Illustration of double vision caused by glaucoma surgery.

Double Vision After Glaucoma Surgery? What You Need to Know

Rhea Morgan in Health & Wellness December 2025 • 3 min read.

"Understanding the unexpected side effects of glaucoma treatments and how they impact your vision."

Glaucoma, a condition damaging the optic nerve, often requires surgical intervention to lower intraocular pressure (IOP). While procedures like trabeculectomy (TE) and glaucoma drainage device (GDD) implantation, such as the Baerveldt glaucoma implant (BGI), are effective, they can sometimes lead to unexpected side effects, including double vision, also known as diplopia.

Diplopia occurs when the eyes fail to work together, resulting in seeing two images of a single object. Normally, our eye muscles coordinate to maintain binocular vision, preventing this disorienting effect. However, glaucoma surgeries, particularly GDD implantation, can disrupt this coordination.

A recent study investigated the incidence and causes of diplopia following glaucoma surgery, comparing outcomes between BGI and TE procedures. Understanding the factors contributing to diplopia can help patients and surgeons make informed decisions and manage expectations.

Why Does Diplopia Occur After Glaucoma Surgery?

Illustration of double vision caused by glaucoma surgery.

The study, published in Translational Vision Science & Technology, analyzed 51 patients who underwent BGI and 52 patients who had TE. Researchers quantified diplopia and motility changes by asking patients about their experiences one year post-surgery. They also measured eye movements (ductions) in eight directions, along with ocular alignment and fusion range, both before and after the surgery.

The results indicated a significant difference in the occurrence of diplopia between the two groups:

BGI Group: 14 patients (28%) experienced diplopia.
TE Group: Only one patient (2%) reported diplopia.
Eye Movement Changes: Significantly more common in the BGI group (35%) compared to the TE group (19%).

Specifically, in the BGI group, movement restrictions were most noticeable in:

What Does This Mean for Glaucoma Patients?

This study underscores the importance of discussing potential side effects, including diplopia, with your ophthalmologist before undergoing glaucoma surgery. While TE carries a lower risk of diplopia, BGI may be more appropriate for certain individuals based on the severity and type of glaucoma. Knowing the risks allows patients to be proactive in managing their eye health and seeking timely intervention should complications arise. Further research is needed to minimize post-operative complications.

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Everything You Need To Know

What is diplopia and how does it relate to glaucoma surgery?

Diplopia, commonly known as double vision, arises when the eyes struggle to work in unison. This lack of coordination results in the perception of two distinct images of a single object. Glaucoma surgeries, particularly the implantation of glaucoma drainage devices like the Baerveldt glaucoma implant, can sometimes disrupt the coordinated function of the eye muscles, leading to this disorienting effect. Typically, our eye muscles collaborate to ensure binocular vision, preventing diplopia. Understanding the potential for diplopia is crucial when considering glaucoma surgery options.

What are the differences between trabeculectomy and Baerveldt glaucoma implant?

Trabeculectomy is a surgical procedure used to treat glaucoma by creating a new drainage pathway for fluid to exit the eye, thereby lowering intraocular pressure. Baerveldt glaucoma implant, on the other hand, is a glaucoma drainage device (GDD) that is implanted in the eye to achieve the same goal. A study comparing the two procedures showed a higher incidence of diplopia following Baerveldt glaucoma implant procedures compared to trabeculectomy. The choice between trabeculectomy and Baerveldt glaucoma implant depends on individual patient factors, the severity of glaucoma, and the potential risk of side effects.

What causes double vision after glaucoma surgery?

The occurrence of diplopia following glaucoma surgery can be attributed to disruptions in eye muscle coordination. Surgical procedures, particularly the implantation of a glaucoma drainage device, can affect the muscles responsible for eye movement, leading to misalignment and double vision. A recent study revealed that patients who underwent Baerveldt glaucoma implant procedures experienced diplopia more frequently than those who had a trabeculectomy. This difference highlights the impact of different surgical techniques on eye muscle function and the subsequent risk of diplopia.

What did the study reveal about the risk of diplopia after different glaucoma surgeries?

A recent study published in Translational Vision Science & Technology compared the incidence of diplopia after Baerveldt glaucoma implant and trabeculectomy procedures. The study involved assessing patients' experiences and measuring eye movements before and after surgery to quantify changes in diplopia and motility. The results indicated a significantly higher occurrence of diplopia in the Baerveldt glaucoma implant group (28%) compared to the trabeculectomy group (2%). These findings underscore the importance of considering the potential risk of diplopia when selecting glaucoma surgery options.

What should I discuss with my eye doctor before glaucoma surgery regarding double vision?

Before undergoing glaucoma surgery, it is crucial to have an open and thorough discussion with your ophthalmologist about the potential side effects, including diplopia. Knowing the risks associated with different surgical procedures, such as trabeculectomy and Baerveldt glaucoma implant, allows you to make informed decisions and manage expectations. While trabeculectomy may carry a lower risk of diplopia, Baerveldt glaucoma implant may be more appropriate for certain individuals based on the severity and type of glaucoma. Understanding the benefits and risks of each procedure is essential for proactive management of your eye health.