Question: Our son had LASIK 1-2 years ago and now reported that he has been having blurry vision and double-vision off and on for about the last 4 months in his left eye. He didn't think too much of it at first, blaming it on tired or strained eye. He went to his eye doctor that did the LASIK Surgery, has had blood tests and an MRI-there was nothing seen behind his eye in the MRI. The problem is also that his left eye-ball sticks out about 3 millimeters more then his right-eye. That's reason for blood tests and MRI. He is to see his eye doctor on Tuesday to discuss result of all tests. Can you give me some insight as to what this problem he has could be?
Answer: Although it is impossible to really tell what might be causing the complaints without an examination or results of testing, it does sounds like the LASIK Surgeon your son is seeing is taking a careful thorough path to finding the cause. We do not know your son's age, but the onset of double vision or diplopia of any type is reason for concern. You state that the double vision is in the left eye. It does need to be confirmed that the double vision is occurring in one eye rather than when both eyes are open. Monocular versus binocular diplopia can have different causes. You state that you can physically determine that the left eye "sticks out 3 millimeters further than the right eye." Without examination and measurement we do not know whether the eyeball itself is actually protruding or it appears to "stick out" because the Cornea is too curved and protruding-these have different causes. So, the eye doctor your son is seeing will carefully evaluate the actual physical location of the eye in its socket, the pupils, the color vision, the eye muscles, the retina and especially the shape and thickness of the Cornea to determine if they are all normal and might be contributing to the problem. In addition the eye doctor will be looking at the blood work for any signs of systemic problems such as thyroid disease or diabetes that might be contributing as well as possibly ordering a visual field test to test the function of the visual pathway overall. So, as you can see it must be determined whether it is the eye itself, the visual pathway and nerves or a systemic problem that is causing the problem.
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