Double Vision in Children

Binocular double vision in kids is often caused by strabismus, also known as squint or misaligned eyes, an eye muscle disorder.

Since the eyes are crossed or misaligned, the child may see two images of the same object.

On the other hand, monocular diplopia can be caused by dry eyes and astigmatism.

Other causes of diplopia in a child include conditions that affect the nerves or muscles that control eye movement. Examples of these are head injuries, traumatic brain injuries and brain tumors.

Double vision in childhood can be hard to spot without the help of a professional since most of the time, children have difficulties expressing what they see. However, there are some common signs that indicate a child is suffering from diplopia. A visit to the eye doctor for a comprehensive medical history taking and eye examination is important for an accurate diagnosis. 

These signs of double vision in toddlers and younger children include the following:

• Frequent squinting or narrowing of the eyes
• Covering one eye repeatedly
• Unusual turning or tilting of the head
• Using peripheral or side vision instead of central vision more frequently
• Moving the eyes side to side when looking at an object.

An ophthalmologist needs to conduct an eye examination before recommending the most suitable treatment for a child’s double vision.

An eye examination for diplopia usually includes checking the patient’s vision, pupil responses and eyelids.

The specialist will also check for refractive errors and the eyes’ movement, position and ability to work together. They may also use a microscope to evaluate the front part of the patient’s eyes.

Once the specialist determines the child has double vision and identifies which type it is, they will recommend a treatment.

If the child has monocular double vision, the ophthalmologist may recommend the following treatment options:

• Opaque contact lenses (with the appropriate prescription)
• Prism lenses (with the proper prescription)
• Artificial tears and other dry eye treatments to lubricate the eyes

Binocular diplopia treatment for children includes prescription glasses with permanent or temporary prism lenses and wearing an eye patch to blur the vision in one eye.

The specialist will recommend surgery if the diplopia is caused by a traumatic head or brain injury or any severe medical condition.

Aside from wearing the prescribed glasses, contacts or eye patches, the ophthalmologist can recommend eye exercises that can help the child improve their vision.

These exercises are usually doctor-supervised and effectively train the child’s eyes, brain and body to eliminate or reduce their double vision and improve the overall function of their eyes.

The specialist may also teach the child convergence exercises (smooth and jump convergence) to improve their visual skills.

If left untreated, diplopia can affect a child’s balance, movement and reading ability. It can also develop into amblyopia or lazy eye since the brain will continuously try to compensate for the error.