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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8059
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I had cataracts removed in June 2010.Since then I have had

Customer Question

I had cataracts removed in June 2010.Since then I have had repeated contact with my eye doctor. My eye would not not dialate fully so they used a tool to manually expand my
pupil. Repeated tests show nothing but I have a very dark spot(vision) to the left of my pupil. It is especially apparent at night when I drive. Also the same pupil remains partially
dialated. My corrected vision is 20-20 in right eye but is only 45 in my left. Any suggestions?
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Let me first address the pupil issue. It is very common for the pupil to no longer come down as small as it used to after being dilated mechanically for cataract surgery. At this point I would wager it will stay the way that it is right now for the rest of your life.

Dr. Rick :

Concerning the dark spot in your visual field that you notice, especially when driving at night. Does it always seem to be in the same relative spot in your visual field? Have you ever had an amsler grid test where you look at a grid of lines on a piece of paper using your reading glasses? If so, does this spot show up on that test?

Dr. Rick :

What tests have you taken to better evaluate this dark spot?

Customer :

I have had that test and no it doesn't show up. The test I have had are all mechanical taken

Dr. Rick :

Ok. Well, the most definitive way to map an elusive macular scotoma (small blind spot in the central 10 degrees of vision) is with a focal ERG. This is usually done by retina specialists and University Ophthalmology programs.

Dr. Rick :

does this spot affect your ability to read using just the affected eye?

Dr. Rick :

I can see that you are typing. That means either, you are typing a lot, or the system is frozen.

Expert:  Dr. Rick replied 3 years ago.
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Expert:  Dr. Rick replied 3 years ago.
The chat system froze up. We can continue here using Q&A...it is like text messaging.
Expert:  Dr. Rick replied 3 years ago.
Also, if the you have only had this evaluated by an optometrist I would see an ophthalmologist first before going to a retina specialist or a high powered University program. I am sure that one of these specialists will be able to come up with some information on the spot you are seeing and, hopefully, have a solution for it.

Does this make sense to you?


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.

Positive Feedback and/or Bonus is welcomed and appreciated.

Are there any other concerns or issues you would like addressed on this topic? If so just drop me a note and we can continue our discussion.
Customer: replied 3 years ago.
Thank you for the suggestion. I will try that. It is so frustrating to try to explain it and get and not get a bonafide answer.
Expert:  Dr. Rick replied 3 years ago.
My pleasure.

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