prism contact lenses for double vision

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Double vision is a relatively common problem, and is responsible for 850,000 visits to the doctor and hospital each year.Double vision, also known as diplopia, is a common symptom of convergence insufficiency, lazy eye and strabismus, though it can also result from any of the following conditions:StrokeTraumatic brain injuryBrain swellingBrain tumorBrain aneurysmCranial nerve palsyThyroid dysfunctionDiabetesMyasthenia gravisMultiple sclerosisIf you have any of these conditions contact an eye doctor to evaluate your vision.Why are you seeing double?To achieve the single vision the two eyes need to work together by looking at and focusing on the same image, simultaneously. Each eye is then responsible for transmitting visual information to the brain, where the two images are then fused into a clear, single image.Double vision most commonly occurs when the two eyes are not aligned properly and are unable to look at and focus on the same image, at the same time.As a result, the brain is unable to fuse the two visual signals transmitted from the two eyes into one single image— resulting in double vision.The two images of a single object may be seen horizontally (side by side) or vertically (one on top of the other).Double vision can be very worrying and significantly impact your quality of life. Fortunately, double vision can be effectively treated with prism lenses and vision


Prism Glasses for Double Vision (Diplopia)

Prism glasses correct diplopia or double vision. Double vision means someone sees two separate images of a single object. The prism in the glasses helps align the two images and correct the problem.

Normal, standard glasses typically only correct two types of vision conditions, including astigmatism (curved cornea) and focal distance (farsightedness and nearsightedness). Prism glasses also have a thicker base and thinner apex than standard prescription glasses.

Your eye doctor (optometrist) may prescribe prism glasses if you struggle with:

  • Eye strain
  • Frequent headaches
  • Strabismus (eye turn), which causes difficulty fusing two images together into a 3D view
  • Tiredness with close-up work, such as looking at a computer
  • Suppression

In this article

What Causes Double Vision?

Double vision has numerous causes. Sometimes these causes are easy to treat, while others can be symptoms of more serious eye problems. 

Monocular diplopia means double vision that is still present with one eye closed. Making this distinction helps to figure out the cause of double vision. Binocular (true) diplopia generally has more serious causes than monocular diplopia.

double vision

Some of the most common causes of double vision include:

  • Dry eyes
  • Misalignment of lenses
  • Migraine headache
  • Squinting
  • Stroke
  • Thyroid problems
  • Diabetes
  • Cataracts
  • Multiple sclerosis
  • Keratoconus
  • Brain tumor

The most common cause of double vision for children is squinting. It occurs because the eyes are not properly aligned and they look in different directions. Over time, a child’s eye muscles weaken or become completely paralyzed. Vision corrections in childhood can lead to temporary double vision that eventually adjusts and goes away.

Double vision is a fairly common side effect of certain serious health conditions. Stroke patients sometimes develop temporary double vision because of damage to the blood vessels responsible for supplying the nerves. 

When a person has diabetes or a thyroid health issue, especially hyperthyroidism or Grave’s disease, double vision can occur. Diabetes and multiple sclerosis are also linked to double vision.

Eye health issues can lead to diplopia. The two most common vision conditions that cause double vision are cataracts and keratoconus.

Finally, something as simple as someone’s eyes not producing enough tears can cause diplopia. Inflammation and soreness are symptoms of dry eye, and that irritation can lead to double vision. Over-the-counter eye drops can help, but when the condition is this severe, it usually requires prescription eye drops designed to provide lubrication and hydration.

Hemianopia & Prism Lenses

Hemianopia is a cause of double vision. When someone experiences hemianopia, he or she is blind in half of the visual field. This condition is usually caused by brain tumors, stroke, and other trauma. In addition to partial blindness, hemianopia causes other symptoms, including:

  • Double vision
  • Vision distortion
  • Dimmed vision
  • Poor depth perception
  • Reduced night vision
  • Moving the head or body from the affected side
  • Difficulty comprehending what’s seen
  • Visual hallucinations

Symptoms tend to increase when someone’s vision is focused on a single object.

Causes of hemianopia include:

  • Stroke
  • Traumatic brain injury (TBI)
  • Brain tumor
  • Dementia
  • Alzheimer’s disease
  • Epilepsy
  • Multiple sclerosis
  • Lymphoma
  • Hydrocephalus
  • Shaken baby syndrome
  • Elevated pressure in the brain
  • Carotid artery aneurysms

Any type of damage to the optic nerve or brain can trigger hemianopia.

Prism glasses are prescription glasses designed specifically to correct certain types of double vision (diplopia). They work by refracting light before it enters the eyes to make sure it is directed onto the same area of each retina.

For many, experiencing double vision (diplopia) is an occasional event that follows a theme park ride or a few too many cocktails. While this kind of double vision typically resolves on its own, diplopia caused by underlying conditions can be long-term or even permanent.

Fortunately, prism glasses can provide clear vision for many people who experience diplopia. Read more to get details on prism glasses, including how they work, how much they cost and how they can hurt your vision if used incorrectly.

What are prism glasses?

Prism glasses are primarily used for individuals who experience the types of double vision caused by eye movement problems such as strabismus. Other underlying conditions, like a head injury, stroke or diabetes, can also lead to nerve damage and or weakness in the muscles that control eye movement. 

When these muscles don’t work properly, the eyes can become misaligned, causing double vision. Prism glasses are made with customized prism lenses that bend (or refract) light entering the eyes to make sure the light falls in the same spot on both retinas, even though they are not aligned. The lenses help the eyes work together to create a single image.

In some cases, prism glasses can also be beneficial for monocular diplopia caused by corneal abnormalities.

SEE RELATED: Double vision causes 

How prism glasses work

For clear vision to be possible, the corneas need to filter light into the eyes and properly focus it onto the retinas. Typically, with refractive errors like nearsightedness and farsightedness, the light hits the retinas in both eyes at the same place but not quite in the right spot to create a clear image.

When it comes to diplopia caused by eye misalignment, the corneas filter light onto the retinas correctly, but the misalignment causes the light to be focused onto different areas of the retina for each eye. This results in each eye sending a slightly different image of the same object to the brain, which results in double vision.

Prism glasses for diplopia refract the light before it enters the eyes to compensate for the misalignment and focus the light onto the same place on each retina. This enables the brain to produce a single image and resolve any double vision issues.

SEE RELATED: Double vision (diplopia) treatment

What prism glasses look like

While prism glasses look the same as any other pair of prescription glasses, it’s common for one lens to be thicker than the other. If this bothers you, opt in for slightly thicker frames to hide the edges of the lenses.

You will keep your individual vision prescription and have a separate prism prescription that is added to one or both lenses. The prism will be applied according to the type of diplopia you experience: horizontal, vertical or oblique (diagonal). If required for long-term correction, prisms can be permanently ground into the lens. 

If you aren’t sure if prism glasses are for you, temporary prisms, called Fresnel prisms, can be applied. Fresnel prisms are made of a thin, vinyl material and can be pressed onto your lenses. 

Fresnel prisms are somewhat visible, so they aren’t meant to be a permanent solution. However, they allow you to try out prism glasses and can also accommodate those whose diplopia is temporary or has the tendency to change.

Cost of prism glasses 

The cost of prism glasses depends on several factors, including where you purchase the glasses, the frames you select for the lenses and your vision insurance coverage.

Fresnel prism glasses, which only work as a temporary solution, can cost anywhere from $250 to $500. Permanently ground prism lenses cost between $600 and $1500, usually not including frames or other prescription requirements, resulting in an even higher price tag.

Luckily, because prism glasses must be prescribed, they should be covered by vision insurance and are FSA or HSA eligible health expenses. It’s always a good idea to speak with your eye doctor to get a better idea of what your out-of-pocket cost could be.

Can prism glasses hurt your eyes?

Just as wearing an incorrect prescription for refractive errors can strain your eyes, so can wearing incorrectly prescribed prism glasses. Wearing prism glasses when you don’t require them or with an incorrect prescription can cause the same symptoms experienced when you have diplopia, including:

  • Double vision
  • Misaligned eyes
  • Headache
  • Pain in and around eyes during eye movement

It’s not recommended to wear prism glasses unless prescribed by an eye doctor. If you do have a prescription and are still experiencing the symptoms listed above, contact your eye doctor promptly. It’s possible that the prescription needs to be adjusted.

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