If you define them both yes, but you're still free to use them both.
var my_var = 1
myVar += 1
echo(my_var)
Will happily compile and give you 2. I'd prefer an error in that case because while I'm not liable to make that mistake but I could easily mistype long_variable_name as long_variablename without noticing and then cause myself problems when I try to grep.
Searching has never been a problem for me in years of using Nim but there is `nimgrep` bundled for style insensitive search. Also I'm no RE wiz, but seems like RE might help if it came down it.
Just to stress myself as an anecdote though, I have years in the language and it hasn't come up yet for me, and I've never needed to use `nimgrep`.