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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10903
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I had cataract surgery in my left eye and after three months

Resolved Question:

I had cataract surgery in my left eye and after three months I am experiencing intermittent loss of vision in that eye for brief periods. the vision gets either very blurry,, or very light overall image with faint objects, or the whole scen is grey and not clear. Lately I now experience some faintness and dizziness when the eye phenomenon occurs.
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.

Dr. Rick :

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

Dr. Rick :

It sounds like you may be experiencing Amaurosis Fugax

Dr. Rick :

Amaurosis fugax is the transient loss of vision in one eye. It has many causes and, in the early 1990's, a study called the Amaurosis Fugax Study Group defined and grouped them to help with diagnosis and treatment of this problem.


 


What can cause AF? It can be due to an embolism, problems with the blood, problems with the eye itself or, sometimes due to no cause we can figure out (idiopathic). I would be happy to go through all the different diagnostic possibilities in each of these categories but I don't think that is the best use of your time.....you need to know what to do.


 


AF is a symptom that something serious is wrong. It can be a warning that you are heading toward a dangerous vascular event such as a TIA, stroke or even death. It is important for you to see your ophthalmologist and possibly your internal medicine physician ASAP. What will they do? A complete history and physical, a complete eye examination, maybe a fluorescein angiogram of your retina, laboratory tests, possibly ultrasound of your carotid arteries or an CT/MRI of your head.


 


Treatment depends on what is found on the above workup.


 


I can not stress enough the need for you to be seen for a complete exam as soon as possible.


 


 

Dr. Rick :

Does this make sense to you?

Dr. Rick :

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


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Dr. Rick :

Oh...Hi. Welcome to chat.

Customer:

OK I understand and that is sort of what I thought the next appropriate action should be rather than simply assume that the problem is simply from the cataract operation.

Dr. Rick :

You are correct. I suggest you see an ophthalmologist as your first stop.

Customer:

Those are wom I have been seeing almost every week and noone has suggested going for any of the fuirther exams other than the sending me to the retinalogist last Friday.

Customer:

I have been regularly going back to the original surgeo who performed the cataract operation.

Dr. Rick :

I am a retina doc.....she will point you in the correct direction. I'm surprised that multiple ophthalmologists (MDs) didn't do a workup on you...

Dr. Rick :

You problem will not rest with a primary retina issue......

Customer:

Are you saying that I shold go back to my regular surgeon and ask him what further to do, or just go to my regular doctor and bring him into the pictuire

Dr. Rick :

I don't think going to your eye surgeon will be of any benefit....he already has his turn at bat... I'd keep the appt with the retina doc as she will do a complete evaluation and will do any necessary workup. Regular MDs really aren't much help in this condition unless consulted by the eye doc for specific test or evaluations.

Dr. Rick :

Did you mean that you have already been to the retina specialist?

Customer:

i ALREADY SAWE THE RETINALOGIST LAST FRIDAY AND WAS TOLD THERE WAS NOTHING WRONG WITH MY RETINA

Dr. Rick :

Ya. I believe that. A retina problem will not,as I said, cause your symptoms.

Customer:

At that time, I did not associate dizziness with the loss of vision, I suspected it over the weekend, and feel today that it is definitely hapening when the vision loss occurs

Dr. Rick :

You need a carotid doppler, cardiac echo, cbc/esr/c-reactive protein to start. Since you don't seem to be getting much help with the docs you've seen, ask your primary care MD to do the tests. She can look up the entire workup for amaurosis fugax in any medical reference. Sorry you aren't getting much help from the docs you've already seen

Dr. Rick :

You've already had the complete eye exam part of the workup :o)

Customer:

I called the surgeon while we were chatting and he is now sending me a prescription for an MRI which I will act on right away.

Dr. Rick :

A MRI is nice.....but not the first test I would order.

Customer:

He previously did not know about he dizziness since I was not reallyclear that it was happening with the loss of vision

Customer:

Which test would you start with

Dr. Rick :

You might just tell him you have talked to a retina specialist who thought you might benefit from a work up for Amaurosis Fugax

Customer:

will do, I will call him back

Dr. Rick :

carotid doppler and cardiac echo, along with the blood work I mentioned above.

Customer:

OK will do

Customer:

thank you for the advise

Dr. Rick :

You may not have this, and since I've never examined you your doc has the upper hand on me....but if you were my father and called me from out of town and told me what you have this is what I would suggest. Make sense?

Customer:

Yes it does, it certainly does not hurt to rule out possibilities rather than ignore them

Dr. Rick :

Truth.

Customer:

I am also going to speak with my regular doctor who is my cardiologist also.

Customer:

Thanks again, now I ahad better get the process started.

Dr. Rick :

my pleasure.

Dr. Rick :

It is now safe to press that Pretty Green Button so that my poor, starving, barefoot, daughters can buy new shoes and, once again, feel safe from the mean, nasty snakes, as they walk through the tall grass.


 

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