Causes of intermittent or occasional double vision are varied including very benign to cancer.

“Your brains keeps your eyes lined up, working in sync to avoid double vision,” says Dr. Brian Boxer Wachler, MD, eye surgeon and founder of The Boxer Wachler Vision Institute, and developer of the Holcomb C3-R® procedure which treats a degenerative eye disease called keratoconus.

“Being tired at night or having a few drinks can temporarily affect the brain’s ability to keep both eyes aligned, like car headlights,” continues Dr. Boxer Wachler.

“Your eyes can ‘wander’ from each other and not be in sync. When the eyes aren’t lined up, then you can get double vision.

“Another condition the commonly causes double vision is keratoconus, but that is not temporary (unless a procedure is done to treat it).”

Other Causes of Double Vision that Comes and Goes 


Non-ruptured, it can cause intermittent double vision.

Brown’s Superior Oblique Tendon Sheath Syndrome

A form of eye misalignment (strabismus), an effective treatment is eye exercises.

Cataract Surgery

In a small percentage of patients, changes in ocular alignment can occur.

Fixation Switch Diplopia

People with a childhood history of strabismus (misaligned eyes) may develop this.

Multiple Sclerosis

Neurological condition.

Myogenic Ptosis

Sagging eyelid due to a weak muscle.

Ocular Myasthenia Gravis

Neurological condition.

Ocular Neuromyotonia

Spams of muscles near the eye; a very rare condition. These spasms are NOT the same as common muscle “twitching.”

Prostate Cancer

A report in the journal Urology (Sept. 2004) is actually titled, “Intracranial metastatic prostate carcinoma presenting as intermittent double vision.”

This means a secondary brain tumor arising from a primary (original) site: the prostate.

The paper’s abstract begins, “We describe a prostate cancer patient whose initial symptom was intermittent double vision.”

Skull Base Plasmacytoma

Rare brain tumor.

Sjogren’s Syndrome

This autoimmune disorder is primarily characterized by very dry eyes, a very dry mouth and joint pain, but can cause occasional double vision.

Superior Oblique Myokymia

Neurological disorder that affects vision.

Temporal Arteritis

Transient Ischemic Attack

This is a temporary or “mini” stroke. However, the odds of many recurring TIAs being in the exact same spot in the brain (and hence causing the same symptom every single time) are essentially nonexistent.

The double vision from a TIA will last for minutes or seconds, but it will not be intermittent – which means it keeps occurring periodically.

You can bet the farm that the next TIA will cause a completely different symptom such as slurred speech, facial paralysis, confusion or a limp feeling on one side of the body.

IMPORTANT NOTE: The above list is not complete. In general, if a condition causes periodic double vision, there will very likely be other symptoms present.

These will be quite varied, depending on the cause of double vision that comes and goes.

For instance, an aneurysm can cause a headache and a drooping eyelid.

dr. boxer wachlerDr. Boxer Wachler has delivered hundreds of lectures on eye surgery to thousands of eye surgeons from around the world, and is a pioneer in keratoconus treatment.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
Top image: Shutterstock/Erica Danger
Sources: Causes of intermittent Double Vision Causes of Occasional Double Vision