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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: 2412
Experience:  MS Ophthalmology with 13 years of surgical expereince
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I have had problems with Rt eye pain and Rt side headaches

Resolved Question:

I have had problems with Rt eye pain and Rt side headaches for several months--also noticing Rt eye bulging, especially on the nasal side (which is increased with head down positioning), and blood shot appearance. I had a retinal detachment in the Rt eye approx 7 yrs ago, underwent vitrectomy 2X, also have a sceral buckle in place in that eye. The eye pain and headaches have resulted in at least 2 ER visits. During 1 of these, it was found that the buckle extruded in 1 spot--this was repaired last Sept, but symptoms above persist. I use 3 different drops and Diamox for pressure in that eye (ranging from mid 20s to 40s when the buckle extruded). I am under the care of a retinal surgeon who I see every 3-4 months and who is aware of the symptoms, but aside from the pressure and the buckle issue, no other investigation has been pursued. I have a pituitary adenoma treated Bromocriptine, but am otherwise healthy. Are there certain options/investigations I should discuss with the surgeon or with my GP? Thx
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 5 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 :

Is your retinal surgeon aware of the new symptoms of bulging of the eye, which increases on bending down?

Customer:

I have told him about the bulging, but I have only recently noticed that it increases with head down positioning

Dr. A.S. Desai :

How was the diagnosis of a pituitary adenoma made- CT scan/MRI scan? Were visual fields tested by perimetry?

Customer:

it was diagnosed approx 30 yrs ago--have had both CT and MRI over the years, but nothing in past 10 yrs or so--have had regular visual fields done--no problem with those--I have very limited vision Rt eye secondary to the ret detach

Dr. A.S. Desai :

Any noticable bulge in an eye is called proptosis. First this has to be differentiated from pseudo-proptosis which canbe seen in case of high myopia/ shallow orbits.Though it is normal for very mild bulging of eyes on bending forward or on holding the breath , it is significant if it is obvious or more visible.

Customer:

it is quite noticeable at times--not necessarily when I experience pain

Dr. A.S. Desai :

Since you have had raised intraocular pressure(IOP) in the right eye, along with a scleral buckle, these could be attributed to the present signs. But apart from this probablity, thyroid profile has to be checked as it is one of the commonest causes for proptosis ( thogu bilateral it can begin in one eye initially).

Dr. A.S. Desai :

"though"

Customer:

would the thyroid issue be best followed up through my GP?-I see the surgeon agin in May

Dr. A.S. Desai :

You can discuss with your surgeon about the thyroid profile test and ultrasound of the eye ( it is a safe and non-invasive test) which can contribute to form a diagnosis. Yes, your GP should be able to help you with the thyroid test.

Customer:

can a buckle slip?

Dr. A.S. Desai :

Not so common since it is sutured firmly to the sclera.

Customer:

plan to follow-up with GP office for investigation and with surgeon for scheduled visit in May--will also have pressure checked again at optometry office.

Customer:

thank you

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