“Bad migraine, vertigo, and vision issues,” said one MyMigraineTeam member. “Does anyone else get double vision?”

Another member shared, “I’m having a daily migraine attack. My vision is 3D, blurry, double and tunnel vision.”

Double vision is one of several possible visual changes that can happen with migraine, but it’s relatively rare and tends to go away quickly. Many other conditions — including potentially serious ones — can cause double vision, so it’s important to tell your doctor right away when you notice this symptom. You may need urgent testing to rule out other causes.

Here’s what you need to know about double vision and migraine.

What Is Double Vision?

Double vision, also known as diplopia, means you see two images of everything you look at. The images slightly overlap with each other, giving objects a slightly hazy or shadowy appearance.

• Vertical diplopia means the extra images appear above or below the object.
• Horizontal diplopia means the extra images appear on either side of the object.
• Oblique diplopia means the extra images appear diagonally.

Some people also experience eye pain, head pain, dizziness, or nausea while they’re seeing double. Blurred vision and eyestrain can also happen along with double vision.

What Types of Migraine Can Cause Double Vision?

Seeing double during a migraine attack could mean you’re experiencing a rare type of migraine called migraine with brainstem aura. This form of migraine used to be referred to as basilar migraine.

Possible symptoms of migraine with brainstem aura include:

• Double vision
• Other vision changes in both eyes, like flashing lights or zigzag patterns
• Vertigo (feeling like the room is spinning)
• Slurred speech
• Tinnitus (ringing in ears)
• Walking unsteadily
• Loss of consciousness
• Numbness or a pins-and-needles feeling in both arms and/or both legs

You only need to experience two of these symptoms to be diagnosed with migraine with brainstem aura. The symptoms usually appear before or during a migraine attack, and they may not happen with every attack. They are temporary and can last just a few minutes or more than an hour.

Migraine with brainstem aura is uncommon — about 30 percent of people with migraine experience some kind of aura. Of those, about 10 percent have migraine attacks with brainstem aura. Considering more than 39 million Americans have migraine, that means about 1.2 million may have experienced symptoms like double vision.

Do Other Types of Migraine Cause Double Vision?

Hemiplegic migraine can also cause double vision and other visual disturbances. This type of migraine can feel scary because it causes one-sided muscle weakness and speech difficulties, mimicking a stroke. It feels like a throbbing, severe headache.

If you can lift both arms over your head and one feels heavier than the other, it’s more likely to be a hemiplegic migraine than a stroke. When in doubt, seek medical care right away.

A retinal migraine or ocular migraine causes visual changes in only one eye. Current literature doesn’t explicitly mention double vision as a symptom of retinal or ocular migraine, but it does mention that it can cause “visual changes.” These changes usually go away after 10 to 20 minutes.

If you’re seeing double in only one eye, talk to a healthcare professional immediately. There could be something else going on.

Other Headache Disorders and Double Vision

Most people with a headache disorder called recurrent painful ophthalmoplegic neuropathy (RPON) experience double vision. While migraine causes temporary double vision, diplopia caused by RPON can linger for weeks to months.

Though technically not a type of migraine, RPON can cause migraine-like head pain. However, these conditions have different causes and treatments. A headache specialist can determine whether you have RPON or migraine.

What Else Can Cause Double Vision?

Migraine is one of many conditions that can cause double vision. One or both eyes may be affected.

Common causes of binocular diplopia (double vision in both eyes, which makes up 94 percent of cases) include blood vessel issues and trauma (injury). Monocular diplopia (double vision in one eye, which happens in 6 percent of cases) is often caused by astigmatism, some eyeglass and contact lenses, and various issues with the eyelid, cornea, lens, iris, pupil, or retina.

Diplopia can also happen when image-processing nerves don’t work properly. This is often what happens during migraine attacks, but it can also occur due to cranial nerve palsy (third and sixth nerve palsies), multiple sclerosis, or encephalitis (brain inflammation).

Other conditions that may cause double vision include:

• Nearsightedness
• Farsightedness
• Cataracts
• Dry eye syndrome
• Bulging eyes
• A cornea malformation called keratoconus
• Thyroid eye disease caused by Grave’s disease
• Vitamin B1 deficiency
• Guillain-Barré syndrome
• Conditions affecting cerebrospinal fluid
• Brain lesions or tumors
• Diabetes
• Stroke
• Brain aneurysm
• Myasthenia gravis

Some of these causes can be life-threatening. If you’re concerned about your double vision, have a conversation with your headache specialist about how to recognize double vision as a migraine symptom rather than a symptom of another condition. When in doubt, seek prompt medical care.

How Does Double Vision Affect Everyday Life?

Double vision affects your depth perception, which means you may have trouble judging the distance between you and an object. This can feel disorienting and frustrating. For example, you might reach for a door handle and struggle to grasp it because you’re too far away.

Poor depth perception makes driving dangerous. If you experience double vision when you’re away from home, get someone else to drive you back. This keeps you and other people safe on the road.

Even walking safely can be difficult with double vision because you may run into stationary objects or step off a curb accidentally. Take your time, and consider asking someone to guide you.

Can Double Vision Be Treated?

Migraine-related double vision is short-lived and doesn’t usually require targeted treatment. It should go away even if you don’t take migraine medication. When double vision is caused by something else, treating the underlying condition may resolve the visual disturbances.

For some people, double vision lasts a long time. If double vision is caused by weak eye muscles, periodic botulinum toxin injections (Botox) may provide relief. A surgical procedure targeting the strabismus muscle offers a more permanent solution.

If double vision makes your migraine symptoms worse or disrupts your daily life, try covering one eye with a patch. This stops the brain from producing two images of the same object, effectively eliminating the double vision. A special kind of eyewear called Fresnel prism lenses may also help.

You may need to coordinate with your primary care provider, neurologist, and eye doctor to find the best double vision treatment for you.

When To Talk With Your Doctor

Talk to your doctor as soon as you experience a new migraine symptom for the first time, including double vision. There are many types of migraine, and your doctor needs to understand which one you have in order to recommend a safe and effective treatment. Track your migraine triggers and symptoms in a headache journal so you can easily discuss trends and changes with your doctor.

Seek immediate medical care if double vision happens without warning or comes with the following symptoms:

• Sudden “worst headache ever”
• Headache lasting longer than 60 minutes
• Muscle weakness
• Confusion
• Slurred speech
• Eye pain
• Dizziness

Serious conditions like cancerous tumors, aneurysms, or brain inflammation can cause you to see double, and prompt treatment could save your life.

You should also talk to a doctor right away if your double vision gets worse or doesn’t go away within a few hours. Your healthcare provider may want to rule out other underlying conditions.

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