Q. I have bilateral monocular diplopia with rapidly deteriorating eyesight. Kindly suggest solution.

Answered by
Dr. Aida Quka
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 30, 2020

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.

Dr. Aida Quka

Neurology
#

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.


Was this answer helpful?

 | 

Thank you doctor,

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.

Dr. Aida Quka

Neurology
#

Hello,

Welcome back to icliniq.com.

This could be due to thyroid gland dysfunction. That is why it is necessary checking 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.


Was this answer helpful?

 | 

Thank you doctor,

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 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.

Dr. Aida Quka

Neurology
#

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 this clinical situation. 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.


Was this answer helpful?

 | 

Ask a QueryAsk a Query Consult by PhoneConsult by Phone Video ChatVideo Chat
Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


My tinnitus has worsened. What is my chance of recovery?

Query: Hello doctor, I am looking for a second opinion. I got tinnitus from loud noise three weeks ago. Most of the time the noise is constant 3 or 4 on a scale of 1 to 10. Yesterday morning I experienced my best day as the noise seemed to reduce to a 2. However, it went back up to a 3 and 4 again yesterd...  Read Full »

Tinnitus worsening mom's anxiety. What might help her?

Query: Hello doctor,My mother is in a care home and is experiencing very loud tinnitus. She is becoming very stressed and anxious as this has been going on for months. We have asked her GP to help but it does not seem that anything can be done. She has had her ears cleared but this has not helped either. S...  Read Full »

I am having double vision which goes away by pulling the corner of the eye. Why?

Query: Hi doctor,Five days ago, when I woke up, I felt dizzy, and my vision was off. I was sluggish all day and had a headache upon waking. I figured I was coming down with something and laid around all day on the couch. When I woke up the next, I had no headache and was no longer lethargic, but my vis...  Read Full »

Popular

Popular

Ask your health query to a doctor online?

Ask a Neurologist Now

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.

Fee:  

 


Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.