Double vision at operating microscope

[jsh1986]

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Hope someone could provide a suggestion on what may be going on:

I recently watched a vitrectomy case with my attending and her fellow. When I sat at one of the three heads of the microscope, I had no trouble with viewing the anterior chamber and the eye's external structures through the microscope. The images were fused.

But when they placed the contact lens down onto the cornea and began instrumenting the posterior chamber, I saw double.

I'm a bit confused with what could be causing this. I have no trouble using the slit lamp or indirect. Even with this microscope during this same case I could see fine during the anterior portion of the case.

It has been a few months since I was in an ophtho OR. I honestly don't recall whether I had troubles like this in the past (my previous retina attendings have had an assistant hold a handheld bio lens.) To say the least, it was all a bit alarming for me to have difficulty visualizing the posterior anatomy/instruments.

Does it make sense that I would have difficulty fusing the images on the posterior portion of this case with the contact lens, but not the anterior? Is it something with the microscope?

I have better than 20/20 vision and no problems with stereo that I'm aware of...

 

[Visionary]

Likely was simply an optical issue with the microscope. Supplemental heads on an operating microscope are notorious for not being properly aligned. After all, the surgeon's view is the important one. I ran into this in residency with one particular scope at the VA. The attendings had a terrible time trying to see what I was doing, because the view through the side scope was messed up. If you've never experienced similar problems, I doubt it's you.

 

[jsh1986]

Thanks for the response, Visionary!