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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7896
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have had lasik surgery, epiretinal membranes removed and

Resolved Question:

I have had lasik surgery, epiretinal membranes removed and lens replacements due to cataracts. Recently I have been experiencing frequent temporary diminished acuity and am wondering if my pupils are not adjusting to differing lighting conditions, or if there is another factor that could be causing this? Thanks
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 :

Does this occur in both eyes or just one? If in one, is it like someone is turning down the dimmer switch on your vision and then turns it back on?

Customer:

It is both eyes. I would not describe it as turning a dimmer switch down as there is no loss of brightness. Objects just become blurry with lack of acuity

Dr. Rick :

What makes it get better?

Customer:

I am not sure I am doing anything to cause improvement other than putting lubricating drops in my eyes. I was on the golf course earlier this evening when it again occurred. Now that I am indoors and have put the drops in my eyes seem to be improving. My wife looked at my eyes and thought my pupils were small for the low light we were in??

Dr. Rick :

Since you mention the persistent small pupils, that seem to slowly dilate back to normal, it is possible that you are suffering from Adies tonic pupils.

Dr. Rick :

Usually in this condition the pupils are large, but after it has been present for a time, they can become small, and get 'stuck' there.

Dr. Rick :

I would feel better if you could have an ophthalmologist give you a through going over just to make sure nothing more serious is going on. It is possible that it could also be something as minor as a tear film issue/blepharitis, or it may be a retina problem. There are a lot of conditions that could cause the symptoms you are having but, when it comes to decreased vision, even transitory, it is best to have it checked out.

Dr. Rick :

does this make sense to you?

Customer:

Does this always involve the pupils getting "stuck" when small or does it inhibit the pupils normal reaction to all lighting condisons with the pupils remaining larger when they should get smaller?

Dr. Rick :

There can be a number of different things that can affect how the pupils respond to light/dark since the innervation system that dilates and constricts the pupils is very complex. Adies, for example, just kinda affects then either dilated early on, or constricted, not so much in the middle/rate.....if that makes sense....

Dr. Rick :

What do you think?

Customer:

I have an appointment with a retina specialist for a followup to the membrane removal and will ask him about this. Are there any type of drops that could help

Dr. Rick :

No, nothing OTC. I am a retina specialist. When you go in tell the nurse you want the doc to look at your pupils BEFORE they put the dilating drops in. It is ok to put in the drop to numb your eye to check your eye pressure, but ask them not to dilate your eye. Everyone in my office is dilated when they step in the door and I bet it is the same at your retina doc's place.

Dr. Rick :

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


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Dr. Rick :

Does that sound OK to you?

Dr. Rick :

I guess you have stepped away from your computer.

Expert:  Dr. Rick replied 3 years ago.
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Expert:  Dr. Rick replied 3 years ago.

Let me know if there is anything else you would like to discuss pertaining to this issue.

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7896
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and 3 other Eye Specialists are ready to help you

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