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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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A new question is answered every 9 seconds neurologist (MRI, optic nerve test: no tumors..inflammation

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Hi, I have been experiencing the following symptoms since a few months: difficulty to focus my eyes (nearby and faraway), sensitive eyes, double vision (but only for seconds), 'jerking' vision (tiny left-right movements of what I see), while my eyes are not moving. i tried covering one eye, but this does not help. My eye doctor did not find anything wrong (extensive tests done), neither did my neurologist (MRI, optic nerve test: no tumors, no sign of inflammation). I have a history of migrane and visual migrane without headache but this is very different from what I experience now. The visual symptoms can last from 10 minutes to hours to days. Seems to be stronger in the morning (about 30 minutes after I get out of bed) and mostly subsides towards the end of the day. Sometimes days or even two weeks can go by without symptoms. I wear glasses - they were just checked and still OK. I find it difficult to read and drive the car, since the vision is so unsteady and the symptoms are tyring.
I look forward to your answer,

Welcome to Just Answer: I sorry about your difficulties. I may not be able to provide you with solution or cause your problem considering the extensive testing and evaluation the you have gone through already. However, I can suggest few things to help reduce your symptoms of nystagmus and focusing difficulty.

1. The fact that the symptoms are worse in the morning and subsides in the evening suggests a relationship to difference in the body level of stress hormones in the AM and PM. Since the stress hormones are more in the AM, it is possible that your doctor can consider the use of anti-anxiety medications such as Buspar, low dose propanolol to reduce adrenergic flow and hence reduce your symptoms. In addition, your doctor could also evaluate you with tests to determine the imbalance hormone, including 24-urine cortisol, catecholamine metabolites and 5-HIAA. However, you should discuss such option with your eye doctor, preferably neuro-ophthalmologist.

2. It is also likely that you are experiencing eye cornea exposure at night causing increased irritation and sensitivity of the cornea nerve and hence worsened symptoms in the AM. So, I suggest that you use over the counter Genreal gel or Lacri-lube gel at bedtime to reduce dry cornea and/or irritation in AM. In addition, if the pain-killers are narcotics, then there is higher chances of dry cornea. In that case, I would even suggest that you use preservative free tear drop 4 times during the daily, and the gel at bedtime.

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