Patient's Query
Hello doctor,
I have bilateral monocular diplopia. This began five months ago, along with unilateral tinnitus of the left ear. Tinnitus is constant. Eyesight is rapidly deteriorating. I had several new glasses prescriptions that help slightly with the double vision, but are not completely resolved. I recently had an MRI of the pituitary without contrast.
In the last year, I had to have two colonic polyps removed, but I fear that cancer was missed. I believe I have secondary metastases in my brain. I also performed FBC, CRP, and CEA tests.
Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
There is no need to panic about your brain. The double vision is not related to any neurological disorder. Anyway, I would recommend checking the thyroid hormone levels.
Regarding the tinnitus, it seems to be related to an inner ear infection as there is a presence of inflammation in the left mastoid sinus right next to the left ear. For this reason, I recommend consulting with an ENT specialist.
Regarding the double vision, I would also recommend performing repetitive nerve stimulation in order to investigate for possible Myasthenia gravis syndrome.
I hope you will find this information helpful.
Take care.
Patient's Query
Hi doctor,
Thank you for the reply.
What concerns me the most is the fact that double vision is in both eyes independently. I know this is extremely rare. Looking through a pinhole corrects it to some degree, but only through the tiny pinhole.
The ghost images can be double or sometimes triple; they are intermittent and can appear horizontally or vertically.
Kindly help.
Thank you.
Hello,
Welcome back to icliniq.com.
This could be due to thyroid gland dysfunction. That is why it is necessary to check thyroid hormone levels and anti-TPO (thyroid peroxidase) antibody titer.
Another possible cause to consider would be a myasthenic syndrome or ocular myopathy, although not really typical, considering your symptoms. Anyway, performing repetitive nerve stimulation is recommended.
I would exclude any pituitary gland tumor or brainstem disease, considering your MRI (magnetic resonance imaging) and the description of the symptoms, which is not typical of any neurological disorder.
I hope this helps you.
Take care.
Patient's Query
Hello doctor,
Thank you for the reply.
I have had my thyroid test done, and all appears normal. I have read about cerebral polyopia, and I fear this is what I have. Also, I recently had a migraine aura for the first time at 45 years old. I never had a migraine before in my life, and the visual aura was not followed by a headache. These symptoms are terrifying.
The vision issues and tinnitus are present all the time. I have uploaded more scan results for you to peruse. I had a contrast MRI of the brain and orbits. Can I be confident that no tumor is there? I am concerned about the brain stem as I have other symptoms such as fatigue and high blood pressure.
Kindly suggest.
Thank you.
Hello,
Welcome back to icliniq.com.
I am glad that your thyroid is normal. I understand your concern and would explain that your symptoms do not seem to be related to any migraine aura or cranial polyopia. You should know that migraine aura usually lasts some minutes to hours and is usually followed by a headache. So, it does not last 24 hours. I would exclude any brain tumor, including the pituitary gland, considering your brain MRI with contrast.
As your blood pressure is high, the first thing to do is to try to manage it, as it can mimic all these clinical situations. Another issue to consider is a possible allergic reaction, considering the inflammation in your sinuses. For this reason, I would recommend performing allergy tests and trying an anti-allergy drug, and see if it helps improve your situation.
In the end, if all the above tests result are normal, you should consider anxiety as a possible cause for your underlying complaints. In such a case, I would recommend trying Alprazolam 0.25 mg and see if it helps improve your situation.
I hope this helps you.
Take care.
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Answered byDr. Aida Abaz Quka
Medically reviewed byDr. Vinodhini J.
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