Nursing Double Vision


Irene is an adult who happens to be a nurse working in a doctor’s office.  For the past three years she’s experienced double vision.  She went to an ophthalmologist who said she had cataracts and wanted to do surgery. This didn’t make any sense to her, since when she covered either the right eye or the left eye her vision was fine.  It was only when she looked with both eyes together that she realized there was something wrong with her vision.

So she went to a different ophthalmologist for a second opinion.  He said: “Your lenses are clear as a bell, you don’t have cataracts, but we’re going to put prism in your glasses to help your problem.”  He did, and it didn’t.

Irene then went to a third ophthalmologist who said:  “You have diplopia and I want you to see a woman who might be able to help you.”  [Turns out it is an orthoptist]  Irene felt like she was getting nowhere, when one day a young boy came into the office and in the course of taking his history his mother mentioned that she was just coming from our office because John had vision therapy.  Irene asked, “What’s that?”.  When mom explained what John was doing, Irene thought:  “This sounds exactly what I need to help with my double vision.”

When I examined Irene in my office yesterday I determined that she had 2 units of vertical prism in her glasses, and required a bit more to fuse.  Equally important, she had severe convergence insufficiency.  Even with the vertical prism in place, her near fusional convergence range was break at 6 prism diopters and recovery at minus 6 prism diopters.  Not surprisingly she told me that she was able unable to read for any length of time.  Irene was very pleased when I explained to her what was happening to her vision, and even more so when I reviewed with her the concept of optometric vision therapy to address her binocular vision problems.

– Leonard J. Press, O.D., FCOVD, FAAO

One thought on “Nursing Double Vision

  1. I need to know the age of the patient and when she first experienced diplopia. When was the vertical prism first inserted into her glasses? Was it vertical diplopia that sent her to an opthalmologist who prescribed the prism? Was there any relationship between the onset of the CI and the vertical prism? It is not surprising that three different ophthalmologists missed her diagnosis. Because, as Ralph Garzia once told a patient, while a resident at PCO, “they are not REAL OPTOMETRISTS!”

    chuck allen

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