Verticle double vision after a fall

[automch]

I am a 68 year old male in very good health. I do have type 2 diabetes controlled by diet my last A1c was 5.6.  In June I was standing in the bed of a pickup truck and passed out falling onto concrete driveway.  I don't remember falling or hitting the ground.  I remember being on the ground and unable to get my legs to work for a few seconds.  I struck my left shoulder and wrist and left side of my head. I ended up at the ER where I was admitted for 24 hrs,had CT scan and MRI along with heart and other tests and no real reason was found.  After being told I was released I discovered that if I look up, as in combing the back of my hair I would see double and it was angular.  I saw my Ophthalmologist and was told this was due to some swelling around the eye socket.  It went away in about a week, however I began seeing a double shadow especially in bright light or white lettering. It comes and goes.  Upon follow up to him he explained it could be from my dry eyes.  At m primary care's recommendation I saw a Neuro Ophthalmologist who likewise had no answers.  He suggested it has preceded the fall and since the fall I was oversensitive to the effects of he fall which is totally wrong.  I have a CDL and have my eyes tested every year.  Now I can't read street name signs.  Some days it is not there at all???  Others it varies in degree of shadowing.  It is in both eyes and remains if I cover one eye.  I apologize for the long post but I feel you should have all the facts.  

[JohnHaganMD]

You're welcome and best of luck.
JCH MD

[automch]

Thank you.  I will pursue that venue.

[JohnHaganMD]

Cataracts get worse, not better, they progress at variable rates and some times grow quickly after an injury.  Cataracts can cause symptoms such as what you describe without being bad enough to require surgery. Your symptoms getting better by squinting is consistent with cataracts.  Cataracts often begin to make the eye myopic (actually what is called pseudo-myopic) this blurs the distance vision; sometimes make the near vision better; sometimes makes vision better without glasses ("second sight") and vision is better when squinting.  Cataracts often cause ghosting and arching of light.  You've seen a neuro-ophthalmologist who did not find an eye muscle palsy (like 6th or 4th cranial nerves) that can follow head trauma. You know you have cataracts they don't get better and the symptoms you describe are consistent with progression of them.

JCH MD

[automch]

Thank you for your response.  Yes CDL is commercial drivers license.  Also I do have cataracts in both eyes; but both Ophthalmologists say they are not bad enough to remove yet.  I have found that if I squint it does help.  Also it is white objects that seem much more difficult to see clearly than colored objects.  Also why so sudden the onset as the cataracts have been there for about 3 years but I have always been told that they are too small to deal with.  Thank you.

[JohnHaganMD]

I have concluded that CDL means commercial driver's license.  You are not having true double vision which means seeing two distinct objects and one goes away if you close one eye.    Your biggest problem is reduced central vision (since you say you can't read street signs).  Your symptoms suggest more cataract formation that any residua of your fall.

Consider returning to the ophthalmologist you are the most comfortable with: ask for a glasses refraction and a dilated exam to see if you have cataracts on your eyes.

JCH MD

[JohnHaganMD]

What is CDL?