Hi all,

Probably the wrong sub-forum, but I have PN (due to ganglioneuritis from Sjogren's) and this is where I typically post.

About 3-4 months ago I had a single sudden episode of double vision lasting a couple hours. It returned about a month ago and occurred a couple times a week. Now it's several times a day. I have seen the eye doctor (both ophthalmologist and optometrist) and they could not see anything abnormal (other then dry eyes from the Sjogren's). The optometrist thought at first it might be eye strain, but it still occurs even when I put on my reading glasses.

I'm going to see my neurologist at Hopkins next week, but thought I'd ask here if anyone has some thoughts on what type of neurological problems could cause this. MS is about the only thing I keep running across...or medicine side-effect. I have had LP (not recent) and an MRI of the brain (last year) and there was no indication of this.

I know it's not medicine related even though I take quite a hefty list, because I have not added anything or increased/changed dosing in a long time...with the exception of a new cardiac med last week (Renexa) but the double vision was already occurring and has not changed since starting this. Just in case I stopped the only two I could possibly attribute to this (Ambien & small doses of Percocet) and it still occurred.

Any thoughts?

Hi en bloc - long time no see! A thought on your double vision. I have a problem with my vision when my pain increases my vision clarity decreases - I get a much blurry picture as my pain gets worse. Also as my pain is getting bad one of my eyes will try to re-dialate under direct light instead of staying contracted. My neuro attributes this directly to the ganglioneuritis. I am not sure how or why, your probably alot more educated on it then I am, but if it is possible perhaps your vision is being effected by your ganglioneuritis as well. Sorry I don't have more for you... best wishes...

Not double vision but pain,pressure,and hard focusing eye problems I have and developed about a year into this condition. I went to 50 eye apts,10 eye specialists,neurologists for mri etc. I would cry from the pain. Anyhow for me I was dx with blepherititis and dry eye but they said it would not cause the pain I was in. My neuro did mris and I had scans of my eyes with still no dx. Every eye med or other treatment made it worse. Anyhow over the last while my eyes have gotten to a better point and I can't say from what. I still have flares though and 24/7 pain but not to the extreme. I also have RSD and it may be in my eyes but that is hard to dx.
Since you stated you have sjogrens I remember since I have a lot of symptoms of that I was on a forum and some had eye problems as well such as dry eye you stated you have which I thought I read could impact vision? When I had my mri of the brain I had one about a year before because of my leg pain but the neuro still wanted to repeat it. Also of my ear because I had pain there. Do you have any pain with the eyes or in your head area? Have you had blood work done lately and your thyroid tested? I ask because one eye specialist said thyroid issues could impact eyes but then I was also thinking lets say you had blood sugar problem etc that could also
Sorry I am not much help but hope you get some answers

Daniella: I did not know Thyroid or blood sugar could effects the eyes and vision. I'm curious how it can effect them. My neuro usually does lots of blood work, so I make sure that's on the list when I see him next week.

The Sjogren's can cause slight vision changes from severe dryness, erosions, etc but the eye doctor said it would not cause double vision.

My eyes don't hurt, no headaches, and my vision is not even blurry...just distorted, but it's double imagines (not far apart, but far enough to drive me nuts). Very annoying, for sure.

Adelina: Yes, it's been a while since we spoke. Hope you're doing okay. The double vision also does not seem to get worse when my pain level is higher. I thought it might be associate with the profound fatigue, but it also happens when I don't have fatigue. I'm lost as for the cause or what to do about it.

I think low blood sugar and low blood pressure can independently of each other cause double vision. If you have BOTH at the same time
the effects may be increased. Also increased blood viscosity may be a culprit?

I'd check your blood pressure at home with a cuff when you have this effect, and see if there is a correlation.

I also get vision changes from MSG.

I think if you journal your episodes during the day, you might correlate to food (hunger), or low pressure.

Blurred vision also comes from anticholinergic drugs. OTC things like Benadryl and Imodium, and RX things too. I don't recall on your list however, that you sent me, an anticholinergic drug.

I don't have a means to check blood sugar at home, but can certainly check BP and will do so.

I also hadn't considered MSG. I don't eat many processed foods...very little actually, but I will pay attention and journal to see if there is a connection.

No anticholinergics for me with the Sjogren's...they cause dryness, which I have plenty. I was given atropine once during a chemical stress echo...thought I would die afterward. I couldn't talk or swallow at all...literally. It was actually quite scary.

Thanks for all the suggestions. I will note when it occurs for patterns, BP, food, etc.

You can roughly correlate to blood sugar. Since you take those heart meds... beta blockers typically block sweating etc so that sign is not there for you to use.

But if you get the vision things, when you get hungry, or just before a meal is due...or first thing in the morning before breakfast, etc, it might be low blood sugar. If it gets better with food, then comes back, that would implicate blood sugar IMO.

The tiny muscles in the eye that change the lens shape, are very sensitive to metabolic changes. Low oxygen, low electrolytes, low sugar, low pressure (results in slow blood flow).

I am thinking the beta blocker. This drug tends to make cold extremities, and constricts the bronchioles of the lungs. The beta blocker might be causing vision issues. If you look up
"beta blockers vision" on Google you will see vision changes listed as a side effect. I was on atenolol for about 13 yrs and all of sudden it started to make me wheeze. Even though I did well otherwise, my doctor took me off and will not let me have it again...I ask each time! So side effects can come much later in therapy and not be paid attention to.

The double vision has already occurred today (and I had already eaten) so I'm doubting blood sugar.

But the beta-blocker...I had no idea side effects can cause problems long after taking it...like years. I assumed once you tolerate a medicine and don't have side-effects, that you won't have them later. I have taken a beta-blocker for many years, so automatically discounted it being the cause.

I will have to discuss it with the cardiologist. Gosh, that would be horrible if it's the beta-blocker. Don't know what I would do without it. I have tapered off once about 1.5 years ago and had numerous problems and had to start again...but it is a lower dose. Pacemaker recorded 76 cardiac events in only a couple months when I was off the beta-blocker. I have severe sick sinus syndrome and already had one EP study and double ablation to help. There are not many other options. I really hope it's not the beta-blocker, but you may be right.

If it is the beta-blocker effecting (constricting) blood vessels to the eye, would they be able to detect this with MRI? That way we would know for sure.

Well the thyroid question was asked by an eye specialist I saw if I had it checked because it can cause eye issues. I don't know about double vision but just a thought. The blood sugar just came to mind because I thought diabetics often have eye problems but again these are not facts I have just thoughts.
Have you been on sjogrens support forum to see if others there have double vision?

Yes, I asked on the Sjogren's forum, and a few (very few) had double vision, but it was unexplained. Dry eyes can cause problems with vision, but more blurry vision vs double.

There seems to be a big difference in double vision and blurry vision and what cause each to occur. From what I've read double vision is usually a muscular dysfunction caused by a neurological problem...whereas blurry vision has a wide variety of causes.