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Ask Dr. A.S. Desai Your Own Question

Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2139
Experience:  MS Ophthalmology with 11 years of surgical expereince
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In my left eye, when I look to the left, I can see a brown

Resolved Question:

In my left eye, when I look to the left, I can see a brown ring in my vision whilst focusing. what is this?
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 3 years ago.

Dr. A.S. Desai :

Hello, Welcome to Just Answer

Dr. A.S. Desai :

Are you available for chat now?

Customer :

yes

Dr. A.S. Desai :

Since how long has this symptom been there?

Customer :

about three weeks

Dr. A.S. Desai :

Is the brown ring large or more of a small spot?

Dr. A.S. Desai :

Does it kind of move along with the eye movements or is it specifically seen only when you look to the left?

Customer :

it is large, and i can see clearly through it. It changes size, depending on where I am focusing.Once in a position it appears to fade.

Dr. A.S. Desai :

Ok.

Dr. A.S. Desai :

The plus point here is that the vision is pretty normal in both eyes inspite of this symptom. It appears to be a floater which is most often seen in posterior vitreous detachment.

Customer :

it also has a small spot to one of the edges ( within the ring)

Dr. A.S. Desai :

Let me just briefly explain this condition.

Customer :

i have a vitrectomy in the eye 3 years back, could this still happen?

Dr. A.S. Desai :

What was the indication for the vitrectomy?





Customer :

pregnancy related retinopathy - i have been told there is no active retinopathy only six weeks backs

Dr. A.S. Desai :

ok

Dr. A.S. Desai :

Were you detected with diabetes ?

Customer :

i have had my fair share of floaters in the past, this is not like a floater at all

Customer :

yes i have had diabetes 25 years - type 1

Dr. A.S. Desai :

ok

Customer :

could this be early catarract symptom? I am told I will get one post surgery but it is in its earliest stages of growth. Just wondering if its advanced, and this is what I can see?

Dr. A.S. Desai :

Yes , I was just going to suggest this possibility.

Customer :

is this a common symptom?

Dr. A.S. Desai :

Post-vitrectomy there is always a high risk of developing cataract.

Dr. A.S. Desai :

Not exactly.

Customer :

I have also had a whiplash injury 12 weeks ago , could this affect the focusing on my eye. I am of course very worried.

Dr. A.S. Desai :

But some cataracts begin in the periphery of the natural lens and cause such symptoms especially when indoors.

Dr. A.S. Desai :

Have you had an eye exam after the whiplash injury?

Customer :

In this regard, I have also had black shimmering / flashes in the left eye, usually light sensitivity induced, which is intermittant.

Customer :

yes, there was no damage to the retina, seen by my opthalmologist

Dr. A.S. Desai :

Have you experienced any headache along with the flashes of light?

Customer :

the ring appeared afterwards however

Dr. A.S. Desai :

Is the ring seen only while focusing near or is it obvious even for distant vision?

Customer :

no headache, MRI brain scan normal and EEG normal, Working diagnosis is opthalmic migrane with regards XXXXX XXXXX I have, however, not seen my opthalmologist in the last 6 weeks, so am worried about the flashes

Customer :

its obvious for near what I would call, middle vision, as I can only see it from the corner of my eye, it doesnt affect close up work

Customer :

I cant see it looking straight ahead, and it appears more with focusing than when my eye / head is still

Dr. A.S. Desai :

Ok. So as we evaluate your symptoms and past clinical history one by one, let me assure you that you can ease down for now. The most probable cause for your flashes of light is ocular migraine( the headache may not be very prominent). As for the brown ring in the periphery of your vision , I would suggest a slit lamp exam by an ophthalmologist to check out for any progress of cataract in the left eye. The other concern would be for proliferative diabetic retinopathy but in your case it is less likely since your last eye exam has revealed a normal retina( and retinopathy cannot develop overnight). Glaucoma is another condition in which such a symptom can be experienced but I guess it would have been a constant feature and even seen at any gaze.

Customer :

the pressures in my eye are normal, so i assume that would rule out glaucoma?

Dr. A.S. Desai :

Yes.

Customer :

and again, if there was no active retinopathy at my last examination, that is unlikely?

Dr. A.S. Desai :

Yes , as I did mention , diabetic retinopathy will take years to progress.

Customer :

can i just ask finally, can a whiplash type injury accelerate a catarract growth, and specifically you would not have cause for concern that the flashes are linked to the retina. I am also wondering if the flashes/shimmering could be linked to the growth of a catarract

Dr. A.S. Desai :

No, the flashes of light are usually seen in migraine, conditions with retinal traction such as vitreous or retinal detachment . I would not corelate it to the formation of cataract.Any injury to the eye can accelerate a cataract in the eye.

Customer :

can a retina still detach after vitrectomy. please pardon my ignorance.

Dr. A.S. Desai :

In your case I would not say the risk of retinal detachment is high as it would have had to be of diabetic origin ( tractional retinal detachment) which is more often seen in long standing diabetic retinopathy.

Dr. A.S. Desai :

And moreover after vitrectomy , the risk arising out of vitreous traction is also reduced.

Dr. A.S. Desai :

By any chance do you have any lid problem such as a tiny stye/ raised swelling on the upperlid?

Dr. A.S. Desai :

In the left eye?

Customer :

bit of swelling on lid as compared to right eye

Customer :

was also very sore and tender around eye after injury , although I didnt hit the eye, this has now gone

Dr. A.S. Desai :

Ok. If the swelling has disappeared then none of these are related. In that case I believe a routine eye exam by your ophthalmologist would be confirmatory for any progress in the cataract. As your vision is good, it is likely to take long to progress if at all. ( traumatic cataracts differ from each other based on the nature of injury- some progress rapidly say within months while some remain stationary).

Dr. A.S. Desai :

Do you have any follow up questions?

Customer :

i thank you for your time and explanations, it has been reassurring. Just out of curiosity, with my left upper eye lid still being swollen, is this any concern?

Dr. A.S. Desai :

No not a thing of concern, but I was actually wondering if it is kind of putting pressure on your left upper lid during left gaze thus causing the symptom of a brown ring to appear( as it is seen only on left gaze). Which is why I asked for any presence of lid swelling.

Dr. A.S. Desai :

You can apply warm compresses to reduce the swelling and if persistent , can take oral anti-inflammatory tablets for 3-4 days.

Customer :

blood flow to the optic nerve is normal, as seen by MRI. Could it possibly be some damage/ swelling in the neck, affecting the eye or eye muscles.

Customer :

thank you for advice re swelling.

Dr. A.S. Desai :

No , wouldn't think in terms of any damage to the neck/eye .

Customer :

Thank you for your time and patience , it has been very beneficial and reassurring as I have been extremely worried particulary with my history.

Dr. A.S. Desai :

You are most welcome.

Dr. A.S. Desai :

Thank you and best wishes

If you are satisfied with the answer , please press the accept button so that I get my dues.

A bonus and positive feedback are welcome.

Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2139
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you

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Dr. A.S. Desai
Dr. A.S. Desai
Eye Doctor
2139 Satisfied Customers
MS Ophthalmology with 11 years of surgical expereince