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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10893
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Granddaughter had a physical for the Navy.The internist said

Resolved Question:

Granddaughter had a physical for the Navy.The internist said she had an eye tic.She has never been diagnosed with this but, she gets nervous when someone goes toward her eyes. She had her regular eye Dr. and another eye exam-and bothDrs. said she does not have a tic disorder or a tic. She took both exams to her recruiter and the copies were sent to the main corporate headquarters.Today her recruiter said she was denied due to the tic. I'am a Neuroscience nurse and would like an opinion where we should go from here.? Thank you for you time and expertise.
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 :

I do not do heart attacks and internal medicine doctors should not do eyes........

Customer:

I thorougly agree with you. What do you think we should do from here?

Dr. Rick :

From what you are telling me, first of all, your daughter has nothing wrong with her that should keep her from doing an excellent job in our Navy. I would bet that what is going on with her is called myokymia.

Dr. Rick :

Myokymia is an involuntary, local twitching of a few muscle fibers in the body of a muscle. This twitching, if it occurs in a limb, is not strong enough to actually move a joint but can be felt and sometimes seen as an area of quivering.

Myokymia commonly involves the eyelids and muscles around the orbit. It often appears and resolves for no apparent reason and has not been linked to any underlying significant pathology. What causes myokymia? Studies have shown that it is associated with anxiety, stress, lack of good sleep, high caffeine intake and the use of some drugs.

The best way to treat myokymia is to get more sleep, decrease caffeine intake and decrease stress. The good news is that myokymia is not a sign of serious underlying pathology and often resolves on its own.


 

Dr. Rick :

I just can't understand why, with two other physicians (were either of them an ophthalmologist?) saying that she is OK why the main recruitment office is not letting her join. It just doesn't make sense.

Dr. Rick :

Here is a very good article on this topic:

Dr. Rick :

http://emedicine.medscape.com/article/1213160-overview

Customer:

I too think Brittany just got nervous. Both Drs. that examined her were optometrists.She was trying for the second opinio to be done as quickly as possible.

Dr. Rick :

That, most likely, is why the main office didn't give their opinion much weight against the word of a (completely out of his field) MD internal medicine doc. If they will still allow her to appeal her case she should see an ophthalmologist....maybe a neuro-ophthalmologist just to bring out the big guns....and see what the recruiter says to that.

Dr. Rick :

Does this make sense?

Dr. Rick :

I would also hold off on a second navy physical until she has seen an Eye MD for an opinion on this mystery twitch.

Customer:

I will read the article you suggested. your thoughts were also mine. I too think a Neuro-opthalmologist is in order. Thank you so much for your expert opinion. It is amazing when someone who is so eager to serve her country is getting the run around.

Dr. Rick :

That is just what I was thinking.....Don't we want and need young people in our Armed Forces?

Dr. Rick :

I wish your daughter the best of luck.

Dr. Rick :

 


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Expert:  Dr. Rick replied 5 years ago.
Let me know if there are there any other concerns or issues you would like to discuss on this topic.
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