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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
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I have had a black/grey half moon come up on my left eye -

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I have had a black/grey half moon come up on my left eye - five times now in past 3 weeks; also one of double vision that lasted about 4-5 min. What could be causing this?

Does the black/grey half moon come down like a curtain then disappear? or is there all the time?
What was the result of the carotid ultrasound?
Do you have any vision problems?
What other medical problems do you have?
Customer: replied 7 years ago.

It starts at the bottom and possibly covers half the eye - lasts around a minute or so - 5 occurences in last three weeks.

The ultrasound turned out ok - slight plaque but not enough to do anything.

I can tell my eyes have changed - that eye has torn retina so I am a little used to things waving around in the eye, but this was different - was solid and came up from bottom.

No other vision problems - good eye examination few months ago. Lenses did not need change.

I have had many surgeries, have aorta valve replacement (porcine), shoulder replacement, spinal fusion, diabetes (2) take glyburide, and thyroid cancer - gland removed in 1966 - long time ago - on levothyroxine for that.

The symptom you are describing is called amaurosis fugax. The plaques of your carotid artery is likely flaking off small bits into the blood stream. When it travels into the eye, it temporarily impedes blood flow and causes the half-moon grey that you see. This same process can happpen if pieces go to your brain and impedes blood flow to specific parts of the brain, causing numbness, weakness, slurred speech. In this case, it is called a TIA (transient ischemia attack).

The symptoms are concerned because it can lead to a stroke. That is why your eye doctor was so concerned. Because of your heart history, your doctor may also order an echocardiogram to check for clots to see if that may be a cause of your symptoms. Your primary care doctor will discuss your risk factors for stroke and put you on the appropriate medicines.

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.
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Thank you for the feedback.

To answer your question, surgery is not always the best option. There is a risk of stroke during the surgery as well, so you have to weigh the benefits of the surgery. If the blockage is minimal (less than about 60-70% usually), then medicines can help stabilize the plaque to lower the risk of a stroke rather than risk surgery.
Customer: replied 7 years ago.

Is this also the reason for the 'seeing double' - before the double vision, I could feel a pull across my face - possibly from eye to eye. It was like elastic being pulled. I gather that this is the same problem as the black spot?

I thank you for answering so soon - and your clear explanation.' but we kinda forgot about the double vision - I am assuming that the cause is the same - except for the pull I felt.

Did you have the double vision along with the grey vision?
Do you have double vision now?
Customer: replied 7 years ago.

No, it had that a couple days ago - only the one time, but it lasted about 4-5 min. (so it seemed). Funny part is I thought I would look in a mirror and see if I would be seeing something weird in the mirror - that would explain the greyh/black - and all I saw were 4 eyes - it was wierd. Has not happened again - (this was 5 days ago). I have had the grey-black again at dinnertime - seemed larger.

Thank you for answering again.

It is likely related. The blood flow to the muscles of your eyes can also be impeded and cause the eyes to be misaligned -- resulting in your double vision. If you are having increasing frequency of symptoms, you should notify your primary care doctor.
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Customer: replied 7 years ago.

Dr. James, - I had my mri yesterday and late afternoon my internist's assistant called and said' everything is ok,' brain and blood flow' ' I asked what my next step was - she said, she didn't know what the problem was so went to the dr., and he said go to my opthalmologist - who was the one who sent me to my internist. I have appointments with both the end of this month. The carotid artery exam was done by opthalmologist who said, slight plaque, but not a bad problem.

So - I don't know why I should go back to either one - evidently I don't have to do anything. I had the black/grey once on Fr. and that has been the only time in past week. Maybe it will all disappear.

Thank you for the update. You should ask your internist if he suspects your visual symptoms are due to emboli. If so, the next step should be an echocardiogram to make sure there are no clots in your heart as the source of your emboli.

If you have not have recent blood work, then I would recommend lipid tests and CBC (complete blood count). You internist may consider starting you on a daily aspirin. If there is a confirmed clot in your heart, then you may need to be on a blood thinner such as coumadin.

If the grey is persistent and still there, you should notify your ophthalmologist for a repeat eye examination as there may be limited blood flow to your retina.

Edited by Dr. James on 10/10/2009 at 5:07 PM EST
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