Double Vision

[TimbaLanD]

Double vision

 

Hi guys, hope you can help in some way here.

 

A friend of mine all of a sudden started having double vision. He though it will go but then started having very high temperatures and was admitted to hospital. They did not know what it was so they ran a blood test then a lumber puncture. He was still having high temperature and started shivering! Was a bit scary! After being on heavy anti viral his temperature started stabilising. He couldn’t eat properly and he threw up most of the time.

 

After the Anti viral, he started feeling a bit better. So they have sent him home but he is still on anti viral pills (can’t remember the name).

 

Anyway, although he is feeling a little better… he is still has the double vision! He said it’s getting better but when he looks down he sees double. How could this be?

 

The doctors have not confirmed anything so I am a bit confused to what it might be!

 

What do you guys think it is?

[armygas]

Double vision

 

Hi guys, hope you can help in some way here.

 

A friend of mine all of a sudden started having double vision. He though it will go but then started having very high temperatures and was admitted to hospital. They did not know what it was so they ran a blood test then a lumber puncture. He was still having high temperature and started shivering! Was a bit scary! After being on heavy anti viral his temperature started stabilising. He couldn’t eat properly and he threw up most of the time.

 

After the Anti viral, he started feeling a bit better. So they have sent him home but he is still on anti viral pills (can’t remember the name).

 

Anyway, although he is feeling a little better… he is still has the double vision! He said it’s getting better but when he looks down he sees double. How could this be?

 

The doctors have not confirmed anything so I am a bit confused to what it might be!

 

What do you guys think it is?

 

Your friend may want to be on the look out for a thrombus within the brain, sinuses, or orbits. That usually accompanies a fever combined with diplopia.

[blike]

The curious thing to me is the downward diplopia. A good eye exam would have to be done. It could be trochlear dysfunction, or it could be that the patient is correcting for the dysfunction except in downward gaze. If a good eye exam were performed and it was strictly a downward diplopia, then I might start thinking about things other than cranial nerve pathology. With no other neurological signs or symptoms and no significant history reported (i.e. coagulopathy, afib, recent trauma / surgery) I probably wouldn't go down the thrombus pathway. Again, a neurological exam would have to be performed to rule out these things.

 

One thing that might fit the initial clinical presentation is a periorbital abcess (or even a CNS abscess). However, I'd think that would be more bacterial than viral, and it appears the attending physicians determined it to be viral in origin. With the history of a viral infection, some sort of encephalitis also comes to mind. This could, perhaps, explain all of the symptoms.

 

The best thing to do is ask the doctor who treated you about it.

[TimbaLanD]

Hi guys, thanks for your input. The neurologist has told him that its nerve damage and that the nerve grows at 1mm a day and may take a long time for him to get back to normal. When watching TV my friend tilts his head to a side. All other symptoms like fever and vomiting has gone. He is in good health except for the double vision!

 

Are these nerve sells quite long? It may take months to heel if they are a few inches long (?)

[Revenged]

The curious thing to me is the downward diplopia. A good eye exam would have to be done. It could be trochlear dysfunction, or it could be that the patient is correcting for the dysfunction except in downward gaze.

 

i think that it does sound like trochlear nerve damage... perhaps i should explain it a bit for the orginal poster as what they wanted to know is how can a virus cause double vision...

 

ok, if the virus affects the trochlear nerve it may lead to the nerve becoming non-functional... the trochlear nerve runs from the stem of the brain and supplies the superior oblique muscle of the eye... this is the muscle that moves the eye downwards with the help of the inferior rectus muscle (another muslce of the eye)...

 

if the superior oblique muscle does not work on one side, only the eye with a functional trochlear nerve will be able to use it's superior oblique muscle and so only in this eye will it be able to move the eye downwards... this causes the two eyes to be in different positions within the eye socket and this causes two separate images from different positions to be formed, which causes double vision...

 

so in other words, your friend had a virus that affected a nerve that runs to the eye, which means a muscle that moves the eye can't function and this means that you get a double vision when that muscle of the eye is used (as the muscle only works on one side)...

 

but as the neurologist said, the nerve would grow back and so the double vision shouldn't be permanent... i don't know how long this will take... i don't think the entire nerve needs to be regenrated... so i don't think you can do something like the trochlear nerve is X cm long and if it regenrates at a rate of 1 mm per day it'll take Y days to get better... it isn't like that...

[TimbaLanD]

Thanks Revenged!! ) Yep, what you have said makes sense. I understand that only a portion of the nerve is damaged but am curious about the physical length of this nerve cell! I’ll look it up on the net.. By what you have said, one of his eye should be healthy, so if he patches up the other he should be able to see ok with just one eye!

 

I’ll keep you guys updated!