, cause or exacerbate double vision. However, it’s a bit more complex than it might seem, and often, double vision is tied to other issues like strabismus or squint.

For those with double vision, understanding the possible causes and treatment options can bring a lot of relief. If you’re struggling with dry eyes, double vision, or both, read on to understand how these issues may be related, how they differ, and when surgery might help.

What is Dry Eye?

Dry eye is a condition where your eyes do not produce enough tears or the right quality of tears to stay comfortably lubricated. This can happen for many reasons, including age, hormonal changes, environmental factors, screen time, and even certain medications. When your eyes don’t have the moisture they need, they can feel irritated, itchy, and scratchy. Vision may blur temporarily, and in some cases, dry eye can lead to other visual symptoms, including double vision.

How Dry Eye Might Cause Double Vision

Double vision from dry eye is not the same as double vision caused by conditions like strabismus (misalignment of the eyes). With dry eye, the lack of moisture on the surface of your eyes can cause the light entering your eye to refract abnormally, leading to blurriness and sometimes a mild form of double vision. The medical term for this is monocular diplopia, which means the double vision is occurring in one eye. When you close one eye, the double image often disappears.

Here’s how it happens: when the surface of the eye becomes dry, the irregular tear film can disrupt the way light focuses on the retina (the back layer of the eye that detects light). This causes light rays to scatter rather than focus sharply, making objects appear doubled or blurred. However, it’s worth noting that dry eye usually causes more of a ghosting effect rather than true double vision.

Double Vision in Strabismus

Unlike dry eye, strabismus or squint involves misalignment in the positioning of the eyes. This misalignment can cause both eyes to point in slightly different directions, resulting in binocular diplopia, or double vision that happens when both eyes are open. Unlike monocular diplopia, closing one eye will resolve this type of double vision, but the root issue — the misalignment of the eyes — persists.

Strabismus is typically present from childhood, but it can also develop later in life due to trauma, illness, or nerve damage. People with strabismus may also experience eye strain, headaches, or difficulty focusing on objects up close. In adults, untreated strabismus can lead to amblyopia, commonly known as “lazy eye,” where one eye becomes dominant, and the brain starts to ignore input from the weaker eye.

Differentiating Between Dry Eye and Strabismus-Related Double Vision

If you experience double vision, determining whether dry eye or strabismus is the cause is essential. An eye specialist can help by performing a series of tests that check for both tear production and eye alignment.

With dry eye, the double vision or ghosting effect typically varies throughout the day, often worsening after activities that strain the eyes, like reading or using digital screens. Dry eye symptoms, such as redness, burning, and the feeling of something in the eye, also tend to accompany the visual disturbances.

In contrast, double vision from strabismus remains constant and doesn’t change based on how dry or irritated your eyes feel. People with strabismus often notice that closing one eye helps their double vision disappear, indicating the issue lies in eye alignment rather than surface moisture.

Treatments for Dry Eye and Strabismus

The good news is that treatments are available for both dry eye and strabismus, although they differ significantly.

For dry eye:

  • Artificial tears can help supplement your natural tear film, providing much-needed moisture to the eye surface.
  • Warm compresses and eyelid hygiene can improve oil production in your tears, helping tears last longer on the eye.
  • Prescription medications for dry eye can reduce inflammation and increase tear production.
  • Lifestyle changes, such as taking breaks during screen use or using a humidifier, can also reduce dry eye symptoms.

For strabismus or squint:

  • Eyeglasses or prisms can help correct minor alignment issues, especially in young children.
  • Vision therapy may help in certain cases, though it’s generally more effective in younger patients.
  • Surgery is often recommended for moderate to severe strabismus or for those whose double vision does not improve with glasses or other therapies. Surgical correction realigns the eye muscles, bringing the eyes into proper alignment. This can resolve double vision, improve depth perception, and enhance overall vision quality.

When to Seek Help

If you’re experiencing double vision, don’t ignore it. Determining whether the cause is dry eye or strabismus can be challenging on your own. An eye surgeon or specialist can perform tests to help pinpoint the issue and recommend a tailored treatment plan. Double vision can impact quality of life, making daily activities more difficult and potentially dangerous.

With modern treatment options, relief from double vision is within reach, whether it’s related to dry eye, strabismus, or a combination of factors. And if you’re unsure about your symptoms or want to understand your eligibility for corrective options, start by taking our self-test. It’s a quick way to assess whether you might benefit from further evaluation and care.

Take the self-test today to start your journey toward clearer, more comfortable vision.

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Hi, I’m Nadeem Ali

I’m one of only a few eye surgeons in the world with 100% focus on Adult Squint and Double Vision Surgery.

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