Neurological conditions can sometimes cause eyes problems that lead to double vision.

The orthoptist will help to diagnose, monitor and treat these symptoms. We have outlined some of those conditions below, along with useful links, although the list is not exhaustive.

Multiple Sclerosis (MS) can affect eye sight and eye movement. Eye muscles can be affected in MS causing double vision. The orthoptist will be able to check which muscles are affected, and help to manage the double vision. A prism may help keep things single.

Neuromyelitis Optica is is an autoimmune condition characterised by inflammation of the optic nerves and spinal cord. The immune system in this condition starts to attack its own nerves. This can cause reduced vision and double vision.


Myaesthenia Gravis (MG) can affect your eye movements and cause your eyelids to droop (ptosis). It is an autoimmune condition and effects the transmission of nerve impulses to your muscles. It sometimes only effects the eye muscles (ocular myasthenia), or sometimes effects all your muscles (generalised myasthenia). The orthoptist will help to monitor this condition and manage any double vision with prisms. The neurologist and ophthalmologist will also manage the MG.

Brain tumours can cause vomiting, balance problems, coordination problems, abnormal eye movements, double vision, behaviour changes, fits, seizures and a head posture. The orthoptist can help monitor and manage any double vision. A neurologist would manage general treatment.

Idiopathic Intracranial Hypertension (IIH) is a neurological condition defined by increased intracranial pressure around the brain without the presence of a tumour or disease. Symptoms may include headaches, double vision, light sensitivity and pain behind the eye and on eye movement. The orthoptist may be able to help with blur and double vision using prisms.

The third, fourth and sixth cranial nerves control eye muscles. If these are affected you will have double vision. There are many causes of nerve palsies and the ophthalmologist will try and find this out. The orthoptist can monitor and try and manage any double vision you have.

Guillain-Barre syndrome (GBS) is a rapid onset muscle weakness. It is an auto-immune disease caused by the immune system attacking its own peripheral nerves. Muscle weakness normally begins in the hands and feet. Orthoptists help to diagnose eye movement abnormalities, and manage any double vision.

Neurological symptoms such as problems with moving the eyes, confusion and movement problems are caused by a deficiency of certain vitamins (B vitamins, particularly Thiamine). This is sometimes (but not always), the result of alcohol misuse.

PSP is a Parkison's-like neurological condition caused by the loss of nerve cells in certain parts of the brain. This can lead to problems with balance, movement, vision, speech and swallowing. Eye problems may include difficulty looking up and down and double vision.

Parkinson’s is a progressive neurological condition that causes tremor, slowness of movement and stiffness. It can also cause double vision. The orthoptist can check the eye muscle strength, and help alleviate double vision with prisms.