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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
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Experience:  Eye Physician and Surgeon
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My father is diabetic. Back in April, we found him on the floor

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My father is diabetic. Back in April, we found him on the floor of his apartment. The ER stated that tests revealed a history of a minor stroke and heart attacks. It could have been more than one ministroke. He has had his eyes examined by the VA opthamologist and optometrist, and more recently a private opthamologist. They all say his Rx is correct and his eye glasses are correct. Based on examination, they all say that based on the health of the eye, there is no reason why he cannot see but he cannot see. The last opthamologist has yet to get back to us. He is trying to obtain tests results from the hospital ER to see if the scans reveal any reason. My father contintually complains he cannot but he seems to have spells of reading. He uses a magnifier. What could be causing this? Is it psychological? What should they look for?
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. James replied 4 years ago.
Hello,

Is your father able to get navigate around the house?
Has he had a visual field test?
Was he unconscious when found on the floor?
Is the vision poor in both eyes?
Customer: replied 4 years ago.
He in the VA nursing home and he can wheel himself from his room. He sees shapes and he can determine who he is talking to but he says he cannot see the television or read, that his sight is blurry. He has had a visual field test but not sure what the results were. He was conscious when we found but was there for 24 hours. He did fall quite a bit but never knocked himself out (so he says). He was in diabetic shock when we found him. Yes, he says it is blurry in both eyes but an exam reveals them to be healthy and no reason why he can't see.
Expert:  Dr. James replied 4 years ago.
Loss of vision can occur at any point along the visual pathway from the eyes back to the brain. The function of the eye seems to be normal per the doctors who have examined him. They would have picted up on cataracts, wrong glasses prescription, or retinal problems if they were present.

With him found in diabetic shock, I would be concerned for the functioning of the optic nerves or the part of the brain that deals with vision. Diabetic shock or coma occurs in people who can be severely dehydrated and thus cause limited blood flow to the optic nerve or brain. An MRI would be useful to make sure there was not stroke in the brain. Damage to the optic nerves are more difficult to assess as it would not be seen on MRI. To assess optic nerve damage a automated visual field is very helpful or a manual tangent field is his vision is very poor.

The best doctor to figure out the reason for his vision loss would be a neuro-ophthalmologist. It is also possible that it is psychological, but with his history, his vision loss is likely real.

It was a pleasure helping you with your question and best wishes. Feel free to ask any additional questions. Remember to press the green accept button.
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
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