Double vision when looking to the right

😕hey everyone, what's up?
I was wondering if anyone else here deals with something similar to my situation, or if anyone actually knows what this diagnosis might be:
So, I'm 22, and for a few years now—honestly, I can't even tell you when it started—I've been getting double vision whenever I look toward the right side, even when my head stays perfectly still. It doesn't happen instantly either; it’s more like once I hit those last few degrees of my field of vision, the image from my left eye just sort of "slips downward."
It gets way more obvious when I'm looking at things close up, like staring at my laptop screen or whatever.
It isn't totally ruining my life or anything, but I think I'm going to go see an ophthalmologist in the next few days because the more I dig into this online, the more it feels like I've somehow managed to catch a million different diseases at once.🙂
Anyway, if anyone has gone through something like this or has any insight, please let me know. Thanks!

I mean, come on, it can't be that nobody knows a single thing about this.🤷
Seriously though, please, throw whatever info you have my way because I’m such a massive hypochondriac that I’ve already managed to convince myself I’m carrying around a literal ton of different diseases.🙂

To whom it may concern,

The symptoms could point toward weakness—specifically paresis—in an extraocular muscle. However, without a clinical evaluation, it’s impossible to determine if that's actually what's happening or if there's some other underlying cause for the double vision.

You'll need a full ophthalmology exam and a specialized strabology assessment (essentially seeing a specialist focused on strabismus and pediatric ophthalmology). A Hess-Lancaster test should definitely be part of that diagnostic process.

I'd recommend finding an ophthalmology clinic that includes a dedicated strabology clinic on-site. You should start by asking your primary care physician for a referral to this specific type of specialist.

Maria Fisher46 said:Look, folks,

The symptoms you're describing could definitely point toward some weakness—specifically a paresis—in one of those external eye muscles. But honestly, without an actual physical exam, it’s impossible to say for sure if that's what's going on or if there's some other underlying reason why you're seeing double.

What you really need to do is schedule a full ophthalmology clinic visit and get a specialized strabology clinic evaluation—basically, you need to see an eye specialist who focuses specifically on strabismus and pediatric ophthalmology. And you should absolutely make sure they perform a Hess-Lancaster test to check those double images.

Your best bet is to find a major medical center, maybe somewhere like Cedars-Sinai Medical Center, that actually has a dedicated strabology clinic on staff. Just have your primary care doctor write you a referral for that specific type of specialist workup.

thanks so much for taking the time to explain all this, I'm heading to see some specialists over at Cedars-Sinai next week so I'll definitely keep all this in mind.
I just really hope it isn't anything too serious.

I have mixed feelings about this. I’ve been diagnosed with myositis causing thickening of the eye muscles. At first, things were much worse, but now it’s just like what you're describing—everything goes double when I look toward the right corner, especially right when I wake up in the morning. How long has this been going on for you? Did you deal with any eye issues before this started?

So, I was at the ophthalmology clinic today and the doctor tells me I’ve got some kind of strabismus. He spent all of three minutes staring at me through a bunch of gadgets before basically telling me to go see a specialist at a strabology clinic next week.
From what I gather, myositis is an inflammation of the muscle, not some weird thickening issue.🤷
And as for the double vision, I’ve honestly never had any eye issues in my life, and this whole situation stays exactly the same, so 🤷

Get yourself to a neurologist!

He’s been dealing with double vision for at least five years now.
It gets way worse when he’s exhausted. Man practically overextends his whole arm just to hit a button. His vision itself? Perfect. They’ve bounced him from one specialist to another, but nobody has a clue what’s actually going on.
Brain ultrasound came back fine. Based on my GP's recommendation, I finally got him scheduled for an MRI, but we can't even get in until March 25th.
At this point, he doesn't even see it as an issue anymore. Double vision is just part of his daily life.🤣
He didn't even want to go to the MRI, so I lost my mind and booked it myself.
He won't be seen until the 32nd, so we'll just have to wait and see what they find.

swiftbison92 said:mm has been dealing with double vision for at least five years now.
It gets noticeably worse when he's tired. He holds his phone out at arm's length just to see it. His visual acuity is perfect, yet they've bounced him from one specialist to another without any real answers.
He had a brain scan, everything came back fine, and two months ago—following a recommendation from his primary care doctor—I finally scheduled an MRI, though it isn't set until March 25th.
At this point, he doesn't even view it as an issue; the double vision has just become part of his daily reality.🤣
He was resistant to the MRI, so I had to step in and book it myself.
The appointment is on the 32nd, so hopefully, we get some clarity then.

Dear swiftbison92,

Double vision is a symptom that requires a thorough investigation by both a strabology clinic and neurology.

Has your husband undergone a full strabological workup (including the Hess-Lancaster test for diplopia, motility testing, Maddox wing, Maddox cross, cover tests, etc.)?

Patients often claim their vision is perfect, pointing to ophthalmologist reports showing 20/20 acuity. However, in your husband's case, checking visual acuity is insufficient. He needs an extensive evaluation by an ophthalmologist subspecialized in pediatric ophthalmology and strabismus, as very few specialists possess deep experience in this specific field.

The fact that the double vision intensifies with fatigue could suggest heterophoria—essentially an imbalance in how the eye muscles function together.

Given that you mentioned he struggles to read characters on his phone and compensates by holding it further away, near vision must also be assessed; it could potentially be hyperopia.

Without a complete strabological and neurological evaluation, reaching an accurate diagnosis will be difficult.

Best regards. 🙂

Maria Fisher46 said:Look, swiftbison92,

Double vision means you need a deep dive at a strabology clinic and a neurologist. Period.

Did her husband get a full workup from a specialist (Hess-Lancaster test for diplopia, motility, Maddox wing, Maddox cross, cover-test, etc.)?

Patients always claim their vision is perfect because an eye doctor wrote down "20/20" on a chart. That’s not enough. For your husband, just checking visual acuity isn't the move. He needs an exhaustive evaluation by a pediatric ophthalmologist specializing in strabismus. Most regular ophthalmologists don't have the experience for this specific stuff.

If the double vision flares up when he's tired, it could be heterophoria—basically an imbalance in how his eye muscles work together.

Since you mentioned he struggles reading his phone and holds it far away, they definitely need to check his near vision too. Could be farsightedness.

Without a complete strabological and neurological evaluation, you're just guessing. You won't get a real diagnosis that way.

Best, 🙂

That's exactly why he's losing his mind. These doctors seem totally clueless. They don't know what to do with him, so they just stick him in front of a chart and call it a day.
It wasn't until the third visit that they actually did some kind of exam with a light candle thing😕, I'm not even sure what it was.
Then they sent him for a brain CT, and once that came back clean, they still had no clue, so they suggested an MRI, basically saying, "We don't know what's next, maybe try an MRI?"
What should we do?
Thanks.

swiftbison92 said:That’s exactly why he’s losing it. It feels like they lack expertise; they don't know how to handle him, just point him at an eye chart and call it a day.
It wasn't until his third visit that they actually performed some kind of dilated exam😕, though I'm not entirely sure of the specifics.
They sent him for a brain CT, and once that came back clear, they were still at a loss—so they suggested an MRI, basically saying, "We aren't sure what to do, maybe let's try an MRI next."
What would you recommend?
Thanks much

To whom it may concern,

From what I can gather from your description, a thorough strabological evaluation hasn't actually taken place.

I suggest asking your primary care physician for a referral for a full diagnostic workup at a specialized strabology clinic or an orthoptics and pleoptics department. These specialized units are typically housed within larger hospitals or clinical centers under an ophthalmology clinic.

Depending on where you are located, you could seek an evaluation at the Mayo Clinic, St. Jude Children's Research Hospital (if you are in the Washington, D.C. area), Cedars-Sinai Medical Center, Cleveland Clinic, Johns Hopkins Hospital, or other major medical hubs (such as a General Hospital in cities like St. Louis or Pittsburgh).

The specialists in these clinics are ophthalmologists who have specifically sub-specialized in strabismus issues—essentially disorders involving eye alignment and motility, double vision, amblyopia, and more. They will conduct a comprehensive assessment to determine your husband's exact eye positioning and movement, whether there is an imbalance in the ocular muscles, the presence of diplopia, if all muscles are functioning correctly or if one is weakened, and his depth perception capabilities.

Only after this extensive battery of tests will a concrete diagnosis be possible. Often, a neurologist is brought into the diagnostic team as part of this process.

I hope that this time, your husband can see specialized ophthalmologists who will take his vision issues seriously.

Best regards. 🙂

Maria Fisher46 said:Look, lady,

From what you're telling me, nobody actually did a thorough job on the strabology side of things.

My advice? Get your primary care doctor to write you a referral for a full diagnostic workup at a specialized strabology clinic or an orthoptics department. You'll usually find those setups attached to major hospitals or within an ophthalmology clinic.

Depending on where you're located, you could head to the Mayo Clinic, St. Jude Children's Research Hospital (if you're near Washington, D.C.), Cedars-Sinai Medical Center, Cleveland Clinic, Johns Hopkins Hospital, or just a decent regional hospital—maybe somewhere like a General Hospital in a place like St. Louis or Pittsburgh.

The specialists in those clinics are ophthalmologists who focused specifically on strabismus—you know, eye alignment, mobility issues, double vision, amblyopia, all that stuff. They’ll run the whole battery of tests to figure out exactly how your husband's eyes are positioned and moving. Is there a muscle imbalance? Double vision? Are the muscles working right or is one weak? How's his depth perception?

You won't get any real answers until those extensive tests are done. Often, they'll even bring a neurologist into the mix for the diagnosis.

Hopefully, this time your husband actually sees some real pros who will take his vision issues seriously.

Best, 🙂

Thanks, thanks, thanks a million.🙂
Best,