How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8326
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
48069651
Type Your Eye Question Here...
Dr. Rick is online now
A new question is answered every 9 seconds

Overnight, the eye has gone to the side (wall eyed)

Customer Question

My 52 year old, otherwise healthy brother has had a lazy eye since birth. Overnight, the eye has gone to the side ("wall eyed") and he cannot regain focus. He has himself convinced that he has had a mini stroke, but is asymptomatic except for a noticeable loss in equilibrium. He has a doctor phobia, but has scheduled an appointment at the eye doctor's.
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I can help you tonight.

Dr. Rick :

Does he have any medical problems or take any medicine? Can you have him follow your finger, with one eye at a time, up, down, left, right and then both eyes together and see if his eyes move normally?

Customer :

No, he is 6 feet tall, 190 pounds, active. He in on no meds. The lazy eye that has gone "wall" cannot follow the finger lead. He sometimes can bring it back to the center but has limited focus in that right eye.

Customer :

Are you with me? I'm here and have answered your questions.

Dr. Rick :

It is possible that he has had an ischemic event to the nerve that runs the muscle in that eye.

Customer :

Can you explain ischemic?

Dr. Rick :

Make sure he has an appointment with an ophthalmologist and not an optometrist.

Customer :

He will see the opthamologist.

Dr. Rick :

It is like a vascular stroke, but not like what you think about in the brain but rather somewhere along the course of the third cranial nerve. Is his eye a little droopy on the affected side?

Customer :

Yes, but since it's been "lazy'''

Customer :

oops... it is somewhat droopier than usual.

Dr. Rick :

If the lid is droopy and the medial rectus muscle is weak that would be consistant with a partial third nerve palsy. A complete eye exam will be able to fully evaluate if this in indeed the case. In any event he needs to be seen. When is his appt?

Customer :

Hopefully, tomorrow.

Dr. Rick :

Ok. That is good.

Dr. Rick :

Can you tell if his pupil is larger on the affected side?

Customer :

As for the up, down , left, right finger exam..is there something indicative in those movements that he should be aware of ahead of time?

Customer :

I'm not sure about the pupil.

Dr. Rick :

No. I was just having do a quick partial ocular motor function exam....

Customer :

I will see him again shortly...what should I look for with the pupil size?

Dr. Rick :

ok. Sometimes the pupil is larger, sometimes not, sometimes it is hard to tell....The ophthalmologist will check his pupil function closely.

Customer :

Is a nerve palsy correctable? I know what Bell's Palsy is.

Dr. Rick :

yes, but in the case of third nerve palsy, it is important to find the cause. In the majority of cases it is just a minor microvascular event that resolves on its own, in some cases it is things more concerning like an aneurysm in an area of the brain called the circle of Willis.

Customer :

Is the loss of equilibrium normal?

Dr. Rick :

I have seen it in a few cases where the problem was microvascular in nature, but I would have to say that loss of equilibrium does not normally accompany the other signs of a third nerve palsy.

Customer :

Is third nerve palsy consistent with the lazy eye problem or is it just an anomaly?

Dr. Rick :








Dr. Rick :

It is not related to his underlying lazy eye problem....just happened to occur in the same eye....

Dr. Rick :

still there?

Customer :

Yes...just recalling the info to see what else I need to ask before signing off

Dr. Rick :

ok. You can print this out for future reference too...

Dr. Rick :

While you read let me send you this message:

Dr. Rick :

And, now, the obligatory word from our sponsors: :o)


I hope that this information was helpful for you. 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 very much.

Customer :

He has no pain, just the dizziness. Would I be safe in cautiously reassuring my "doubting Thomas" brother that has not suffered a TIA or a cerebral stroke? He is fearful and will be extremely uneasy until he gets it officially checked out.

Dr. Rick :

Yes, it is to reassure your brother that he has not had a TIA or a stroke. As I said the vast majority of these things resolve on their own with no long term problems. I am glad that he will be seen by an ophthalmologist tomorrow....Keeping him resting easy is the best thing for him at this time.

Dr. Rick :

He's lucky to have a sister like you to help him out. Have a great holiday season and I hope things turn out for the best.

Customer :

Thank you very much...you have been extremely patient and helpful!

Dr. Rick :

my pleasure. Have a good evening.

Expert:  Dr. Rick replied 3 years ago.
What Happens Now?

Your chat has ended, but you can still work with your Expert to get an answer to your question if you have not yet received one.

Come back to this page at any time to see additional information from your Expert.  You will also receive an email when your question is updated.  If you want to send a message to your Expert, use the box below.

If you have already received a satisfactory answer to your question, click the Accept button above.  Experts are credited for each accepted answer they provide.
Expert:  Dr. Rick replied 3 years ago.
k

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
< Last | Next >
  • http://ww2.justanswer.com/uploads/DoctorDanB/2010-6-7_6228_just_answer_profile_picture_60_pixels.jpg Dr. Dan B.'s Avatar

    Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
  • http://ww2.justanswer.com/uploads/anupamadesai/2010-04-13_122313_Dr._A.S.Desai_new_photo.jpg Dr. A.S. Desai's Avatar

    Dr. A.S. Desai

    Ophthalmologist

    Satisfied Customers:

    1903
    MS Ophthalmology with 11 years of surgical expereince
  • http://ww2.justanswer.com/uploads/gsokoye/2009-10-28_181751_Dr._Stan.JPG Dr. Stan's Avatar

    Dr. Stan

    Ophthalmologist

    Satisfied Customers:

    895
    Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
  • http://ww2.justanswer.com/uploads/eyemd/2009-04-07_180315_pic.jpg Dr. Stevens's Avatar

    Dr. Stevens

    Ophthalmologist

    Satisfied Customers:

    629
    Board Certified Ophthalmologist
  • http://ww2.justanswer.com/uploads/CO/CorneaDoc/2012-2-18_0390_photo6.64x64.jpg Dr. Susan's Avatar

    Dr. Susan

    Ophthalmologist

    Satisfied Customers:

    217
    Board Certified & Fellowship trained eye surgeon.
  • http://ww2.justanswer.com/uploads/neuph94/2009-10-11_164729_gif_pic.GIF Dr. JP's Avatar

    Dr. JP

    Ophthalmology, Oculoplastic Surgery

    Satisfied Customers:

    28
    Harvard Medical School, Massachussetts Eye and Ear
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjcufyksv/2012-3-13_44825_crop3.64x64.jpg Dr-Trace's Avatar

    Dr-Trace

    Board Certified Ophthalmologist

    Satisfied Customers:

    26
    Board Certified in General Ophthalmology
 
 
 
Chat Now With An Eye Doctor
Dr. Rick
Dr. Rick
Eye Doctor
8326 Satisfied Customers
Ophthalmology since 1994 with Retina sub-specialty interest