Double vision usually symptom

Dear Dr. Gott: Would you please discuss double vision?

Dear Reader: Certainly.

There are two major types of diplopia (double vision): monocular (one eye) and binocular (both eyes). As a general rule, diplopia is a symptom rather than a condition. It is not life-threatening but can interfere with daily activities. It is always important to see an optometrist if you have double vision, since this may be the beginning sign of a more serious condition, such as cataracts or lens dislocation, which could require further testing and treatment.

When seeing a doctor about diplopia, it is necessary to tell him or her whether it is constant or intermittent, near or far, which or both eyes, and whether the second image is horizontal, vertical or in front of the primary image. These responses can help the doctor pinpoint the cause of the problem and recommend appropriate treatment.

To give you related information, I am sending you a copy of my Health Report “Medical Specialists.” Other readers who would like a copy should send a self-addressed, stamped No. 10 envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: For the past two to three years, I have had a problem with fainting. It has no apparent cause.

When it first started, I was 69 or 70 years old. Sometimes I could feel it coming and was able to brace myself. Other times, it would just happen, and I would wake up on the floor.

I was sent to three different hospitals and had practically every test imaginable. Everything was normal. The blackouts then stopped in November 2007. I didn’t have another one for almost a year. In October 2008, I had three in one day. Two happened in my garage, and another one in my bathroom. I got bruised up pretty good during one of them.

I have been reading your column for years and respect your opinion. I have also seen you pull many rabbits out of your hat and hope you can do the same for me.

Dear Reader: Because you don’t say what testing you have had or what kinds of specialists you have seen, I may repeat some what you have already had.

First, keep a journal of every episode you experience. You should write down the time it happened, what you were doing immediately prior to it and how long you were out. This simple step may reveal a pattern. Include whether you had eaten and any medications you had taken that day – prescription, over-the-counter, herbal or otherwise.

Next, undergo heart testing such as an EKG, heart ultrasound, a stress test and an event monitor to ensure that your heart is functioning properly. A slow pulse, rapid heartbeat or extended pauses in the heart rate can cause blackouts and fainting. If your heart checks out OK, a neurologist is the next step.

This type of specialist can order sophisticated testing of your brain such as MRIs, brainwave testing and more. Perhaps your blackouts are a type of seizure.

You need to determine the cause of your blackout episodes as soon as possible before you are seriously injured in a fall.