Potential Causes of Double Vision and Migraines
I have a relative, a 64-year-old female weighing around 250 pounds and standing at 5 feet tall. She is a non-smoker who enjoys an occasional alcoholic drink each night. Doctors have indicated that she might be at risk for liver disease and advised her to monitor her health. While she has never been diagnosed with diabetes, she does manage high blood pressure with prescribed medication. Recently, she has experienced double vision in her left eye, accompanied by eyelid drooping. For the past two weeks, she has also been dealing with intermittent migraines. After a visit to the emergency room, her blood pressure was evaluated, and a series of scans—including CT and MRI—were conducted. Fortunately, the tests did not reveal any underlying issues that could explain her symptoms. Following this, she was referred to an optometrist, although I question why she wasn't directed to an ophthalmologist initially. The optometrist examined her eyes and found no problems. Now, she is set to see an ophthalmologist. I reached out to the specialist beforehand, and he suggested conducting some blood tests before the appointment. If the blood work yields normal results and no concerns are identified, what further actions should I take to assist her in managing these symptoms?
Answers (1)
2/11/2026, 12:50:38 AM
OpenHealth AI
Thank you for reaching out about your relative's concerning symptoms. The combination of double vision, eyelid drooping, and intermittent migraines can be quite distressing. Given that her earlier evaluations, including CT and MRI scans, did not show any significant issues, it's positive that those serious conditions have been ruled out for now.
Overview
- Double Vision & Eyelid Drooping: This may be linked to several potential causes, including neurological conditions or muscle issues around the eye.
- Migraines: These could be related to stress, certain triggers, or hormonal changes.
- Underlying Health Factors: Her blood pressure management, risk for liver disease, and the potential for thyroid issues are relevant to her overall health.
Explanation
Double vision (diplopia) can arise from various factors, including muscle disorders, neurological issues, or even systemic conditions like myasthenia gravis, especially suggested by the eyelid drooping (ptosis). Migraines may or may not be directly related to the eye issues but can compound her overall discomfort.
The referral to an ophthalmologist is a logical next step to ensure that all potential eye-related causes are thoroughly investigated. Blood tests can help rule out other systemic concerns affecting her eyes or migraines, particularly thyroid function and other metabolic factors.
Next Steps
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Complete Pending Blood Tests: Ensure that she has the recommended blood work completed before her ophthalmology appointment. This could include tests for thyroid function, metabolic panel, and other relevant markers.
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Symptom Diary: Help her keep a diary of her symptoms over the next few weeks:
- Document frequency and intensity of double vision and migraines.
- Note any triggers (like certain foods, stress levels, or changes in routine).
- Record any changes in her overall health, including her blood pressure readings at different times.
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Eye Exercises and Rest: Encourage her to take breaks from screens and engage in eye exercises, such as focusing on distant objects to reduce eye strain.
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Hydration and Nutrition: Ensure she stays well-hydrated and follows a balanced diet, as dehydration and irregular eating can trigger migraines.
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Stress Management: Discuss techniques like mindfulness, deep-breathing exercises, or light yoga, which can help manage migraines that might be triggered by stress.
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Follow-Up Care: After her appointment with the ophthalmologist, make sure she keeps all follow-up appointments with her healthcare providers to monitor her condition and adjust treatment plans as necessary.
If her symptoms worsen, such as worsening double vision, severe headaches, or other neurological symptoms like weakness, confusion, or seizures, seek emergency care immediately.
Your attentiveness to her health is commendable, and the approach you've outlined is proactive and supportive. Please keep me updated on her progress or if you need further assistance!
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