Ask an Eye Doctor and Get an Answer ASAP
Hi. I'll be happy to help you with your question.
Did your vision return to normal each time and was it 100% no light perception?
Yes, it returned to normal. Sorry, I'm not sure what you mean by 100 percent no light perception?
blind. Can't see to the sides, center etc, at all with that eye....as if you were in a deep, dark cave
I could not see anything but blackness. A blackness I have never experience before. It was terrifying. No light what-so-ever.
Any discomfort associated with the episodes? And it was only in one eye, the other one is fine, correct? Also, what medical problems do you have and what meds do you take? (sorry for all the questions.....)
The explanation you were given makes no sense to me at all, to put it kindly.
There was no discomfort. I had no sensation of pain. The explanation makes no sense to me either. I was shown a computerised image of my eye. I have been assured that my eye, both to the front and the back, is perfectly healthy and normal.
complete blindless associated with photostressing (shining a bright light in you eye) is very rare. I've never seen it. It could, possibly be associated with some type of global rod/cone dysfunction, optic nerve damage or macular disease.
I don't mean to be nasty, but in a case like yours an optometrist wouldn't know normal if it reached up and bit him. I wish you were in the US, your condition is very interesting.....how far are you from Moorfields eye hospital or one of their branches?
I am in Edinburgh. We do have an Eye Hospital and, now that I know the Optometrist is not the expert I thought she was, I will ask to be referred, and quickly, to the Eye Hospital.
You really need a complete workup by an experienced team of ophthalmology sub-speciality experts. I don't think it needs to be done on an emergency basis since things seem to have been gone back to normal, but I would try to have a referral in the next week or two.
I hope I've been able to help some. If you would be so kind as to press 'accept' I would appreciate it. I will be happy to continue to answer questions until you are happy with the result. Also, I know this is a lot to ask, but when you find out what the problem is, could you drop me a note on this site?
Thank-you. I very much appreciate your comments and advice. I wasn't happy with the explanation the Optometrist gave me. I suspected that she didn't actually know what the problem was.
I've been practicing ophthalmology for almost two decades and every day I learn something new......
she should have said so then.
Yes. I will get back to you. And yes, I am completely satisfied with your service.
best of luck to you and have a
Attended Eye Hospital today. I was advised (no examination done) that my problem had nothing to do with my infection. It's vascular. I am going to see my GP today to have him arrange blood/blood vessel tests.
I will update you once I have had a definite diagnosis.
I really don't think your sinus issues have anything to do with it. My desire would be for you to sit down at the slit lamp with one of the senior ophthalmologists at the eye hospital and try to reproduce your episode.
Vascular is a great thought, more so if the episode was induced by excessive eye, head or neck movement. Also, if the blood supply to your retina and/or optic nerve is very, very poor light stress could, maybe, cause temporary blindness as your retina couldn't regenerate visual pigments. If the blood flow to your eye was this bad I would expect to see other signs of ischemia such as inflammation (cell & flair), low intraocular pressure, or retinal edema/cotton wool spots. A floursciene angiogram would be the best way to diagnose such a global ischemia of your eye.
If you go blind, and rush to the A&E department there will be, in my opinon, nothing for them to do. We need to find the cause of your episodes before it gets to that stage.
Thanks for the update. I'll keep pondering your condition and see what I can come up with.
Don't think it's gonna be a brain tumor.....so now you don't have to worry, right? :)
Good job making sure they take care of you. It's not that bad in the USA yet but if our current President has his way, it may just be. Try to muscle your way into a slit lamp exam with an experienced ophthalmologist and try to reproduce your experience and/or get her to do a fluorescein angiogram with a transit of your left eye.
I've taken a note of your recommendation and I will do my very best to make it all happen. It's absolutely incredible the attention you have given me. I sincerely XXXXX XXXXX the only way I can repay you is to give you a detailed (as per the Doctors on this side of the Atlantic) medical account of the diagnosis, prognosis.
I was back at the optometrist today but there was no examination of my eye. We just had a discussion. I was informed that it was a slit lamp examination I had previously had. The optometrist has put forward the suggestion, with confidence, that the setting of the light (too bright) has had an adverse effect on the function of the rods and cones. Also, as mucus was being removed from my eye with a cotton bud at the same time as the light was in use, there is the possibility that this operation could have deflected the rays and shut of my source of vision. They are holding back from referring me to the Edinburgh Eye Hospital (Princess Alexandra Eye Pavilion) until I have had the results of my blood tests. (Blood tests Monday. GP consultation Wednesday. Don't know if my results will be back by then.) The only reason they are holding back on the referral is because they have already been pulled up by the Eye Hospital for referring patients who did not actually require their skills and expertise. They obviously feel I fall into this category. I hope they are right.
She said my eye had been bleached. I can't think of any Eye Doctor you could email or call on my behalf. I don't know any. Unfortunately, until I get referred to the Eye Hospital there is nothing I can do. Walking in of the street did me no good yesterday.
I attend 20 20 Opticians,XXXXX Edinburgh. There number when dialling within the UK is 0131(NNN) NNN-NNNN They do not have an email address.
Anyway, I will get back to you to let you know of my progress. Thank-you for your advice and concern.
Just called them. Spoke to one of the other optometrists. She is going to have ?Christy, the optometrist who has been seeing you, call me back. Well see what can be done.
How strange. I have been treated by both of the optometrists. They will ignore you.There is no way they will make a call to America. I'll phone them back to find out what you thought should be done.
Sounds like their best stills are in the arena of "the magic runaround" Let me know what I can do.
Hello. Moorfield Hospital have a help line and I called them. I spoke with a nurse who took my query (which was about the slit light being too strong and bleaching my eye [to use the optometrist's terminology] resulting in me going absolutely blind in the one eye. No perception of light in my left eye yet the right eye was okay.) and then passed it onto a Doctor. The Doctor has spoken to me and has assured me that this is normal. It does happen.
I'm glad she talked to the doctor.
I've been practicing ophthalmology since 1994 and have done fellowship work as a retina specialist and I am still not convinced by their answers. From what you have told me I just don't buy that a slit lamp can cause 40 seconds of total, lights out blindness. During the episode the least they could have done was check your pupils for a loss of reaction to light (relative afferent pupillary defect or RAPD).
I would feel much, much better if the ophthalmologist would give you a good going over and I would feel really good if you had a fluorescein angiogram at the ophthalmologists office that came back normal.
Nope, I'm not pulling your tail. I must admit, I am who I say I am and I've had the training I said I've had. You can find me listed with the American Academy of Ophthalmology (I'll be Chicago starting this Friday for our annual meeting), American Board of Opthalmology and the states in which I am licensed to practice medicine. To find me in all these places you'd have to have my last name, which I don't think justanswer.com makes available.
I'm glad you've done a lot of research. There is much to find on the internet, sometimes too much. I admit I have also gone to the AAO website and talked to colleagues in search of more information about your condition....not much else there until we have a good examination by an ophthalmologist, some basic lab tests and, perhaps, a fluorescein angiogram.
Should you so desire, let me know what else I can do for you. I would appreciated knowing how things are going and what you are learning as you battle with the UK health system.
I don't know what's wrong. Medical tests and time will tell. However, on doing my research, I did read up on rods and cone receptors and the adverse effect, as explained by the optometrist, and confirmed by the doctor at Moorfield Eye Hospital, that light can have on them. I am attending the accident and emergency Eye Department of Gartnavel Hospital (In the city of Glasgow) tomorrow and, unlike Edinburgh Eye Hospital where I was unable to see an eye specialist, I will do so there. As for not being able to give your real name? Other experts on the site are most definitley listed under theirs. I have checked. I will let you know the outcome my consultation with the opthalmologist at Gartnaval. Until then.
My apologies for not getting back sooner. I am just off to Gartnaval Hospital this morning. Unfortunately, due to unexpected events, I have been unable to go until now.
Anyway, here's what's been going on this week:
The blood tests set up by my GP have all come back negative. My ECG, again organized by the GP., showed everything to be normal.
I visited the A&E department at Edinburgh Royal Infirmary and relayed my experience to a Doctor. The Doctor told me that the split lamp examination, due to lighting conditions and the light hitting my eye at a certain angle, could produce the result I had described.
My GP told me the same but, to confirm this, phoned an opthalmologist at the Princess Alexandra Eye Hospital. Opthalmologist confirmed that this could happen.
So far, Moorfield Eye Hospital, Princess Alexandra Eye Hospital, Edinburgh Royal Infirmary, GP., and last but not least, the optometrist who originally blinded me, (I associate her with the blindness) are all in agreement that it was the light from the split lamp and possibly lighting conditions preceeding the examination, that caused my loss of vision. However, as far as I am concerned, the conculusion they have all arrived at appears to be all down to their understanding of the law of physics. None have ever had any personal/professional experience of this happening.
If Gartnaval come up with the same answer, I will have to draw a line under all this and get on with my life.
I have been advised (not that I need any Doctor to advise this) that should I lose my vision again, and if it lasts for a period much longer than my previousl experience, I should go straight to A&E.
I promise I will get back to you one I have returned from Glasgow. This will not be until late Thursday afternoon. It is Thursday, 08:50am local time as I write this.
I'm glad to hear that every test so far has come back normal and that many ophthalmologists have said such a thing can happen.....albeit without ever examining you.
It is true that the light of a slit lamp, indirect ophthalmoscope etc, can cause a period of decreased vision -- much like a camera flash. I have never seen, I have never been taught and I have never talked with any ophthalmologist who has had a patient go totally blind from such a thing. Blind, of course, would entail a pupil that does not react to the swinging flashlight test (RAPD), and where other tests show that there is no light perception at all.
My hope is that you have a complete eye exam in Glasgow today and that they can't reproduce your symptoms and everything is normal. The next best thing is that they do reproduce the event that occurred at your optometrists office and, after going over you with a fine tooth comb, find the cause......and it can be treated.
I leave tomorrow for Chicago (about aXXXXXSouth) and will have spotty internet access during the yearly AAO meeting over the next 6 days. I will check in as I can and see how things are going.
Good luck and hang in there.
Hi. I had a complete examination at Gartnaval. This time I did not go blind although everything was a bit dull for a few seconds afterwards. (Both eyes.) Opthalmologist said this was normal.
This Doctor did not accept that the split lamp was responsible for my blindness. He constantly shook his head in disbelief as I relayed my story. He said it was definitely not the light from the lamp that caused the problem and that I needed further tests to determine what had caused the problem. He has referred me to the Stroke Hospital in Edinburgh. He feels that TIA is the most likely cause.
Once I have attended the Stroke Hospital I will get back to you about the outcome of it all.
Thank-you for your interest. Enjoy your conference.
I am sitting eating a very large slice of humble pie at the moment.
Well, a normal eye exam. Not able to reproduce the event at the optometrist office? That, in and of itself, is good news.
Stroke. Could be. He, of course, didn't see anything in your eye, such as an hollenhorst plaque ( a piece of broken off cholesterol that can cause strokes in the eye) or he would have said so. Still, overall this is good news. It it turns out to be a stroke it was a small on and, by having this "warning" event you can avoid something worse.
And at least another (very intelligent) ophthalmologist thinks what your optometrist said was a bunch of BS too! :)
Looks like you are gonna get yourself an MRI, carotid doppler exams and more blood tests. Good luck and thanks for keeping my informed.
A question that no-one put to me throughout all of this was - do you suffer from visual migraines? I do and have done for about 15 years. My first experience of this took me to the A&E department. (Panic - I thought something really awful had happend.) The episode, flashing zig-zag lines in front of my eyes, lasted for about 30 minutes. 10 minutes at my work station, further 5 in the taxi, 15 minutes in the hospital. I had recovered by the time I was eventually seen by a nurse and she quickly determined that I had just experienced my first ever visual migraine. Since that day I have frequently experienced visual migraines. They are fairly regular occurances. I was a migraine headache sufferer for many years before this. They would last 3 days. Day one I could feel it coming on. Day two - had to go to bed in a darkened room. Day 3 post-migraine symptoms. Exhaustion. Day four back to normal. I have been reading up on TIA and note that migraine and TIA are hard for an ophthalmologist to distinguish between. I have also read that for optical? visual? (can't remember the correct terminology) migraines, a very bright light can initiate total blindness. I hope this is a possibility in my case. However, I will not be mentioning my migraine history to any doctor at the Stroke Unit until after I have had a scan. I am fearful of saying anything beforehand in case it might detract from this action. Given my recent experience of experts who have sent me away with the words 'this can happen' ringing in my ears, and their obvious reluctance to continue with any further investigation, I am now mistrustful of their commitment. This does not include the ophthalmologist, or indeed the nurse who first listened to my story and was possibly my entry key to the doctor's office, at Gartnaval. Should you ever visit Edinburgh and decide to call in on the Princess Alexandra Eye Hospital, you may possibly think you are in a third world country. It's a dump. I feel sorry for patients and staff alike.
I am glad you are doing such a great job of using the resources at your disposal to be involved in your health issues.
I also have a life long history of visual migraines and they should have no bearing on the episode you reported where you went totally blind at the slit lamp.
A neurologist will not be confused between visual migraines and TIA's so I I don't believe you have to worry on that account.
I'm off to Chicago in a few moments. Keep up the good work and let me know how things go. It would be great to have an answer that makes sense and can be confirmed by some solid finding,eh?
My own research has brought up an explanation that includes being exposed to bright light.
Severely atherosclerotic carotid artery may also cause amaurosis fugax due to its stenosis of blood flow, leading to ischemia when the retina is exposed to bright light.
Unilateral visual loss in bright light may indicate occlusive disease and may reflect the inablilty of borderline circulation to sustain the increased retinal metabolic activity associated with exposure to bright light.
Atheroscleric opthalmic artery - presents similar.
My GP said that in 24 years of practising medicine he had never heard of any association between a split lamp "light" and vascular problems.
Yup. You are right. This has been my number one diagnosis possibility and why I wanted you to have a complete exam looking for other signs of ischemia.
A fluorescein angiogram would be grossly abnormal if this is what is causing your problem.
Isn't the internet great? Keep up the good work and make sure the doc's listen to you.
I'm at my meeting right now sitting in a kiosk with about 10 other ophthalmologists watching me type on "their": computer.....doctors really can have an entitled attitude :)
Thanks for the update. Have a great Sunday
re your answer: 10/7/2010 - 2:50pm. (very, very poor light stress could)
The importance of a little comma.
Unfortunately I didn't read this message as it was meant to be delivered to me. Because the comma was missing after the second "very" in the sentence I read "very poor light stress could" as meaning poor lighting. It's only after re-reading your answers that I can see you the message is "light stress could".
Under different circumstances I would have picked up on this and it would have saved me days and days of internet search trying to find some connection between a bright light and the vision loss I experienced. However, at the moment I am just too stressed out.
Thank-you very much the time you have allocated me. I feel now that the time has come for me to leave you in peace. I don't think you'll need any further update on my condition because I think we both know what the cause is.
Kindest regards XXXXX XXXXX
It has been a pleasure to help you during this difficult time. I wish I could have done more. Hopefully things will work out for the best and you will be able to put all this stress behind you.
Please don't hesitate to contact me if I can be of any further service at all.
Thank-you for all your past help. You were extremely thorough. However, as I am being monitored by my own doctor, I now no longer require to ask any more questions of you.
Should you be interested - here is where I am now.
There has been no answer to the reason I went blind. The consultant cardiologist was 99.9% sure I did not experience a mini stroke. He came to this conclusion because there was a series of temporary blindness. He said that it would be very rare (actually unheard of) to have had three mini strokes.
I do have inherited high cholesterol though and am now on statins. Horrible drugs. Very high cholesterol, smoking, aged over 60, puts me at risk for a stroke. So...................... who knows.
I did write to a Neuro Ophthalmologist at Moorfield Hospital in London in the hope that he could offer some explanation. He has not replied.
I had just wondered if migraines could be behind all of this. I do suffer from optical migraines quite frequently. I have been a migraine sufferer all my life although I have had no migraine headaches for the past 20 years. Just the zigzags and shimmerings.
Since going on the statins, although this could just be coincidence, I have developed extremely dry eyes. I now have to use drops throughout the day, last thing at night, first thing in the morning. I am also aware that my eyes are not focusing as before. I do have astigmatism in one eye and that seems to have got worse.
Blood sugar test to be taken.
Kind regards XXXXX XXXXX again, thank-you.