Ghosting, double vision

The visual perception of "ghosting" is a source of concern and Visual discomfort in patients who sometimes find unexpectedly these symptoms by the appearance of a duplication of a line of sub titles of cinema, of a second Crescent Moon shifted into the night sky, etc.  These symptoms when they are monocular (they persist when you close the other eye: we're talking about monocular diplopia) are usually (always?) optical original.  Ghost images are thus an indication to the realisation of an aberrometrique examination, and ideally topo-aberrometrique (aberrometrique of the entire eye study coupled with a study of the cornea only).

Symptoms of double vision, Ghost images.

Image ghosts qualifies any "parasite" image that the pattern perceived by the patient presents a certain loyalty with the main image. The patient realizes that he sees double with one eye: this perception is maximum in certain circumstances, such as watching movies under titles: to detach the film images, the titles are particularly bright, and their prominent duplication. The dark atmosphere of the rooms of projection causes a dilation of the IRIS Pupil (Mydriasis), which also helps increase the effect of aberrations at the root of the Visual noise.

double vision in one eye: under double titles

Example of perception of a line of sub titles seen as split down: this is called "vertical monocular diplopia.

Even if they are sometimes associated with ghosting, bright halos correspond to a concentric circular spreading of light around the source. they often have an optical origin, but do not exactly match the symptomatology of the ghost image. The "starbusts" anglicism dedicated for particularly starry appearance or "spicule' of a point source of light are also distinct images split, even if they are also related to a reduction in the optical quality of the eye. The famous Van Gogh canvas titled 'Starry night '.' provides an artistic representation of the subjective perception of "halos" of light.

As pointed out earlier, the Visual symptoms characteristic of ghosting are «» monoculars ": when you close one eye, then the other, this split or shifted vision persists for at least one of the eyes (double vision can be observed on both eyes separately). On the other hand, if the occlusion of one eye removes the double vision, the origin is not optical but orthoptic (parallelism eye "failed").

The ghost images are essentially perceived when the ambient brightness is reduced, and when the eye looks particularly bright light sources, which easily stand out against a dark background (ex: under titles, urban displays bright, neon, LEDs etc.). In other words, the observed object is mixed, and greater sense of ghosts (s) image (s) is marked. The double vision is related to the existence of a "parasite" bright home, or a directional light spread (unlike the halos where bright sprawl is concentric).  It is logical that more a light source is bright, more secondary home receives energy and stimulates the retinal photoreceptors concerned effectively.

monculaire double vision diplopia ghost image

Schematic representation of light spread for an affected eye of monocular diplopia is horizontal. Instead of stimulating 'a' photoreceptor, the degradation of the stigma causes a horizontal dispersion of light energy.

The observation of a line of sub titles, a traffic light flashlight, light floor lamp in the distance, or the Crescent Moon by the concerned eye allows generally the patient to characterize the intensity and location of the ghost-like image (s) (s) (above, below, etc. of the main image).

The distance and the size of the light sources (their apparent diameter) also affect ghosting: the ghost images are often more pronounced when the source is far, and occupies a small Visual angle.


Optical mechanism causing ghosting

The cornea and the lens to focus the light emitted or reflected from the surrounding objects and captured by the eye. Central vision is Foveal: the light captured by the targets must be focused on the mosaic of the retinal photoreceptors of the fovea. If the image of an object is double, it is a particular distribution of incident light energy focused on the retinal screen (fovea) happens.

We can break down a scene set in a set of points basic sources: these sources points should be imaged punctually also ' ' as possible on the retina to "reconstruct" a faithful image of the source: this property is referred to as: "stigma".  Thus, a good stigma (a property that allows a point source to be imaged almost punctually in terms of collection of image - here the retina) is an important condition for obtaining a good performance in Visual optics. In certain circumstances, the image of a point source may give rise to a one-time main image and a one-time "satellite." Some of the light energy emitted by the source and captured by the eye is focused in a main focus, and a secondary home (where there is a sufficient 'concentration' of light energy emitted by the source to give rise to a "perceived home", by effective stimulation of photoreceptors. By assimilation to a set of point sources, light information transported from the observed source will be so split into two homes. The management of the secondary home gives the direction that the offbeat image is perceived. Because of the retinal inversion, an offset anatomically noted "to the right" secondary home by an observer who despite the retina of the patient within the eye would in fact be perceived as a duplication "to the left" by the patient.

In the case of multiple ghosting (polyplopie), there is not one but several bright secondary outbreaks, where incident light energy is sufficiently concentrated to make an image appear 'ghost' by juxtaposition of these homes.

Exploration aberrometrique

Exploration aberrometrique can confirm the optical source of symptoms and, facing the eye exam, specifying the cause.

Confirmation of the optical source: calculation of the PSF and convolution

Calculation of the PSF

To study the stigma of the eye, the aberrometer measures the ocular Wavefront then performs a calculation of the PSF (Point Spread Function) or FEP (function of spreading of the Point). This calculation can be done for the whole of the optical defects of the eye (aberrations of low and high level) or simply aberrations of high degree; in this case, we simulate the retinal image from a source point seen by one eye corrected for the defocus (myopia or hyperopia) and theastigmatism. The appearance of the PSF is an element of importance; a split-aspect, where the light is concentrated in at least a secondary zone located near a main focus to support optical originally by a feeling of double or multiple vision.



From the PSF, one can generate an image called "convoluee" of a Board reading for measurement of Visual acuity.  The resulting image can be compared with the sensation described by the patient; as for the PSF, homology in terms of direction and spatial distribution of ghosting (up, down, left, right, etc.) allows to accredit the optical assumption of visual disturbances. It is often instructive to draw the patient the picture he perceives a distant point light source, or a letter (Snellen) and compare it to the PSF calculated by the aberrometric or image convoluee of the optotype for the same conditions of correction (for aberrations of high and low degree for an eye uncorrected, for the only aberrations of high degree if the patient is corrected in glasses).

horizontal diplopia, double convolution vs design vision

Example of image convoluee (after collection of ocular wave-front and calculation of optical aberrations of high degree - OPD SCAN III Nidek) and Freehand drawing. The patient had received a refractive multifocal implant (M more Oculentis) and complained for a horizontally split vision (ghosting).

Even if the parallelism is perfect, the presence of qualitative similarities to generally corroborate the symptoms of the patient to the aspect of the theoretical PSF, or the convoluee image. The differences between the PSF or image) calculated and the PSF (or image) drawn ('subjective' visual perception) take many factors such as the fact that the PSF is a calculation of physical optics, which ignores the transduction mechanisms, coding and transmission of information captured at the retinal level toward the Visual brain areas, and that this calculation is done for a correction to be complete or is zero aberrations of low degree (while the correction in glasses can be imperfect). Finally, the effect of diffusantes opacities (frequent in case cataract, or inflammation corneal laser post) is generally not well made at the level of the calculation of the PSF. Similarly, the presence of folds or micro pleats at the level of a flap of LASIK is a potential source of duplication of image, but the very high levels generated optical aberrations sometimes exceed the dynamic range of the aberrometric. The use of the OPD double-pass (OQAS) is an interesting option when we suspect the presence of an optical broadcast and/or the presence of aberrations of high degree.


Causes and origin of ghosting.

The cornea and the lens are the main optical tunics of the human eye. It is at their level that may sit optical phenomena responsible for the appearance of ghost images.

Ghosting of corneal origin

Corneal topography combined with the aberrometrique review is the test of choice when exploring the pathologies listed after. In particular, it must focus on the topographic instruments analysis software allows the specific calculation of corneal aberrations, as well as the calculation of the corneal PSF.

The presence of a corneal asymmetry pronounced is a frequent cause of ghost image, and which resists correction by glasses. Keratoconus, which is associated deformation and progressive corneal thinning, is an etiology (cause) of double vision. Diplopia appears or is increased when the pupil dilates. Exploration of a feeling of ghosting allows often to discover infra clinical beginner Keratoconus. It is related to the asymmetry or the corneal irregularity. Classically, the rise in the rate of optical aberrations of high degree of type coma is responsible for a directional FHP "averaging" well correlated to the feeling of the ghost image.

ghosts & keratoconus OPD images

Review topo aberrometrique in a patient reached Keratoconus with a sensation of vertical diplopia. The PSF is calculated from the high degree of the total ocular Wavefront aberrations (it is represented such as "seen" by the eye). Optical Quality ((c) D Gatinel - Nidek Display card

Any corneal trauma (SCAR) inducing a deformity marked and asymmetrical of the cornea at the level of the pupillary area is also potentially induced a feeling of ghost image.

Irregular astigmatism after corneal transplant (keratoplasty) is potentially inducing a feeling of duplication single or multiple of the image, despite an often marked regular astigmatism correction. The deformation of the graft and Chin-ups imposed by sutures points are responsible for pronounced asymmetries.

The radiaire keratotomii technique now obsolete (superseded by techniques laser since the end of the 1990s) was based on the realization of deep corneal incisions in 'Star' around the pupil. The necessary imperfections related to this manual gesture were source of an important irregularity of the surface of the cornea

Finally, the folds of flap in LASIK may be responsible for the appearance of a troublesome image split. If there is in general a good spatial correlation between the direction of duplication and the orientation of the fold, the mechanisms to the acquisition of data allowing the calculation of the ocular wavefront by the aberrometric do not always allow to characterize the optical effect of these folds.


Internal origin (crystalline, implant)

The occurrence of a partial or broadcast of the lens opacification may be responsible for a monocular diplopia, or even of a polyplopie. The existence of local fluctuations of the refractive index of the clouded lens can create significant variations in the refractive power of the lens. some advanced nuclear cataracts cause sometimes the perception of a 'triplopie' (triple vision).

A subluxe implant and/or tilted (tilt) is also provider of a lateral light spreading (in the sense of the rocker or the displacement of the implant, retinal reversal near the point of view of subjective perception).  The calculation of the internal optical aberrations (corneal extra) to accredit the internal origin of these visual disorders. The disappearance of the symptoms after surgery of the eye and/or the cristallinien implant reaffiliation to finally confirm ex post the internal cause of these symptoms.

Multifocal implants, refractive individuals with asymmetric distribution of the additional power, may be responsible for perception of ghosting, when they are inserted into eyes including the optical quality of the corneal diopter is altered. Refractive multifocal implants induce the multifocalite thanks to a 'cocktail' of optical aberrations of high degree (provided by the implant depth of field is increased through the stigma reduction provided by these aberrations). If the cornea generates an additional rate of aberrations (alterations of the corneal surface, infra clinical Keratoconus unknown, irregularity of the corneal curvature, scar, astigmatism uncorrected, etc.), the addition of a refractive implant exposes to a significant reduction in the quality of the retinal image.

The OPD can objectify the manner in which a refractive multifocal implant induces the multifocalite necessary for the induction of a vision closely uncorrected. In the case of this implant (Oculentis M more), two lower sectoral areas allow a local addition of refractive power, for near vision. These topo aberrometriques (OPD SCAN III, Nidek) results have been acquired after multifocal implantation in a patient operated cataract, complaining of a bad Visual recovery, with perception of ghosting (horizontal duplication). The variation diopriques of the refractive card (card OPD, pout the whole eye) are dictated by internal aberrations, but there is an additional sectoral area of addition (yellow arrow), possibly related to the existence of a direct corneal astigmatism (red arrow). The patient plagiary of a horizontal split to its right (the picture drawn by the patient as well as the corresponding rendering to the convolution by the PSF and calculated by the aberrometric are represented above)

The presence of folds pronounced of the capsule of the lens can induce an effect of duplication or light streaks around the sources of bright light. Perceived trails orientation is similar to that of the folds, retinal reversal close.

folds of capsule slit lamp

Cataract surgery is to replace the lens clouded by an implant. We, however, retains the envelope of the lens, called capsule. (Biomicroscope) slit lamp examination to well to objectify the presence of folds of the posterior capsule. These folds can be seen in case of laxity of the zonal crystalline or during the evolution of secondary cataract.

A simple test is to show the patient a Basic Visual pattern as a source disk, then ask him to draw the orientation and the appearance of the Visual streak. This is what observes the previous patient with his eye surgery cataract but with folds of the posterior capsule:

Box corresponds to the Freehand drawing done by the patient during the observation of a bright disc with the operated eye cataract. Overnight, this patient perceives light stripes, dashes goshawks of car headlights, street lights, etc.

Box corresponds to the Freehand drawing done by the patient during the observation of a bright disc with the operated eye cataract. Overnight, this patient perceives light stripes, dashes goshawks of car headlights, street lights, etc.


A special case: the rainbow glare


The 'rainbow glare' (= Rainbow rainbow) is a feeling of duplication of bright images, with a gradation in "Rainbow". This complication occurs in the immediate course of LASIK (with femtosecond laser). One page is specifically dedicated to him.


71 responses to "phantom images double vision"

  1. Jessie Davis says:

    Good evening
    Would it be possible to have an appointment with you or one of your colleagues? I'm two hours from Paris. My diplopy empire, I see triple even sometimes more than that... Down and on the sides. This polyplop is monocular although I have paralysis for 8 years (no link between the two apparently). We can't find what I have. Moreover, at night, for 3 days I see streetlights or green lights totally distorted in the form of Trefle or star. I also have big pains behind my eyes constantly for 2 weeks and an ocular drought. I am very worried and would really like to have a quick appointment in your hospital. Thank you very much.

  2. Jessie says:

    Good evening
    I passed a topography + Oct and we can not find anything. My Monocular double view empire as well as my blurry view and I see all the LED type lights totally distorted. The ophthalmologist returns me once more at home without help and without answer... Irregular astigmatism or other worries should have been seen on these two exams? How to have a quick appointment in Paris please? Thanks in advance...

  3. Dr. Damien Gatinel says:

    It must pass a review aberrometrique (measurement of ocular wave-front) to check whether there is a correlation between your symptoms and retinal image predicted by the measure of the instrument. Corneal topography is not enough.

  4. Jessie says:

    Thank you very much but here in Rouen the specialists do not make me pass other ExamenJessie tell me that the topography is enough that it is in my head.... they do not understand. How do I take this exam to Paris as quickly as possible? I do not know what service of the foundation Rothschild I have to call to make an appointment? I'm lost. Thank you in advance.
    Kind regards.

  5. Jessie says:

    Thank you very much but here in Rouen the specialists do not make me pass other exams, they tell me that the topography is enough and that it is in my head.... they do not understand what I am talking about. How do I take this exam to Paris as quickly as possible? I do not know what service of the foundation Rothschild I have to call to make an appointment? I'm lost. Thank you in advance.
    Kind regards.

  6. Dr. Damien Gatinel says:

    You can make an appointment to the Foundation Rothschild - 01 48 03 65 68, with a Dr. Gatinel service assistant, and a balance sheet including an OPD with topography (OPDscan) will be made.

  7. Jessie says:

    Hello Mr. Gatinel,
    I am totally lost because I managed to have an appointment with your assistant Doctor Saad but my ophthalmologist does not want to make me a letter because it tells me that my eye myopathy is neurological and that aberrations is nothing that it is not my eyes (polyopia , total deformation of the lights, visual snow, blurred view more and more every day etc...). How am I supposed to do that? We will not accept the appointment without a letter...? And if it is the visual cortex how to know it? I'm sick of it. Thank you

  8. Jessie says:

    Good evening doctor Gatinel.
    I'm sorry to bother you with my messages but I went to the 15 20 today, waiting for the appointment with Dr. Saad on November 18 at the foundation. I have my view very blurry despite 10/10 and more and more abbérations still (Polyopia, no more form of lights etc.). The specialist found me irregularities of the cornea and with the hole stenopeique I have no more abberations. The blurred view can be linked to you? During the consultation with your assistant should I specify that I was found irregularity of the cornea during a topography? I do not understand this intense blur that worsens despite 10/10 sharpness and the fact that the abberations go with the hole sténopeique what does it mean? Thanks in advance!!

  9. Champagne Cyrille says:

    Dear Mr. Gatinel,

    I read your article on the double vision and ghosting with attention.

    I wear glasses for myopia for 20 years.

    I had a meeting today in the consultations in the ophthalmologic Center rothschild.
    At the first examination the analyst did not understand at all what I described (I explained to him that I could read the letters, but that they split – ditto the test of the white circle: It appears reproduced on itself in several directions...).
    The doctor, in a second review has me (a little taken from very high in passing and) assured that I have nothing to the eyes and that I quote "Your problem is elsewhere", at this point I felt like I was taken for a mythomaniac which is a little confusing when you know VO IR blur and that we are assured "have nothing to do with the eyes"
    (Note that I am a research director, I think I have the head that turns well...!!)

    I came out somewhat destabilized this interview, where lack of listening - for lack of understandable time - a little baffled me. So I had to do some research, I came to your page.

    Could you please tell me what to do to correct my sight; and tell me the coordinates of one gives who would have knowledge of my case, and who would listen to me carefully.
    At this point: I am looking for help, listening and a solution.

    Well cordially

  10. Dr. Damien Gatinel says:

    If slight duplication is seen by each eye (he persists when you alternately close one eye and then the other), must achieve a topographical examination and aberrometrique to search for the presence of an "irregular" astigmatism, that is to say a rise in the rate of the aberrations of high degree. This review (ex: measurement by OPDscan III) is available at the Rothschild Foundation. There are many causes of elevation of the aberrations of high degree, young patients there is often a slight corneal deformation (often consecutive eye rubbing vigorous and repeated, due to allergies or eyestrain). In older patients, a debutante cataract may cause in certain situations an impression of slightly double vision.

  11. BERNAND says:

    Hello doctor Gatinel

    Reading your description I find completely my symptoms!
    I watch more TV and I don't go to the movies with the kids anymore because of that.
    No one offers me solutions!
    In the work I am all day on computer, there I am stopped because it became impossible because of the excruciating pain that it generates in my eyes.
    Moreover I have a very very high myopia, despite a radial keratotomy in the year 90;
    I don't know what a saint to devote to.
    If you offered me an appointment I would be grateful to finally put a diagnosis on my problem that plunges me into a deep depression.

    If you know a doctor familiar with this problem on the Lyonnais region, I can also see him.

    Good to you

  12. Lilian Vincennes says:

    Dear Mr. Gatinel,
    I am "small" hyperopic (+ 1.75 G/D). At the age of 40, I got my first pair of glasses. Since I complain of blurry textures, I have trouble making the difference between grass and a green carpet. People's faces are hard for me to recognize, more than 3m. What shocked me most is the crescent moon (I see three distinct). The pedestrian of the traffic light is very distinctly split. For car or signal lights, it is very disturbing. Indeed, this doubling gives a slight effect of relief (The Phantom image acting as an offset shadow
    Two years later, I am at the same point. I have had several pairs of glasses, none is comfortable. I have a very good vision and so I see this phantom image distinctly. From what I can tell from my personal experience. Between 0 and 2m: not really doubling, the effect starts at 3m and infinitely the objects are split side by side. The OG, my director eye, has a ghost image oriented around 8:00, and right around 4:00. When I'm close to the sources, the brain happens to remove the ghosts at the cost of some computational effort I think. When I move away (+ 3m), it does not happen anymore and I see the Phantom of the OG distinctly. The OD is weaker and remains ignored.
    Your site is the first place I've felt less alone. The ophthalmologists I have crossed combines my near absence of Astigmatie to a lack of aberration. For them I have 16 with both eyes and everything is fine. When I reproduce drawings (I started like this), they're not. The black-letter view test on a white background is ideal because the phantom image is drowned in the light. The same test on white letters on a black background is difficult. In the opticians, at least, those who took the time to help me, the speech is different. From what I noticed, they put an astigmatism correction of about 0.5 with which I am more comfortable because the Phantom is less present. But by testing on the screen (white letters on a black background), I understood that this additional correction floutait The Phantom image and thus diminished a little bit my problem.
    I don't know if there's qqc to do. I called your services and they asked me for a letter of recommendation for an appointment. It's not easy. Technically, I don't know if there is a solution that could improve my comfort without degrading the rest. As my astigmatism seems low, maybe soft lenses could serve to "erase" the aberrations by filling them with liquid on the inner face.
    I'm a consultant. In the meantime, I defer to Saint Zernike:) In any case, congratulations for your site, it has the merit of being very pedagogic and well written.

  13. Dr. Damien Gatinel says:

    It seems that your Visual symptoms are actually in an astigmatism irregular, not correctable by glasses (even if the fixed bezel, in particular the degree and direction of astigmatism affects the perception of ghosting). Irregular astigmatism moderate (aberrations of high degree who trained these impressions of duplication but no decrease in Visual acuity) is usually either irregular (and also moderate) deformation of the cornea, or a beginner cataract. The corneal irregularities are much more common, and are often related to the practice of repeated eye rubbing (allergic, conjunctivitis, work on screen, Visual fatigue, sleeping on the stomach position or the side with eye support extended etc etc). To decide, just make a topographical examination and aberrometrique combbine (ex: OPDscan). There is no urgency to perform these tests. If you regularly rub your eyes, try to do that anymore (friction is often done unconsciously). In all case, if found generally a (corneal) cause these symptoms, there no obvious therapeutic solution, outside the port of contact lenses. These are necessary for you (hyperopia) and as a result, they might actually 'neutralize' a little irregular astigmatism.

  14. Dr. Damien Gatinel says:

    The radial keratotomy is certainly cause to explain your Visual symptoms. This technique (now abandoned) is at the origin of an irregularity of the cornea, which can worsen with time. Sometimes, in case to the hyperopia combined, a laser surgery is possible. But a review is necessary, and you can find the links necessary for the appointment online on this site (contact section).

  15. Agnes C. says:

    Hello doctor,

    Thanks for your article on the double vision and Ghost images. Finally an ophthalmologist identifies perfectly how I feel for 45 years, and disorders which has intensified in recent years (I'm 57).

    At the age of 12, I noticed that I could see the Moon split in the sky, but as my 1st consultation ophthalmologist also revealed a farsightedness, that focused attention and I was prescribed glasses first. 14-15 years, my complaints about duplication have been put on the account of a convergence problem, and I was directed to an orthoptist.

    Increasingly strong glasses + binocular rehabilitation every 5-6 years are the only answers that me have been made since, but over the years I increasingly felt that my problem of duplication was not correctly taken into account: If the binocular rehabilitation does not hurt, of course, I don't think that this is the right answer since , home, each eye sees double.

    I would like to make an appointment through the internet. Can I do this via the link "cataract surgery / support and follow-up of Keratoconus" or through the other topic?

    I would be so grateful to answer me (I wrote you a mail in 2016 which unfortunately remained unanswered).


    Agnes C.

  16. Dr. Damien Gatinel says:

    In your case it is important to distinguish if the duplication is seen with one eye, or if it is present only when both eyes are open. If one (or both) are double (while the other eye is closed), it is interesting to assess aberrometrique looking for a cause to this double vision. Appointments are accessible via the site Doctolib.

  17. Achour says:

    Good morning, sir
    I've been wearing scleral lenses for 17 days because of on keratoconus. However I still have a doubling of vision especially of the left eye. My doctor tells me that it is because of an internal astigmatism of 0.50 but I do think that this could cause so much duplication blatant. So I'm not really sure if it's from the deposits on the lenses or a bad correction?

  18. Dr. Damien Gatinel says:

    It is quite possible that the persistent duplication is related to an internal astigmatism, directly related to the effect 'outed' the posterior face of the cornea. Scleral lenses correct the corneal deformation 'before' (front of the cornea), but not the rear. An indirect way to check that clinically is to observe the direction of duplication and to compare it with that which exists in correction glasses. If duplication directions are reversed, so it is probably an effect related to the combination of an astigmatism regular and irregular related to the posterior side of the cornea.

  19. Elodie says:


    For 1 year, I am suffering from diplopia monocular in ghost image, plus night, especially light sources (road signs, leds), which is modulated in intensity, for example, I don't see anything so it's blurred and double (unable to read a license plate to 5 m, it is so garbled that I see her just white, I'm 30 cm from my screen and I see everything in gray without being able to discern the letters (, right eye only), last month it was just double. Doctors have ruled out MS, and I do reviews eye doctor every month (repetitive, it doesn't help to systematically the same exams!), is not the cause, and this is highly annoying, since I drove at least 3 hours per day, and at night the morning. We pulled me eyes dry, so false tears, it doesn't change anything, they gave me goggles rest blue glare, it doesn't change anything, I feel to be completely misunderstood, see even fabricate crazy (there's no see double with one eye!), I need help, I can't and it's starting to affect my morale... I find myself in the territory of Belfort. Thanks to direct me towards a colleague who will take me seriously and will be pretty competent to explore other than basic since tracks is not a classic case.

  20. Dr. Damien Gatinel says:

    Your symptoms, which increase in condition of low light (night) are evocative optical problem to solve. A topographical examination of the cornea and an aberrometrique of the eye exam are indicated. Need a review by an instrument like the OPDscan for example. I don't know a Center in your area. The causes able to induce these problems (if they are good optical original) associate among other Keratoconus, or cataract (the latter could be diagnosed during an eye exam, if she was pronounced enough however).

  21. Achour says:

    Hello, Mr. Damien. Thank you for answering my last post. As I told you there is persistence of doubling my vision even with Port of scleral lenses (Microlens Misa). My medcin recommended me glasses with a correction of 0.50 to compensate him for what he calls internal astigmatism that the lenses can not correct. But now even with wearing lenses and these glasses at the same time the duplication persists, the goggles do not correct it too. So I don't know what to understand or how to fix it, is that the géometire of the lenses are failing, is what the kératocone is not corrected, etc; What can you suggest, dear sir? Thank you

  22. Achour says:

    For checking the meaning of the balling, is it with wearing lenses and goggles together or each alone for comparison?? Thank you

  23. Benji says:


    Finally it seems that I find answers to my problems.

    I seem to share the same worries as Abdo. That is to say that I have this double vision phantom image on each eye (by hiding them each turn, the double persists). And like Elodie, the symbols are more pronounced at night or in a dark place. However, these are just the scriptures that split slightly, it is less significant than elodie ... For now ...
    Moreover for about 1 year I have "myodésopsies" (another ailment found thanks to the CD Ganeshan).
    I consulted four months ago and the ophthalmologist simply told me that I was slightly astigmatism and that the glasses will solve all the problems.
    Except that four months later, always myodésopsies and always these famous ghost images with or without bezel. I note however that the doubling is more pronounced after exposure to the screens and therefore after visual fatigue.
    Doctor, do you think I should consult again by asking more precisely a topographical examination and a aberrométrique examination??

  24. Dr. Damien Gatinel says:

    Indeed, it is important to decide by conducting an objective study in topography corneal and Aberrométrie. Optical aberrations that cause a single-eye "split vision" are not correctable in glasses. The Aberrométrique examination allows the splitting of correctable aberrations into spectacles (myopia, regular astigmatism, etc.) and non-correctable aberrations in spectacles (so-called high degree aberrations). The latter are mainly at the origin of the sensations of duplication that persist despite the correction in glasses of astigmatism known as "regular".

  25. Achour says:

    Hello doctor,
    As I already told you I was diagnosed at kératocone, which led me to wear scleral lenses manufactured by Microlens. Although my doctor tells me that the lenses have corrected the deformation and that the hint of astigmatism faded after the last consultation I did, the blurry overflow of images and letters remains persisstant by wearing my lenses. My doctor recently gave me treatments for drought and conjunctivitis, but the problem is not solved. Do you have any idea where this might come from?

  26. Dr. Damien Gatinel says:

    Rigid lenses can provide a major reduction in optical aberrations of the eyes with Keratoconus, but in case of significant corneal deformation, a residual rate may persist. Moreover, the rear side of the cornea is also prone to a significant distortion, which also generates a non-negligible rate of aberrations. You might suspect this origin if the imperfections such as duplication of the images or the spread of the lights takes an opposite direction between correction in glasses, and in rigid lenses (due to physical characteristics, for the same deformation, the rear face of the cornea generates aberrations of sign opposite to that of the front face).

  27. Achour says:

    Thank you very much doctor, effectiveùment the doctor suspected internal astigmatism but last week we did tests with colorful shapes, which led us to infer that astigmatism is insignificant in the order of 0.25 and that it is not for nothing. In his opinion, there is no alarm on any deficiency. I still do not know for I have these phantom images that sometimes make the object looked downright blurry, under titling etc, I would like to know if there are other causes besides astigmatism that could cause this, for example when I remove my lenses scleral I find furrows e of the marks left by these on my sclères, is the lens if it is tight can cause a duplication?
    Thank you very much and sorry to write you as much I have no other choice!

  28. Achour says:

    Is this qute the halo effect can apply to me knowing that I have never undergone surgery?

  29. Benji says:


    Right now I have particularly tired eyes. Just a few hours on computer in broad daylight and I need to rest. The weeks of work are very painful and I need to isolate myself in the dark to have less pain. Yesterday I had a pretty strong headache and located on the right with a feeling of pressure and right ear that is getting clogged. I immediately thought of a migraine.
    I consulted a ophthalmologist on Friday (very lucky to have had an appointment soon enough).
    For her, the correction of-0.5 on the right eye was too strong and she reduced me to-0.25 and added + 0.25 to do me good because with the work I shoot on the meadow view.
    She doesn't think I need Aberrometry review. For her it is a visual fatigue caused by the correction too strong and stress. She prescribed a orthoptic balance sheet.
    Besides, she made me a background and pictures of the retina. It seems that I have a slight hemorrhage on the left eye that will need to use a laser to heal around the hemorrhage. She entrusted me to one of these colleagues close to me for a second opinion and to make the laser if necessary and assured me that it was not serious.

    I have some doubts anyway. Do you think that a correction too strong (it's only 0.5 anyway) and stress can cause visual fatigue and can this fatigue cause my symptoms? (Sensitivity to light, sensitivity to contrast, double or blurred vision). Do I have to submit the Aberométrie exam to his colleague?
    And regarding the hemorrhage, is it actually nothing serious? The appointment with his colleague is this Thursday (while to have an appointment in Reims it is several months).
    Because to be honest I was very stressed. Especially when talking about laser in the eyes I really don't like it.
    The problem was that I had the impression of being received in the wind cut as there were a lot of customers.

  30. Marguerite says:

    Bravo doctor for putting a name I believe on something that I described to my parents from my childhood: the lights (lamps, headlights, stars) make stars with long rays. The Triple Moon etc. The letters that are going on (and I don't tell you when the light panels are made of moving bridges). This was confused with my myopia, (view glasses from afar to 10 years old: That's right I need it)) then with glaucoma (I now take the Azopt), a supposed cataract (I think I was wrongly operated).
    Today I have in addition a scotoma in two pieces to the left eye and really the vision, it is not great...
    But thank you for having succeeded in formulating and explaining what we see.
    I'll go back to my ophthalmologist with your article!

  31. Jeremy says:

    Hello, I am 21 years old and I noticed that since when I look under the title to the cinema, they appear very lightly split, I noticed that the problem is sharply accentuated when my eyelids are low
    The phenomenon occurs in both eyes, the doubling effect is very slight
    I categorically refuse to believe that this is a keratokone, I will never admit this, it is an extremely rare disease, I do not want to be afflicted with a rare disease

    Do you think that this is something other than a keratokone? A simple astigmatism?

  32. Dr. Damien Gatinel says:

    Between a slight distortion of the cornea and the proven keratoconus there are all the stages, and it is probable that your split vision is explained by what is called irregular astigmatism (it can be characterized more precisely with an examination Aberrométrique). People with slightly irregular corneas tend to rub their eyes more often (allergy), or sleep on the belly or side (nocturnal prolonged eye compression, wake-up friction, etc.).

  33. John Viou says:

    Hello doctor,

    Like others here my vision is blurred, provoked by the perception of staggered images.
    At my last visit to the ophthalmologist this one announced me with delight: "It is the cataract, it is ripe, it is necessary to operate". He was very unhappy that I refused to make an appointment immediately.
    What appeals to me is that the sharpness of my vision improves greatly if I look through a slit (type Inuit snow goggle) or a grate, for example consisting of 2mm holes spaced 1mm.
    So is the replacement of the Crystalline lens going to fix the problem or the origin of the defect is it to look elsewhere?

  34. Dr. Damien Gatinel says:

    The perception of duplication can actually be observed in cataract case, but this is not the only cause of this kind of visual anomaly. Most often it is a slightly irregular corneal astigmatism. Your observation (disappearance of duplication by looking through a thin aperture) orients to the presence of irregular astigmatism: it is classic to observe an improvement of the visual quality when one looks through a small xxx _ xxx_52755140 in case of optical refractive defect (ophthalmologists use a "pinhole hole" to test the vision of some patients). In Cataract case, the vision can also be slightly improved by a sténopétique hole, but it is not systematic. Fortunately, there are now objective tests (HD analyze, or automated analysis of an OCT image of the Crystalline lens, which we have developed), which allow to slice between "cataract" and "clouding not visually speaking" of Crsitallin. You should take another opinion to decide.

  35. John Viou says:

    Thank you doctor for this review.

  36. Nordine says:

    After an accident, I was operated to suture a scleral wound followed by a vitrectomy at the level of my right eye. My ophthalmologist discouraged me from placing an implant to replace my Crystalline lens disappeared after the accident, in its place I am currently putting a flexible lens correction. The problem is that I see split images when I open both eyes together. Splitting disappears when I open each eye apart. For this purpose, I am speaking to you to orient me. What do I have to do to correct that. Thank you Doctor

  37. Dr. Damien Gatinel says:

    If a ghost image disappears when you close an eye, it is an eye-alignment problem (e.g. strabismus). The Diplope is binocular, its cause can also be related to a difference of image size on the retina but this is unlikely in lens correction.

  38. Renaux says:

    Good morning, sir

    I recognize myself in these symptoms, duplicate ghost images, halos around the lights ETC, however could you explain to me something: how and is it possible that these phenomena appeared without any surgery, without Trauma except for the right eye two years ago, because the left is affected also by these symptoms, and above all, the whole appeared on both eyes in less than 4 me with additional duplication in the space of a month again, exercises line of subtitles Q UI will split even more if I open even bigger eyes.....
    How can this happen in about a month. Thank you

  39. Dr. Damien Gatinel says:

    Anomalies leading to the perception of split vision may appear before the visual symptoms are perceived by the patient. The causes are multiple, as explained. The beginner catraracte can lead to Monovulaire diplopness. In my experience, in patients whose age is between 15 and 40 years, these symptoms are rather caused by a moderate corneal deformation, itself induced by eye rubbing a little too pronounced (allergies, makeup Vigorous, patients who sleep on the belly, etc.)

  40. Lorraine says:

    Hello, I have exactly these symptoms: a slightly double vision, especially clear things in a dark environment. I'm reassured to see that I'm not the only one. Given my age (19), as I understand it is therefore related to a slight astigmatism. Is it likely to get worse over time?
    Moreover, I have the impression that this symptom is much more present since I started my studies and I spend all my days in front of the computer and my worksheets. Can this double vision be augmented by visual fatigue?
    Thanks in advance

  41. Dr. Damien Gatinel says:

    Make sure you don't acez in the habit of rubbing your eyes a little vigorously and frequently during your extended screen work sessions. In our experience this may be the cause of mild astigmatism or modétées corneal deformities but may cause symptoms of split vision. Ditto if your sleep rather on the belly, with the head in the pillow on the side of the eye that sees a little double: you would have to change your position of sleep to avoid any prolonged eye compression.

  42. Sophie Pinilla says:

    Hello doctor,
    I had eye surgery (ocular implants) To correct my myopia (-8) almost two weeks ago.
    Since the operation, I have noticed the symptoms you mention in your article (splitting of subtitles, blurred vision of light sources,...).
    Do you think these symptoms may fade over time (with scarring) or will they be sustainable? If this problem persists, would it be sufficient to reattach the intraocular lens placement to solve the problem?

    I thank you in advance for the time you will take to answer my questions.

  43. Dr. Damien Gatinel says:

    Duplication may be transient (effect of the corneal incision), but may also persist if the implants are relatively off-center compared to the pupil Iris. It is necessary to make a point with your ophthalmologist to discern between corneal and internal astigmatism, as well as the presence of a possible high level of aberrations of high degree (induced by the decentering of the implant).

  44. Eric says:

    Hello doctor,
    Thank you for this very interesting article and that perfectly describes the situation in which I find myself. I was diagnosed with a keratoconus a short time ago (at 34 years old) and prescribed rigid lenses to stop its evolution. But with these lenses the phenomena of double vision and halos are very accentuated (on both eyes and especially at night). I would like to know if the lenses can be adapted to correct this (remove these parasitic images and therefore have a clear view) or if an intervention on my eyes is necessary?
    Thank you in advance for your opinion.

  45. Dr. Damien Gatinel says:

    Rigid lenses are the best means of correction to reduce symptoms of optical quality reduction of keratoconus (see:; However, the lenses do not stop the evolution of the keratoconus; It is the cessation of eye rubbing That helps to curb the evolution of the disease.

  46. Eric says:

    Hello doctor,
    Thank you for your answer and your references.
    However, my question was rather about lens correction. Indeed, the phenomenon of ghost images is very accentuated by wearing them, whereas with my glasses I do not notice it. So I wanted your opinion in relation to that. Do you think this comes from a bad design of lenses or my eyes that would not support the wearing of lenses for example?

  47. Dr. Damien Gatinel says:

    This certainly corresponds to a non-optimal positioning of the lens, which generates high-degree optical aberrations. It is necessary to remake the point with the ophthalmologist who adapted these lenses.

  48. Eric says:

    Okay, that's what I'm going to do.
    Thank you very much for your availability!

  49. Eric says:

    Hello doctor,
    According to my optician, my lenses are perfectly positioned. It made me test a lens with a larger patch surface, but it didn't have any effect. Today it has no solution to propose me to remove, see only reduce, these aberrations. Do you have another suggestion for me?

  50. DUBUS Christelle says:

    Hello doctor,

    I am both relieved but at the same time horrified to read your publication. I am relieved to find and understand what my 17 year old daughter has described to me for over a year. When there is a light a little bright (screen, car headlight, projection on the whiteboard in class... ETC) She sees an image of the letters above, in a little transparent, but it makes reading difficult. She is a senior, excellent student and wants to go to vet studies,.. But she is almost ready to give up because of these vision problems.... the ophthalmologist did not even receive it because we had seen it less than a year ago (he had then prescribed a re-education orthoptic, which of course did not change anything, moreover by reading your Article I understand since when she closes an eye the split is still there)... he did not even receive us, and sent us back to the ortoptiste who almost begged him to prescribe to my daughter an increase in her correction for myopia.... basically he doesn't believe us p As.... I am desperate because the future of my daughter is at play.... what I do not understand in your article is: In the end in the case of a 17-year-old if not cataract... is there a solution? Is this reversible? To whom to turn....

  51. Dr. Damien Gatinel says:

    In the case of your daughter it is advisable to practice a simple topographic and aberrométrique examination. In adolescents, the perception of a slight duplication often comes from more or less regular astigmatism of the cornea. The cause of this astigmatism may be related to eye rubbing Repeated, extended support of the head in the pillow with eye compression etc etc. There is nothing serious a priori at this stage.

  52. Lee says:

    Hello doctor,
    Thank you for your very interesting article. I have a vision disorder that is quite similar to what is described.
    In August 2018, after a week of intense work on computer and quite eye-wracking-the correction of my glasses being then obsolete for a few months (I am astigmatism, hyperopic and longsighted)-I suddenly perceive halos around the Streetlights and car headlights with my right eye (being amblyopic, I really only see this eye).
    I consulted two ophthalmologists ' offices, which quickly welcomed me after a description of this phenomenon, in September, October and November. But they could not make a diagnosis, because after examining them my eye is normal.
    But the phenomenon is very sensitive. When I read a lot, the halos are really pronounced and annoying, and I even feel like the image is splitting. In broad daylight, clear shapes are significantly above the darker environment.
    A curiosity is that the phenomenon fades when I'm outside and it's cold. Also when my eyes are wet. But he comes back very quickly.
    At the beginning of January, I was examined by an optometrist. He noticed clogged ducts channels. He also observed with a ophthalmoscope developed on the cornea a small distortion resembling a "bubble" almost on the optical axis.
    I don't know what to do or who to turn to. I have no idea how serious this disorder is.
    Thank you for your attention. Would you please have a review or advice?
    Kind regards.

  53. Dr. Damien Gatinel says:

    There is certainly an optical cause to your symptoms, it is necessary to realize a balance combining corneal topography, Aberrometry , in order to document the state of your eye and determine whether this slight monocular diplope and halos have a corneal or other origin.

  54. Lee says:

    Hello doctor, thank you very much for these tips.
    Kind regards.

  55. Anjoy says:

    Hello Doctor, and a big thank you for the quality of your site.
    Have you ever received Lyme disease patients?

    I'm sadly part of it, and I was wondering what to expect as a relief by having like me a mono dipoplie on both eyes (diagonally right on left and left on the right) knowing that it varies greatly depending on the fatigue and intensity Bright (much stronger in the night setting)...
    The specialist and surgeon of the cornea who came to me in Lausanne found me (among other things) a distorted cornea, and said I wanted to continue to investigate these aberrations, but without giving me concrete solutions...
    Thank you in advance.

  56. Virginia says:

    Hello doctor
    Your site is very interesting when you find yourself without a pertinent answer from its usual doctors.
    I have been myopic since the age of 7 (I in 40) and I changed glasses in September 2018, because I thought my vision was blurry. A priori the ophthalmologist made a mistake of 0.5 on my correction of the left eye. Since I see blurry of the left eye with a feeling of persistent discomfort, headaches of crane and a lot of fatigue at the end of the day. Recently I noticed that I see double of the left eye (I see distinctly 2 crescents of moon). I then returned to my ophthalmologist (who found his mistake on this occasion and made me a background that he found normal). He told me that the double vision is only because of the bad correction, which left me very dubious.
    On reading your site, I realize that I have rubbed a lot my left eye because of this bad correction, do you think this can explain the onset of symptoms in a few months? If my problem is right from there, how long can it go back to normal? Do I have to insist on doing additional exams or waiting for the natural evolution of the phenomenon?
    Thank you for your attention

  57. Dr. Damien Gatinel says:

    A split vision (under titles, crescent moon, etc.) can quite be caused by irregular astigmatism, itself induced by a corneal deformation caused by eye rubbing Repeated and vigorous. Sleeping on the belly and side, with chronic support on the cornea (and possible morning frictions) can quite be at the origin of this type of painting. This possibility is often misunderstood by ophthalmologists with little Aberrometry , and I often had to consult patients who had "benefited" from numerous neurological, scanner and MRI tests... that had not recovered anything. Instead, a aberrométrique and topographical examination (e.g. OPD Scan, which combines this data and simulates the retinal image of the examined eye) should be carried out. In addition to this review, there is no urgency other than to investigate your friction, sleep position, and stop rubbing of course.

  58. Dr. Damien Gatinel says:

    Lyme disease is a cause of chronic ocular inflammation (e.g., uveitis), and corneal complications are also possible (e.g., interstitial keratitis). It is difficult to correlate a split vision with a corneal impairment without precise examinations (topography, Aberrometry , etc.). A correction in rigid lenses can induce an improvement in vision in some case .

  59. Lorraine says:

    Hello Dr. Gatinel,
    Thank you for this very interesting article. I've noticed this kind of symptom for about a year, but maybe I had it for longer. I generally have a good view, I have a slight myopia to the right eye (-0.75) and 10/10 to the left eye, so I see net with my two eyes, but for about 1 years so I see these famous ghost images, especially the bright or light on darker background. I see the neons and traffic lights completely split. I thought at first that it was related to my myopia of the right eye, but I also see these images of the left eye. I presume this is an astigmatism (the other causes mentioned in your article do not match me).
    I wanted to know if this astigmatism could get worse? And I would like to be sure that this concern has nothing to do with myopia, or any other lack of vision?
    Thanks in advance

  60. Heidi Vogel says:

    Hello doctor,
    I'm 48 years old, I'm myopic and longsighted. For about a year, I started to see slightly double the right eye. The problem has worsened since then, I see now triple. I have a clearer first ghost image at 11:00 and a second ghost image even clearer at 9am. My ophthalmologist does not know what to think, the examination of the visual field is normal, the retina also and the cornea is smooth. I get by because this disorder only affects the right eye.
    How to know the origin of this problem very annoying and especially how can it be treated?
    Is it possible to develop internal astigmatism, Crystalline lens , on one side and at my age?
    I would be very grateful if you could tell me what you think.

  61. Dr. Damien Gatinel says:

    There is often an optical explanation for this type of visual symptoms: either a corneal deformation (often linked to eye rubbing and/or a sleep position which is the result of a support on the eye/orbit etc.) or an alteration of the internal structure of the Crystalline lens ("cataract" very early). To decide a topo-aberrométrique examination (ex: OPD scan) is necessary. It allows accurate estimation of corneal-induced optical aberrations vs. internal elements of the eye.

  62. David says:

    Hello doctor

    I am 25 years old and I have this ghost image problem for 5 years. It's not unlivable but it may be inconvenient in some situations (watch TV in the dark, watch the moon, ect..). It's my right eye that's the most affected. If I hide my left eye, I do not see very sharp with the right and the light sources double in low light.
    I noticed that if I put a flashlight (cell phone flashlight) near my eye my pupil Shrinks and the phantom image disappears. Even if I hide half of my eye with a finger the ghost image disappears...

    Obviously no ophthalmologist understands the problem.

    Can the problem be solved by itself or will I need a lens?

    Thank you

  63. Florian says:

    Hello I have a low myopia and I have ghost image when I read clear letters on a dark background these often on Pc or laptop otherwise I have no phantom mink when I read a book or I look at pictures, photo etc... I wanted to have it if its little be serious or if its can get worse

  64. Dr. Damien Gatinel says:

    Ghost images are always present but they are only perceived by the eye when their intensity exceeds a certain threshold. When you read a book, the light emitted by it (reflection of daylight or a lamp) is much less intense than that of a direct source (eg: portable). The proportion of light present in the Phantom image is too low to be detected in the vision of "passive" (paper) media. The preferential conditions for perceiving phantom images, duplication, combine low ambient light (causing dilation of the pupil ), and the observation of shiny motifs on a dark background (e.g. LEDs, subtitles, neons, etc.).

  65. Dr. Damien Gatinel says:

    The problem you present may be slightly attenuated by soft lenses, and even more so by rigid lenses (if the origin of these visual disturbances is a slight corneal distortion). It is important that you stop rubbing your eyes vigorously if you do, and perform a corneal topography and a aberrométrique examination to document the problem and its origin (eg: OPD scan examination).

  66. Muller says:

    I had surgery a year ago for a myopia by the SMILE technique.
    Today I always see double subtitles and I still can't stand the strong brightness.
    As a result, I went back to see the doctor for the third time and he does not know why, my low astigmatism, now poses a problem when he was not corrected before.
    According to you, would he have to take it into account before the operation?
    He's proposing to reoperate me by PKR.
    Is it a big risk after a smile? Do I have to wear glasses at night?
    What do you think?
    Nice day

  67. Dr. Damien Gatinel says:

    It is difficult to judge the reasons for your phantom images without objective examination: topography and Aberrometry . This may be an astigmatism-related effect, but other causes exist: optical area shift, or interface microfolds (in case difficult dissection of the smile duckweed). It is not possible to make alterations in SMILE with the same technique and this is sometimes a problem because PKR exposes to a risk of haze (prolonged inflammatory reaction) in this context. Everything depends on your degree of discomfort, and the merits of the retouching.

  68. Heidi Vogel says:

    Hello doctor,
    I return to you after you have already written on February 14th (triple vision with the right eye). I live in Germany and my ophthalmologist has now examined my eye with a Pentacam. She says to observe, to the right more than to the left (my right eye is also the most nearsighted), an internal alteration of the Crystalline lens , which would explain this multiple vision. She believes that an operation of the Crystalline lens would probably solve the problem. I find it worrying that at 48 years my Crystalline lens is already at the point where it needs to be replaced. What do you think? Do we have to operate?

  69. Aurélie says:

    Hello, doctor.
    excuse me for disturbing you, I just wanted to ask your opinion. I was operated on December 18, 2018 with a myopia (-6.75 and-7) with a smile RELEX technique. I can see I can't complain. However I see at the level of my right eye and slight splitting (clear characters on a dark background), if I look at both eyes I feel almost no discomfort but if I look at the right eye I feel this phenomenon. I also noticed that my right eye is drier is this can accentuate the phenomenon? Do I have to worry about it?
    Thank you in advance for your answer.

  70. Dr. Damien Gatinel says:

    The symptoms of the right eye after your SMILE intervention can actually be explained by a dry eye, but in this case they must be intermittent and fade after drought treatment by local hydrating agents. A slight shift in the procedure can also explain these phantom images (the centering of the procedure in SMILE is less controlled than in LASIK in some case ). An aberrometric examination would confirm this.

  71. Muller says:

    I would like to go back to you because I want to know if my nocturnal problem can be corrected by glasses that I will only wear at night to drive or for the cinema?
    Indeed, these are at these moments only or I encounter the problem of double vision.
    In the case of a new operation PKR, an inflammation lasts how long and can cause what consequences?
    I have to say that I do not know what to do to improve this defect.
    Thanks in advance
    Kind regards

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