Ophthalmology
Introduction
Double vision, also known as diplopia, is a condition where a person sees two images of one object. Diplopia can be binocular or monocular.
Monocular double vision is double vision in one eye that persists even when the other eye is closed.
Binocular diplopia happens when the eyes don’t work together while both are open, causing each eye to send a slightly different image to the brain. The brain cannot merge these images into one clear picture, leading to double vision, which disappears when either eye is closed.
This leaflet focuses on binocular diplopia and how it affects you if you have a driving licence.
How is double vision treated?
Double vision can sometimes be corrected with prisms, occlusion or possibly squint surgery.
Prisms
• Prisms bend light, shifting the position of the second image so both eyes project it onto the same spot on their retinas (the retina are the most important part of the back of the eye). This enables the brain to merge the images from each eye, restoring binocular single vision.
• Fresnel prisms are thin, flexible plastic sheets with tiny grooves shaped like wedges. They can be cut to fit your current glasses or placed on clear (plain) lenses if you don’t wear glasses. They are usually used as a temporary test to see if prism correction works before applying the prism permanently into the glasses.
• Prisms that are permanently fixed into glasses would be done by adjusting the position of the lenses. The lenses stay clear with no visible grooves, making this option better for long term use. Before adding a prism into the glasses, it is crucial that the prism strength remains the same for a period of 6 months.
Occlusion
• Occlusion stops the second image by covering one eye with a patch or a frosted lens.
Squint surgery
• Your Orthoptist will discuss this with you if it is appropriate to consider as a long-term option.
Can I drive with double vision?
No, you are not allowed to drive with double vision. In some cases, double vision can resolve with time. You should not drive until:
1. The double vision resolves
2. Your double vision can be controlled with treatment (prisms or occlusion or surgery), you have adapted well to the treatment, and you have notified the Driver and Vehicle Licensing Agency (DVLA).
For example, if one eye is occluded (covered up), your other eye’s vision must meet the DVLA driving level standard of vision. Group 2 drivers (bus, lorry, coach etc) are not allowed to drive with occlusion.
If you are using prisms, an eye patch or a frosted lens to help remove double vison, please follow the appropriate guidance below:
1. If the double vision resolves on its own, you will not require further treatment. In this case, you do not need to notify the DVLA. However, you must not drive while experiencing double vison. Driving may only resume once your you have fully returned to single vision.
2. You allow time to adapt to the prism and don’t drive until your next Orthoptic appointment. If your Orthoptist confirms your double vision is controlled with a prism, you should inform the DVLA you’re wearing a prism to correct your double vision.
The regulations established by the DVLA are designed to ensure safety of all road users. Even if you experience diplopia intermittently, it may affect your ability to drive at times. If you are involved in an accident while having a medical condition that could influence your driving, your insurance may be rendered as invalid.
*You can be fined up to £1,000 if you don’t tell the DVLA about a medical condition that affects your driving. You may be prosecuted if you’re involved in an accident as a result.”
*From the www.gov.uk/diplopia-and-driving
How do I report diplopia to the DVLA?
Report your condition online via www.gov.uk/diplopia-and-driving. An alternative would be fill in the V1 form (for cars and motorbikes) or the V1V form (for bus, lorry or coach) and send this to the DVLA. The address is written on the forms. You can find these forms online and print them or request them from the DVLA.
This leaflet is designed for informational purposes. Although we have made efforts to present current information, we recommend verifying any recent updates to the DVLA website.
Note: the information in this booklet is provided for information only. The information found is not a substitute for professional medical advice or care by a qualified doctor or other health care professional. Always check with your orthoptist if you have any concerns about your condition or treatment. This is only indicative and general information for the procedure. Individual experiences may vary, and all the points may not always apply to all patients. Please discuss your individual circumstances with your orthoptist.
The Orthoptic Department at Russells Hall Hospital: 01384 456111 ext. 3636 (8.30am to 4.30pm, Monday to Friday).
Eye emergency, out of hours
In case of an eye emergency after the closing hours of the Eye Clinic (including weekends and bank holidays), please contact the eye doctor on call by ringing the switchboard at:
Birmingham and Midland Eye Centre on 0121 507 4440
The doctor on call is usually based at the Eye Centre, City Hospital, Dudley Road, Birmingham. They may need to call you back, and if necessary, they will arrange for you to visit them.
We are always happy to answer any questions regarding your child’s treatment, if after reading this leaflet you still have concerns or questions, please call the department on 01384 456111 ext. 3636.
Author: Dylan Patel
Orthoptist
If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.
This leaflet can be made available in large print, audio version and in other languages,
please call 0800 073 0510.
This leaflet can be downloaded or printed from:
http://dgft.nhs.uk/services-and-wards/ophthalmology/
Diplopia /DP/ST/DP/ v1 04.2026 Review – 01.2029 Ref: DGH/PIL/02239 Version 01