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Intractable diplopia is a rare condition where double vision cannot be alleviated, except by occluding (covering) one eye.  Because it is relatively rare, the amount of literature describing its incidence, risk factors, and management is limited.  However, a  recently published article has shed a little more light on this debilitating condition.  The hope is that more knowledge will reduce its incidence, and perhaps provide guidance on effective management.

The article’s researchers reviewed ophthalmology reports of intractable diplopia in the UK over the course of one year.  Of 53 cases of intractable diplopia, 32% resulted from strabismus surgery.  Another 30% had a pre-existing strabismus and other procedures or events (such as cataract surgery or a head trauma) resulted in the intractable diplopia.

“The most common event preceding the onset of intractable diplopia was strabismus surgery, accounting for almost a third of cases.”

Many treatments have been tried– a second strabismus surgery, an opaque contact lens, cataract surgery, and the insertion of an opaque intraocular lens (IOL), and botulinum injections to induce a ptosis ( a droopy eyelid). Most are either ineffective or unacceptable.

With no options for effective treatment, prevention of intractable diplopia is paramount. There are other ways to help your misaligned eyes to work together, including safe, surgery-free vision therapy!

Don’t rush to surgery, Locate a Doctor near you who can present all the options to treat your strabismus.


Newsham D, O’Connor AR, Harrad RA. Incidence, risk factors, and management of intractable diplopia. Br J Ophthalmol 2017.  Available at: