PDA

View Full Version : A Problem with My Eye



Donnie B.
2010-Nov-09, 05:09 PM
Maybe this should go into the "rants" thread, as I know I can't rely on medical advice even from the Mighty BAUTers. Still, I wouldn't mind hearing others' thoughts about my situation.

For at least the last two years I've had problems with my vision, which first manifested as trouble with reading -- after some time I just had trouble seeing the page well enough to continue reading. The problem got progressively worse -- less time reading before it got bad. Eventually I recognized what was going on.

It turns out that after close work, reading or working on the computer, I develop double vision in one eye.

Needless to say, that's pretty weird. Most diplopia is "binocular", where the images from the two eyes don't merge right. But if I cover my right eye, I see a double image with the left eye alone.

I've been through a succession of doctors, starting with an OD (optometrist) and culminating yesterday with a retina specialist (MD ophthalmologist). Various things have been tried without success, most of which were attempts to reduce the eye strain that seems to trigger the problem. No joy.

Yesterday, the specialist suggested a diagnosis: Epiretinal Membrane. This is a condition where the vitreous material pulls away from the surface of the retina, leaving a space that gets filled with junk, which can produce an uneven, puckered surface that distorts the image.

I have some reasons to doubt that diagnosis, however. First, there's no explanation for how the condition could change over time as it does. Most mornings I wake up with no double vision at all. It's only after close-focus work (e.g. reading) that the problem is triggered. An epiretinal membrane would be there all the time, I would think.

Second, online resources describe the symptoms of ERM as "distortion", not double vision. For example, straight lines are seen as curved or blurred. But that's not what I see. Lines in a grid are perfectly straight and sharp, but the horizontal lines are doubled (the second image is always displaced vertically).

So even though there is some empirical information that suggests ERM (including an OCT test that shows an uneven surface in that eye, and retinal photographs that show a shadow in the macula area), I have my doubts. Things just don't seem to add up.

It seems to me much more likely that the problem is the lens, not the retina. A tiny wrinkle in the lens could produce a double image, and unlike the retina, the lens is affected by the accommodation muscles that act when trying to focus close. Unfortunately my docs don't seem to be pursuing that possibility.

I'm starting to think this may be an example of "when your only tool is a hammer, every problem looks like a nail" syndrome. What is a retina specialist most likely to find a problem with? I think I need to get at least one more opinion (which would be the fifth, counting the ODs who've looked at this).

In any case, bad as the situation is, it would have to get much worse before I would consider the rather nasty surgery that is done for ERM (look it up if you're curious and not easily spooked). The prognosis doesn't look too good for that approach.

Any BAUTers care to comment? One thing you don't have to tell me 'cause I already have it figured out: getting old(er) is no picnic.

grapes
2010-Nov-09, 05:21 PM
Not only is it not a picnic, it's not a subsistence diet

But I will think about the eye thing, I think I may have experienced it myself a few times.

Buttercup
2010-Nov-09, 05:25 PM
Wow, sorry to know it. :( I can't offer any advice or suggestions. Never heard of double vision in one eye before. :confused:

Hopefully you'll get the answers and solutions you seek soon.

Trebuchet
2010-Nov-09, 06:00 PM
Wow. I went through Posterior Vitreous Detachment (http://en.wikipedia.org/wiki/Posterior_vitreous_detachment) in my right eye about a year ago. That's the condition of the vitreous pulling away from the retina as you describe. Having read your story, I covered my left eye and looked at the screen. Double vision, with the fainter image displaced vertically. I had no idea. I'm overdue for a visit to the ophthalmologist anyhow, this cinches it. I'll let you know if I find out anything interesting.

Swift
2010-Nov-09, 06:03 PM
I have nothing paritcularly useful. Your idea that the "plumber" sees everything as a plumbing problem sounds reasonable; it is something I've seen with other doctors.

I know that the local Cleveland Clinic has an Eye Institute, maybe there is something similar near you, that would have a broader view of the problem.

I wish you luck.

Donnie B.
2010-Nov-09, 06:10 PM
Wow. I went through Posterior Vitreous Detachment (http://en.wikipedia.org/wiki/Posterior_vitreous_detachment) in my right eye about a year ago. That's the condition of the vitreous pulling away from the retina as you describe. Having read your story, I covered my left eye and looked at the screen. Double vision, with the fainter image displaced vertically. I had no idea. I'm overdue for a visit to the ophthalmologist anyhow, this cinches it. I'll let you know if I find out anything interesting.

Well, if nothing else, I'm glad my story got you motivated to have your eye looked at. Please, if you do get any more insight (pun intended), let me know.

Donnie B.
2010-Nov-09, 06:13 PM
I have nothing paritcularly useful. Your idea that the "plumber" sees everything as a plumbing problem sounds reasonable; it is something I've seen with other doctors.

I know that the local Cleveland Clinic has an Eye Institute, maybe there is something similar near you, that would have a broader view of the problem.

I wish you luck.

Yes, we have this very well-regarded institution: http://www.masseyeandear.org/

I may try to get a referral to see someone there.

Trebuchet
2010-Nov-09, 06:44 PM
I wonder if it's some sort of refraction thing with the back of the vitreous no longer in contact with the retina? The whole PVD thing was a major scare for me as I have a lot of history of retinal problems in my family, including four near relatives with RP.

Donnie B.
2010-Nov-09, 07:18 PM
I wonder if it's some sort of refraction thing with the back of the vitreous no longer in contact with the retina? The whole PVD thing was a major scare for me as I have a lot of history of retinal problems in my family, including four near relatives with RP.

That would certainly be scary. My exams did not show any sign of detachment (either retinal or vitreous), and I have not had any of the symptoms like a sudden increase in floaters (I've always had lots of those anyway) or flashes of light. I am highly myopic, though, so I'm prone to such problems.

Trebuchet
2010-Nov-09, 08:13 PM
Yeah, I had major floaters with the PVD. Still have them, actually, I've just learned to ignore them. Had the flashes of light, too.

You say your exams didn't show detachment but in your OP you describe this:


Yesterday, the specialist suggested a diagnosis: Epiretinal Membrane. This is a condition where the vitreous material pulls away from the surface of the retina, leaving a space that gets filled with junk, which can produce an uneven, puckered surface that distorts the image.

The vitreous pulling away is PVD, so at least according to this specialist you may well have had it.

chrissy
2010-Nov-09, 08:40 PM
Hi Donnie B. I am not sure if you can get this link but I think you should read through it all. http://www.eyehelp.co.uk/DoubleVision.html

Donnie B.
2010-Nov-09, 09:50 PM
The vitreous pulling away is PVD, so at least according to this specialist you may well have had it.

Dang it, I considered saying something like "unless that shadow around the macula really is ERM" but omitted it for brevity. And naturally, you nailed me. Ya jerk! :)

Donnie B.
2010-Nov-09, 09:54 PM
Hi Donnie B. I am not sure if you can get this link but I think you should read through it all. http://www.eyehelp.co.uk/DoubleVision.html

Thanks for the link, Chrissy. The pertinent section there refers to cataract as a possible cause, but none of my exams so far has found any cataract. However, if it does turn out that I'm developing same, at least the treatment is less scary than the retinal peel they do for ERM. These days, lens replacement is pretty routine, but has the downside of destroying any remaining capacity for accommodation (changing focus).

chrissy
2010-Nov-09, 10:13 PM
You are welcome, I was also thinking it could be eye strain, I find my eyes suffer when I am reading in bad light or being on the PC for long periods, I have good eye sight but I have glasses when my eyes start feeling the strain.