severe/multiple ghosting images in vision

[ker92ri]

Hello, my vision has changed dramatically in just a couple of months. I've had strabismus since I was 2 (was surgically corrected). Have worn glasses since. I've found that my strabismus has resurfaced and I have suffered from double vision since. However I can fuse the images together quite well. However what is really bothering me is the monocular ghosting/double vision. This started around the same time as the binocular double vision. I've had countless eye dilation tests, visual field tests and an OCT of macula, nothing has been found. I've been diagnosed with blepharitis and dry eye syndrome.im at a loss as to what is causing this ghosting vision. The strange thing is that the ghosting can change in its severity.it only usually occurs at night, some nights are worse than others. I'm scared.

Thanks for reading.

[JohnHaganMD]

I think we've gone as far as we can go in a forum like this. From this point on what's needed is an exam by a cornea specialist and an cornea topography. Best of luck. Odds are its not serious

[ker92ri]

So either way it does sound like a problem with the cornea. I've had no injury to the cornea. I don't know if this is coincidental, but i was diagnosed with blepharitis and dry eye/ MGD just as these symptoms started. I'm extremely anxious about this. I don't know how or why this has started.

[JohnHaganMD]

K conus is a disease, often hereditary, usually bilateral, in which the cornea has a structural weakness that makes it assume a cone shape.  Irregular astigmatism has many causes and means the cornea has an uneven surface. Common causes are trauma and a multitude of corneal diseases other than k-conus.  An example would be due to Saltzman nodular corneal dystrophy or a large pterygium growing on the cornea. Think about the difference between the smooth surface of a ball bearing vs the irregular surface of the moon.  Regular astigmatism has a smooth surface and symmetrical radius of curvature. Think football. It can be corrected by glasses.  Irregular astigmatism can sometimes be corrected with contacts, sometimes soft but more often gas permeable.

[ker92ri]

Could you please tell me the difference between keratoconus and an irregular astigmatism?

[JohnHaganMD]

It is not likely you have k-conus, more likely you have either the wrong glasses RX or some irregular corneal astigmatism. the cornea Eye MD ophthalmologist can tell you for sure
JCH MD

[ker92ri]

No I haven't worn contact lenses for years, I stopped around 2 years ago because I preferred glasses. I was really hoping it wasn't keratoconus as I also have amblyopia I'm my right eye. So I only have one good working eye.

[JohnHaganMD]

Yes while the onset of K-conus is slow it can present suddenly  I would suggest you get a 2nd opinion from a corneal surgeon. Without a corneal topography the diagnosis may be missed
Dry eyes would not cause the problem and the ghosting would go away, at least momentarily, with blinking or instilling artificial tears.  I'm assuming you don't wear contacts with the prism glasses. Contacts often cause this problem

[ker92ri]

Thank you for your reply. Yes I do wear glasses I also have prism lenses to help with my binocular vision. I have researched keratoconus and I think this a real possibility. I've also asked my doctor about this, but he saw no evidence of this. Would the symptoms of keratoconus come on quite suddenly. I just woke up one morning and noticed it, it happened round about the same time my binocular double vision started. Could dry eye cause this ghosting? I should also mention that the glasses don't really help with the ghosting, they do make the ghost image slightly smaller. I understand keratoconus is treated with a hard contact lense. I'm not sure how that would work for me as I need the prism lenses to help with my double vision.

Thanks again

[JohnHaganMD]

Okay, so you understand the "real" double vision that is due to your eyes not being aligned and that you can "fuse" (great!) and that goes away with covering one eye.  As for the monocular ghosting.  Some of the causes that either you do not mention or that would need to be ruled out: Uncorrected astigmatism (do you wear glasses?); improperly corrected astigmatism; early cataract formation; irregular corneal astigmatism (you need a corneal topography test)  JCH MD