A 53-year-old male contracted a mild case of COVID-19 in April of 2020. His symptoms included a fever, loss of smell, and fatigue, which he stated resolved within a few days. Approximately three weeks later, he began to experience a wide range of neurological symptoms, including numbness in the extremities and difficulty swallowing. He consulted a neurologist who started a workup for MS. All scans were negative, and the only abnormal findings were inflammatory markers in his blood tests.
In early August, the patient started to experience double vision. He stated that his left eye could not move past the midline. He had no previous vision problems. He was immediately sent to the emergency room. An MRI of the brain and orbits were unremarkable. Over the next few days, his diplopia improved but did not fully resolve.
His doctor referred him to us for evaluation in early September. We discovered a left 6th nerve palsy of 14 PD. The 6th cranial nerve controls one of the eye muscles called the lateral rectus. This muscle moves the eye out or abducts the eye. In this case, the patient’s left eye could not fully abduct. This will cause double vision in the horizontal direction. Prismatic aligning lenses were prescribed to resolve the double vision.
Thankfully, the patient’s other neurological symptoms have decreased significantly. This gives us hope that as time passes, his eye muscle restriction will be reduced. However, because COVID-19 is a new disease, we are unsure what the future will hold for this very nice gentleman.
The same thing happened to me one month ago. On Dec 9th 2020. I woke up with very bad double vision that has persisted until the present Jan 6th 2021. But i get tested for COVID 19 every month. Last negative test was two days before Christmas.
My Brain MRI was also unremarkable.
But it did state it showed small Foci and Cysts in the front of my brain.
I can give more detail if you write back.
I was told my doctor that it may heal on its own it about 3 months.
I am an essential worker.
Any thoughts.
We can not comment on an individual case. We have seen a number of cases of persistant double vision after COVID. We are unable to determine if and when diplopia will resolve post COVID.
All the best
My double vision started right after I got well. I told my eye doctor I thought it was related. Thank you for your posts.
I have double vision after having Covid, it feels like my right eye gets cross side very hard to straighten up and was hard to drive. It’s almost been a month since I had Covid
I have the same problem I tested positive from December 31 /2020 and after 2 weeks I have double vision problem
I was diagnosed with COVID-19 last October. Two weeks after I got over it the double vision started. They called it 6th nerve palsy. It’s the end of January and still have double vision. Just had a MRI done so am waiting for results.
Hello-
I was wondering in the case discussed above. Did the pt clear covid quickly or delayed? I have a patient that exhibiting similar issues. She has a long COVID viral expression 12/31/20 to be reassessed today again, viral load is decreasing but not yet cleared. Opthmologist consult r/o CN IV and retina, felt could be VI nerve palsy in different dx. CT was unremarkable. MRI pending and neurology pending. Besides horizontal dipola extreme fatigue and a generalized weakness, perplexed how else to support her. For comfort it was suggested an eye patch. These symptoms started after what I felt to be her initial presentation of COVID and she improved, then as viral load begin to drop she developed the more neurological process.
Interested to see if others are seeing cases-
L Cantrell, ANP
We have had many cases like this. I am unaware if any studies have been done relating 6th or 4th nerve palsy to viral load. Most of our cases have improved, however I have yet to see a complete resolution.
All the best.
I am the patient listed above. I recovered quickly from COVID-19 it am still seeing double vision. Had a MRI done and it was remarkable. Everything okay. It’s 6 months now since the double vision has occurred.
I had double vision in both eyes, the doctor had not heard of any other cases at the time she saw me, but she has since the first time I saw her. I have had longhaulers and suffered since December with symptoms after having covid. I finally took cipro about a month ago for a lung infection and the double vision left immediately. So far it has not come back.
Do you think the cipro helped your vision ?
I was positive with COVID Sept 25th. Reco ery seemed fine til this past week end (Jan 23) woke up with odd vision and by nightfall double vision. CT scan and MRIs were all normal. Had antibody testing done in mid November had a fairly high titer value. I work in the lab. Interesting to see similar cases.
This has also happened to me. Had COVID in Sept. Checked my antibody level in mid November and positive for antibodies. Over this past week end I developed double vision due to 6th cranial nerve palsy. All MRIs were normal and the CT scan. Over time this should correct itself… so I am told. Hoping for the best and in the meantime coping and adjusting.
My wife is experiencing this too, COVID positive 1/12 and then 1/23 double vision started and persists if not a little worse. We live in MA. Would you recommend seeing an ophthalmologist or neurologist first?
You should see a neuro ophthalmologist or neuro optometrist.
Hello Dr. Israeloff,
I am a COVID19 long-hauler and been suffering from a vertical double vision 2-3 month after initial COVID19 diagnosis. I had bilateral pneumonia and pretty much all of the symptoms you read about related to COVID19. My Ophthalmologist lowered my eye glasses’ prescription to see if it helps with my double vision but there has been no improvement. It comes and goes throughout the day and it’s more noticeable when I am tired and have brainfog. The intensity varies too. Sometimes I can see clearly and the next minute it comes back. When I see double vision and feel fatigue, I sometimes take a nap if I am home and it disappears for a while after I wake up recharged. I see double vision with my two eyes open. When I cover my left eye with my hand(left eye still open) I see a faint double vision from my right eye. When I actually close my left eye, I don’t see double vision from my right eye. Covering or closing my right eye doesn’t change the double vision that I see from my left eye. I started to see a triple vision from my left eye(three of the same letter or numbers stacked on top of each other, one to the top right corner and the other to the right side). I also saw a neuro-Opthalmogist and he said my vision problem is not neurological which I disagree respectfully because I feel normal at one moment and the next moment it just comes back. My cornea test was unremarkable. Once I drove in a rain and I was seeing double vision when the windshield wiper was wiping upward but the double vision disappears when it was wiping downward. Another rainy drive didn’t reproduce the same effect because I wasn’t having brainfog or double vision. My neuro-Opthalmogist said something is wrong with your windshield. I told him there is nothing wrong with my windshield. I also had issue with ocular migraine prior to getting sick with COVID for several years. Please help me. I most appreciate your feed back.
Hi Kalvin,
I am so sorry that you are suffering so much. We have seen a number of post COVID patients with diplopia. This can be intermittent as you are describing. Were do you live? We could possibly refer you to a colleague if you are too far to visit New York.
All the best,
Dr. Cheryl Berger Israeloff
Thank you for your reply, Dr. Israeloff. I live in Honolulu, HI.
B12 deficiency causes neurological symptoms, as well as vision problems. Many doctors will only test b12 levels and, using outdated ranges, will determine a patient is fine when they are, in fact, deficient. To accurately determine a b12 deficiency you need a CBC and to test homocysteine and MMA levels. My theory is that people who experience post COVID recovery symptoms were already deficient and fighting the illness has seriously depleted them. Many if the symptoms like peripheral neuropathy, loss of taste and/or smell, brain fog, cognitive issues, balance and gait issues and other neuro problems are exactly the same as b12 deficiency symptoms
Thank you. I will try Vit. B12 supplements and see if it helps with my vision problems.
Just FYI
I had not had COVID as far as I know. Have had 2 negative tests in the last several months as others around me tested positive. I was not aware of any vision issues
when my sister noticed my right eyelid was drooping. A day or two later i developed
vertical double vision in my right eye, and have since gotten glasses with prisms to help correct. The problem has improved somewhat since it started, but is still
causing problems..
My friend just had the vaccine and woke up the next morning with double vision
Hi Ami,
We have not heard of a link between the vaccine and double vision. Your friend should contact her eye doctor.
All the best,
The Neuro Visual Center
My husband woke up with double vision 10 days after second vaccine.
My husband experiencing exactly this, 10 days exactly after moderna 2nd shot. Went to emergency, all same tests others here have had and opthalmogist exam. All unremarkable.
My mother is now experiencing double vision about 30 days after her second Pfizer vaccine show.
We have not seen an incidence in diplopia cases after the vaccine which is higher than what happens in the general population.
However, please report your concerns to your doctor.
The Neuro Visual Center
I had my first Moderna shot on March 10th, and on March 20th began experiencing severe double vision. I was taken to the ER and had a CT scan and an MRI. Neither test showed anything abnormal. The on-call Ophthalmologist diagnosed it as 6th cranial nerve palsy. Two days later I had an office visit with another Ophthalmologist who agreed with the diagnosis. As of today, it has shown no improvement. I’m following up with my primary care provider to investigate other possible causes, but in the meantime, I’m not inclined to get the 2nd shot.
Hi Tony
6th nerve palsy happens in the population. I have not heard that it has been associated with the vaccine. Please speak with your doctor.
All the best
I received shot march 26 i had Severe double vision the speed limit had five signs going around in a circle . That clear up . Now just weak Vision in my right eye . I open up door to house it’s brown door it turn blue the hole door . Nothing on web for vision color with COVID-19 shot . After Vaccination right away numb tongue lip and gums . That come goes . I smell cigarette smoke no one smokes in my house . My bottle water taste like well water . I had the Moderna
Please contact your doctor
I am a doctor and had covid in June 2020. I was hospitalized at that time was treated with ectemra, plasma and rendesivir. From the rendesivir I had angioedema and also developed neutropenic fever. I was later vaccinated in December and received 2nd dose in first week January 2021. Several days following the vaccine I had severe debilitating double vision. I had normal CTA of head, neck, normal MRI/MRA head neck. I saw opthalmologist and eye exam normal except for my vision but my symptoms are still present and sometimes very debilitating.
Hi Dr. Brennan
We are so sorry that you are suffering. Double vision is very debilitating. You should seek out someone near you who has experience working with prism.
We wish you all the best,
The Neuro Visual Center
I got my first shot of pfizer and apon waking up the following morning i am expiencing double vision i never caught the covid but i thoght i better get the vaccine but i wish i didnt because i could see just fine before this now im scared to get the second dose im seeking a dr. Tommorow its been 6 days ongoing with this double vision
Hi Michael
We are sorry that you are going through this. We are not sure if the vaccine has a correlation to your double vision. We are not seeing greater rates than what happens in the population.
Please see your doctor.
All the best
The Neuro Visual Center.