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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2280
Experience:  Eye Physician and Surgeon
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I got new glasses in August of this year. My vision has changed

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I got new glasses in August of this year. My vision has changed since that time. I also have had a twitching underneath my left eye which comes and goes and my right eyelid does not open as wide as my left eyelid. I went to my eye doctor last week and he examined my eyes. He said that they had definitely changed but that he wanted to wait for the results of blood work which I had done in preparation for my upcoming yearly physical. My blood sugar level is normal and all the rest of my blood work is okay (except for high cholesterol). He also said that my prescription could have changed. He put drops in my eyes which dilated my pupils and examined the backs of my eyes and said everything was normal. I don't know if I am getting unduly worried, but I am wondering if some kind of brain tumor could be causing this quick change in my eyesight - or - could my prescription simply have changed? I am very concerned and would like your opinion. Thank you so much for your time.
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. James replied 4 years ago.
Hello,

Did your doctor recheck your glasses prescription?
How much change was present?
When are you scheduled to be seen again?
Is your vision poor at near and distance?
Customer: replied 4 years ago.

Hello,

My doctor rechecked my glasses prescription and said that it had changed. I don't know exactly how much change was present, but he said it was enough of a change that I would notice and that I was not imagining that my vision was worse. I am scheduled to see my eye doctor again 1 week from this Thursday. He said he did not want to do anything until he examined my eyes again to see if they had continued to change. He said both eyes had changed about the same amount. I am near sighted and my distance vision is such that I cannot read road signs especially at night and often written things on my television screen are difficult to read. When I first got my glasses I was able to see, but within the past week or two I have noticed that my vision has gotten poorer and I am not able to see as well as I did when I first got the glasses in August.

Expert:  Dr. James replied 4 years ago.
The most likely cause is progression of cataracts. Cataracts are a clouding of the lens inside your eyes. Before the lens get cloudy, however, some patient may notice and increase in their nearsightedness (termed a myopic shift). The lens may still be clear with a very slight change that can be missed on exam.

I agree with your doctor in waiting for blood testing. Checking blood sugar for diabetes and thyroid function test would be the most relevent.

Remember to press the green accept button. It was a pleasure helping you with your question. Best wishes to you. Feel free to ask any additional questions. Smile
Customer: replied 4 years ago.
My doctor did examine me for cataracts and glaucoma both in August and also last week. He said I did not have either one. My blood sugar level also came back normal. I guess my main question is this - could the problems I have explained, in your opinion, be due to a brain tumor? I am very concerned about this. Would the blood work have shown anything to indicate this and when the doctor examined the backs of my eyes after dilating my pupils - would he have seen anything abnormal if I did have a brain tumor? I guess this is what I am very anxious about - could I have a brain tumor?
Expert:  Dr. James replied 4 years ago.
Brain tumors are rare. In the absence of any other symptoms (headache, seizures, nausea, vomiting, weakness), the chances would be even lower. It is a good idea to have your ophthalmologist check your vision again to make sure it is not deteriorating at the current rate. A brain tumor would be unlikely from what you have described to me.

Please accept if my answer has been helpful.
Customer: replied 4 years ago.
In your opinion then, if my eyesight continues to deteriorate at the current rate, your feeling is that I could possibly be developing cataracts even though my eye doctor said that I did not have them? Also, you mentioned in a previous response that I should have my thyroid function checked. That was also checked in the blood work I had last week and it also came back normal. I am sorry to be such a bother, but I am very concerned about this. As far as one eyelid opening wider than the other, what do you feel is the cause of this? Thank you so much for your time and consideration. You have helped me with your answers and I am beginning to feel somewhat better about all of this.
Expert:  Dr. James replied 4 years ago.
Don't worry. You're not a bother at all. For the change in glasses prescription, my suspicion are cataracts.

Did your doctor note and pupil abnormalities?
Do you have a history of smoking?
When did you notice the eyelid abnormalities?
On the eyelid that is open wider, can you see any "white" between the colored part and eyelid when looking straight ahead?
Customer: replied 4 years ago.

My doctor did not note any pupil abnormalities - or if he did, he did not mention it to me.

I quit smoking approximately 20 years ago. I have noticed the eyelid abnormalities for some time, but really did not think too much of it. When I look straight ahead I cannot see any white between the colored part and the eyelid. However, when I open my eyes as wide as I can, there is more white above the colored part of my eye in my left eye than in my right eye. I don't know if this is helpful, but I also have astigmatism and I also wear contact lenses, however I have not worn them in well over a month. My mother died in June and I still cry on a fairly daily basis. It is very difficult for me to wear the lense after I have been crying so I just have not worn them at all since about the middle or so of August and before that I wore them sporadically.

Expert:  Dr. James replied 4 years ago.
I'm sorry to hear about the loss of your mother. A new droopy eyelid with a smaller pupil on that side can be concerning. From what you are telling me, it doesn't seem your doctor noticed any pupil abnormality.

A droopy eyelid (ptosis) can happen overtime. The muscles that keep the eyelids up can get stretched and disinsert from the eyelids. If it is bad and covers your vision, surgery is available to correct this. I suspect the eyelid asymmetry is due to this.
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2280
Experience: Eye Physician and Surgeon
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