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Old 12th Aug 2017, 01:50   #1 (permalink)
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Sudden Loss of Vision.

Youngest offspring, 22 years old, had excellent vision. Woke up a week ago and could not see clearly out of his left eye.

Went to an optometrist the next day and was told they would prescribe glasses as he was severely myopic. When he told us what the optometrist had said we insisted he get a second opinion and a referral to a specialist. He saw a doctor and got the referral.

Yesterday he got a second opinion from another optometrist who said he actually had severe astigmatism and they would make custom glasses.

Today he saw an ophthalmologist who said he could see nothing wrong with the eye but as he had drops for this examination he'd need to do more tests (without the drops) and he was unwilling to suggest glasses or anything until he actually understood what is happening. (Sounds like a sensible guy.)

Son is away counselling at kids camp for next week and will see the ophthalmologist again when he gets back.

It is all very worrying and I wondered if anyone else had an experience like this or has a suggestion?
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Old 12th Aug 2017, 02:28   #2 (permalink)
 
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Acanthamoeba Keratitis is a nasty possibility. I would ask the ophthalmologist soonest if he is satisfied it's not.
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Old 12th Aug 2017, 09:51   #3 (permalink)
 
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Keratitis would be easily diagnosed by an ophthalmologist, and it would be painful to the patient.
The good news is that there is no obvious damage or disease in the physical structure of the eye.
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Old 12th Aug 2017, 10:26   #4 (permalink)
 
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Sudden loss of vision should be an immediate visit to A & E. It could mean a detached retina that needs immediate surgery.
Glad to hear that it doesn't apply in this case.
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Old 12th Aug 2017, 10:41   #5 (permalink)
 
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When I had this it was vitreous detachment.
Big hospitals have a separate A&E for the eyes.
Go there immediately.
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Old 12th Aug 2017, 11:06   #6 (permalink)
 
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The same thing happened to my wife a few years ago. After many trips to doctors etc it was discovered that she had a congenital condition where by the pressure in her head was regulated properly and put increased pressure on her optic nerve, which in turn resulted in vision loss. The medical name for it is pseudotumor cerebri.

We go to a specialist every few months for check ups and it is treated by taking a medicine similar to blood pressure pills. In severe cases it can be treated with surgery to put in a splint in the brain, but that is a last resort treatment.
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Old 12th Aug 2017, 12:11   #7 (permalink)
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Went to an optometrist the next day and was told they would prescribe glasses as he was severely myopic.
You see the bewildering incompetence (I was going to say, ignorance but bit my tongue - mostly.) one is up against when something out of the ordinary occurs. That symptom required the immediate attention of a specialist.

However, there are a few things that might be the cause that are readily treatable. Some that are not treatable are no more than tedious and tend to go away. But, properly researched, it must be.

Vitreous detachment sounds nasty but is readily operable. I can imagine it causing reduced vision but mostly presents a lot of floaters which can be very obstructive. Sometimes there is a moon crescent flashing in the peripheral vision as the eye 'pans' L&R.

A huge change in prescription? This is where I go off solid science and suggest spasm in the extraocular muscles. The trouble is, getting anyone to believe your suggestion.

I could write 2000 words on the problem but can only find a few, perhaps two, reliable papers on 'Focusing the eye with extraocular muscles'. One researcher points out that there are 12 times as many nerve fibres in these muscles compared to skeletal muscles. He is convinced they are the prime mechanism used by the brain to focus the eye. The cornea and then the interocular lens do the rest. In that order.

It happens that very recently, following the complete dismissal of the notion while in conversation with optometrists, that there was a complete slamming of doors on the idea. This was true of one very pleasant surgeon.

I idly googled the subject that night and the results astonished me.

Why this line of logic? One eye, no known cause. Major fluctuation in focus - get someone to explain that!


One link between the two. When the brain is trying to look around a mass of floater debris, it can I am convinced, start to manipulate the eye's focussing.

There will usually be a feeling of tightness on an eye being held in an unusual state of focussing.


I'd be willing to call you and put forward a lot more information if later today you're still worried.
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Old 12th Aug 2017, 15:16   #8 (permalink)
 
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Where are the degree doctors in all this?

google is just enough to scare the hell out of you with or without cause
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Old 12th Aug 2017, 17:04   #9 (permalink)
 
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I've had hangovers like that ..
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Old 12th Aug 2017, 17:30   #10 (permalink)
 
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I think the thing that would worry me is the sudden onset of the problem. I know nothing at all about the eye, but would be worried if something suddenly changed for no apparent reason.
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Old 12th Aug 2017, 17:54   #11 (permalink)
 
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May I suggest a blood test for diabetes (possible type 2) my niece encountered similar symptoms..
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Old 12th Aug 2017, 20:09   #12 (permalink)
 
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Originally Posted by Loose rivets View Post
Vitreous detachment sounds nasty but is readily operable.
As in "I can operate if you really insist, but I really don't recommend it, as that operation tends to accelerate the progress of cataracts".
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Old 12th Aug 2017, 21:38   #13 (permalink)
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Thank you all for your replies.

We have a week's hiatus to do some research while he is at camp.

Yes, I find it extraordinary that 'professionals' faced with something unusual are apparently incapable of thinking beyond their speciality, almost as odd as them not wanting to know everything around their particular training area. I have seen the same thing in other professional areas too.

One possible is Accommodation spasm. The ciliary muscles go into spasm. I will forward the possibility of extra ocular muscle spasm too.

Blood pressure and diabetes are regular considerations and we will make sure he is checked for them but I would think that as they are regular causes for eye problems they would have been checked as a matter of course. There's no family history that presages this.

As it was an 'instant' thing I have hopes it will restore naturally but we will chase it down. On of our other sons had Bell's Palsy which resolved over three weeks or so. We have been here before but this time is a bit more worrying.
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Old 12th Aug 2017, 23:08   #14 (permalink)
 
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Sorry to hear of the problem, and of course I can add nothing to any diagnosis, but sadly the experience only confirms what I am experiencing more and more these days -and was probably always thus, but in earlier days there was less opportunity to contrary information, so one accepted what one was told, but now, ask 3 people and get 12 answers, so exactly how does one gain definitive , accurate, advice ?
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Old 12th Aug 2017, 23:22   #15 (permalink)
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Better, perhaps, than the trusting thoughtless acceptance of poor advice we used to have.
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Old 13th Aug 2017, 01:55   #16 (permalink)
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Quote:
One possible is Accommodation spasm. The ciliary muscles go into spasm. I will forward the possibility of extra ocular muscle spasm too.
Quote:
The effect of contraction is to decrease the diameter of the ring of ciliary muscle. The zonule fibers relax and the lens becomes more spherical, increasing its power to refract light for near vision
So often folk get this the wrong way around. If the issue is focus, it would be very helpful to be sure which way the eye is miss-focussing. Sudden worsening qualifies the patient to a free check-up. The high street optician probably would be able to tell which way the error is. The lens can't be over 'shortened' since one can not push a piece of string, so if the lens had gone ultra short focus, it would have to be something else. Presumably the eye's pressure has been checked, though glaucoma shows no symptoms, let alone distorting the shape of the eye.

As mentioned, in one paper, the author has the eye being shaped as the primary first stage. I would imagine this would settle down during one's lifetime to a steady shape.



The logic on the ramble below is just old records of my vitrectomy etc., etc. While I was awaiting the cataract, I suffered a 'crushing' tension of both eyes which got worse and worse over several days. My focus went from 20/20 or better to crap.

LSS, I went to a surgeon I knew who just turned his back on me. I paid for another one - two visits. No help at all. I spent a day in a dark room which made it better, only to feel it tighten up after half an hour of TV.

We drove to Dedham and had tea with friends in exquisite surroundings. A swan we knew well came and preened herself right beside us. It would have been like Heaven if my eyes hadn't ached so. On the way home the Rivetess braked hard for a pheasant. I kind of reacted too. For a moment the tension eased completely, I mean totally switched off, though came back slowly. It was then that I realised what was happening. This tension loop had been diverted for a moment, following exactly what had happened to my neck muscles 20 years before after a judo injury. That was miserable and wound up every day for weeks but was the clue I needed. Valium had switched that off back then, and I based the logic on that. The funny thing is, it's as though once the game's up the brain doesn't seem to repeat its misguided correction more than a couple of times.

I asked my GP for some Valium for 'diagnostic purposes'. 5mg and 30 minutes later, the eyes relaxed and the focus came back. It was later thought that the brain was trying to see around the nuclear cataract and was multi-lensing - a high speed switching using different parts of the lens. If huge amounts of extra-ocular muscle correction was being put in this would account for the crushing sensation and the major miss focussing.



Quote:
As in "I can operate if you really insist, but I really don't recommend it, as that operation tends to accelerate the progress of cataracts".
Yep, that's a given. There is one surgeon in the US that reckons that he can obviate this miserable reaction by the way he replaces the water. Not known here.

The eyesight in my left eye was ruined. I went from AME's frequently saying things like, "You're better than some of the young chaps just starting." to a huge great black blob swinging about dead centre. My right eye was showing lesser symptoms. Something had to be done.

Why both? Well, I'd rubbed my eyes vigorously during a psychology experiment at my son's house. He hadn't asked me to but I was telling him, a professor of things like this, about when I was a kid I could create wondrous green cubes - all rotating mechanically - while rubbing my eyes. I was about 4 years old and could still do it c 8 years old. I would guess I did the damage while trying to replicate the phenomenon - though it didn't show up for a day or so.

FROM OLD MEMORY. The vitreous humour is contained in a membrane with only 7 attachment points. That membrane is so thin .7micron IIRC, that for a long time it was thought it didn't exist. Anyway, it does, and one of the anchors is near the optic nerve area.


It's about here that I always mention Col. Stapp subjecting himself to 47g 'His eyes are engorged with blood.' Eyes are incredibly tough - up to a certain age.

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Last edited by Loose rivets; 13th Aug 2017 at 02:17.
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Old 13th Aug 2017, 05:28   #17 (permalink)
 
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I get "silent migraines" with no pain, but first there's a twinkle and then it's like a drape gets pulled over one eye. I can't see from it. Scared me so much the first time. It happens when I'm fatigued or extra stressed.

Do get several opinions.
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Old 13th Aug 2017, 06:06   #18 (permalink)
 
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Like somebody above said:
Sudden loss of vision = trip to emergency department.
Not horsing around with some optometrist or technician, or consulting the WWW.

Yes, this is a medical opinion.
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Old 13th Aug 2017, 06:29   #19 (permalink)
 
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Originally Posted by obgraham View Post
Like somebody above said:
Sudden loss of vision = trip to emergency department.
Not horsing around with some optometrist or technician, or consulting the WWW.

Yes, this is a medical opinion.
Hear Hear.

And, yes, this is another medical opinion.
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Old 13th Aug 2017, 10:18   #20 (permalink)
 
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Originally Posted by rjtjrt View Post
Hear Hear.

And, yes, this is another medical opinion.
And it's what you get told if you call NHS Direct. And when you get to A&E you're at the top of the list - if they then decide it's not that urgent (ie minutes and hours) you're told to come back to tomorrow morning's clinic.
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