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Dr. Stan
Dr. Stan, Ophthalmologist
Category: Eye
Satisfied Customers: 2701
Experience:  Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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I have intermitted blurred vision and everything goes extremely

Customer Question

I have intermitten blurred vision and everything goes extremely fuzzy and I feel very distant and foggy with poor concentration when it happens.n I also seem to have difficulty with some depth perception when I park. I think I am up to the curb and I am 2 feet away. I have trouble seeing print on the menu and print seems much darker to me. But my vision is 20/15. My sugar is fine, I use drops for dry eyes, though I dont have dry eyes, I am very tired all the time and have to push myself but all my bloodwork is normal and my vision test is good. I have also been checked for a tumor in my head and artery in my neck but it is negative also. I can feel something is wrong though.

Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Stan replied 6 years ago.
Hello,

Welcome to Just Answer:

It appears that your eye muscles intermittently loss accommodative/focusing strength due to your lack of energy. The intermittent fatigue of the eye muscles is likely contributing to tis problem. To address your fatigue problem, I suggest that you consider evaluation for narcolepsy, fibromyalgia and/or chronic fatigue syndrome. For your eye fatigue, in addition to using preservative free tear drops, such as Refresh or Genteal, I suggest that you consider re-checking your eye for new prescription. Talk with your eye doctor about starting you on Restasis eye drop for normal and better tear formation.

Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances. Narcolepsy can cause serious disruptions in your daily routine. Narcolepsy is a chronic condition that doesn't go away completely. Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Modafinil (Provigil), a newer stimulant, isn't as addictive and doesn't produce the highs and lows often associated with older stimulants. Some people need treatment with methylphenidate (Ritalin).

Fibromyalgia or Chronic fatigue syndrome: There's no specific fibromyalgia or chronic fatigue syndrome treatment. In general, doctors aim to relieve signs and symptoms by using a combination of treatments, which may include - Changing your sleep habits may be enough to help you start getting restorative nighttime sleep. But if techniques such as sticking with a regular bedtime, skipping daytime naps, and avoiding substances such as caffeine and alcohol don't help, your doctor may prescribe a short course of sleep medication.

Some of the medications which have been used include tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) may help. Antidepressants may also help improve sleep and relieve pain. Commonly prescribed antidepressants include amitriptyline (Amitid, Amitril), desipramine (Norpramin) and nortriptyline (Aventyl, Pamelor). SSRIs include fluoxetine (Prozac, Sarafem), paroxetine (Paxil) and sertraline (Zoloft).

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Customer: replied 6 years ago.

 

I have no trouble sleeping. When my head hits the pillow I am out. I teach dance and get pleny of excercise and I do get very tired during the day but I dont need to sleep during the day I do however have to close my eyes frequently as I am tired more so than usual. My sugar is normal on the glucose tolerance test though when I eat starches I get more sleepy but I can eat sweets and it won't effect me.

I also have my right eyelid a little droopy and the eye dr said maybe at night my lid

is flipping up and staying opened....not sure but the lid is saggy where the other side is not. Do you think it could have anything to do with adrenal system at all and if so, what kind of dr should i seek since the general physician cannot figure it out?

Expert:  Dr. Stan replied 6 years ago.
Hello,

Thank you for your reply:

It appears that you have ptosis (droopy right eye lid). This can be caused either by floopy eye lid (flipping), but considering the other symptoms of tiredness and intermittent fuzzy/foggy vision, I suggest that you request for your eye doctor to exclude Mysthania Gravis (a disorder of intermittent decrease in the chemical that stimulate muscle contraction) as the cause of this problem. This can be established by testing for antibodies for acetylcholine receptors and performing the edrophonium (Tensilon) test. The disorder can be often associated with tiredness. I suggest that you follow-up with an ophthalmologist, especially the oculoplastic specialist. The eye doctor should evaluate you for possible blepharoplasty to correct the problem.

Please, feel free to clarify any further question(s). I'm here to assist you to your satisfaction.

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Customer: replied 6 years ago.

The eye doctor did do a test where he injected a dye behind the eyeball and was not too concerned but he did see a little bit of pressure in the eye...

Is that the test needed for what you are describing or if not, how would they test for that?

Expert:  Dr. Stan replied 6 years ago.
Hello,

Thank you so much for your reply.

No, this is a completely different test. You had was fluoroscein angiography to check for fluid leakage from the tiny blood vessels at the back of your eye.

Please, feel free to clarify any further question(s). I'm here to assist you to your satisfaction.

Please, allow me get credit for my time and effort in assisting you and press the ACCEPT button for this assist. I will be glad to answer additional questions until you are satisfied. Thank you so much.

A Positive Feedback and/or Bonus is welcomed and appreciated.

Please note that this answer is for information only. It cannot be substituted for the visit to or the recommendation of your doctor.
Customer: replied 6 years ago.
so what kind of test will they do for that?
Expert:  Dr. Stan replied 6 years ago.
Thank you for your reply.

This can be established by testing for antibodies for acetylcholine receptors and performing the edrophonium (Tensilon) test.The Tensilon test will test whether your eyelid is raised and not stay droopy with trace amount of Tensilon medication. The other is a blood test to detect the antibodies which block the action of the chemical that help the muscle function.