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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7853
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Have pressure in one side of face and around eye. Vision is

Resolved Question:

Have pressure in one side of face and around eye. Vision is not right. Ear ring worse than usual. No nasal discharge. Dr. sent to an eye doctor and eyes are OK.
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. Are you available to chat?

Customer:

Yes

Dr. Rick :

hi


 

Customer:

sorry about my delay - hi

Dr. Rick :

Were you examined by an ophthalmologist (eye MD) or an optometrist?

Dr. Rick :

No problem :)

Customer:

Yes and no problems

Dr. Rick :

What is it about your vision that is not right?

Customer:

3 days ago suddenly I had shimmering around the edge of my right eye vision. This went away and now I have a darken away from my focal point and feel pressure below my eye.

Dr. Rick :

How long did the shimmering last?

Customer:

About 1 hour

Dr. Rick :

Ok. I know exactly what is going on. And, good news.....you will be OK.

Dr. Rick :

 


What you are describing is consistent with ocular migraines, a condition that I not only treat in my office but that I have been dealing with personally for decades.


A typical migraine headache starts with shimmering lights, often times they surround a blurry area or have dots or jaggedly lines associated with them. They tend to progressively increase in intensity and sometimes march across the visual field causing difficulty with reading. Many times this is then accompanied by nausea, irritability, sensitivity to bright lights and/or loud noises. After the onset of the lights (called scintillating scotomas), the headache typically starts and the light show tends to progressively go away.


Many people can have this migraine phenomenon WITHOUT the headache; it is called an acephalgic migraine. Some people even start having these late in life, or may have had a few much earlier in life that behaved differently and haven't had any for decades and then begin to have them; this is not uncommon. A family history of migraines is often present as well.


This is nothing to worry about. It is not a sign of a more serious underlying condition, brain tumor or anything like that. If the episodes become so frequent that they are bothersome there are medicines that can be used to decrease their frequency or stop an episode once it has started.


I, personally, have been suffering from this condition for almost 30 years. I almost never got the headaches after the visual effects.


There was one time, I was in the middle of a very delicate retina operation, when an attack started. After a few moments I lost most of my central vision and the inferior part of my visual field. I, calmly, removed my surgical instruments from the patients eye and we all sat around in the OR for 15 minutes until my vision returned. Other than that my ocular migraines have not really caused me any significant problems :o)

Dr. Rick :

Does this address your concerns?

Customer:

This has been said. But I have had it for 3 days which is uncommon.

Dr. Rick :

You have had the change in your central vision for 3 days, is that what you mean?


 

Dr. Rick :

Is this in one eye only?


 


 

Customer:

No I feel pressure under and around my eye and still have the darkening vision away from my focal point. It has lasted 3 days since the on set of the shimmering (that went away).

Customer:

Just one eye

Dr. Rick :

Ok. Could you tell me a little bit more about this darkening that you have away from the focal point in your one eye?


 


If you took a clean piece of paper out of your printer and made a 1/4 inch dark circle in the center of the sheet with a pen and then, with just the affected eye open, looked at the spot from about 14 inches away, where on the sheet of paper (without looking away from the spot) is this dark area?

Dr. Rick :

use inches from the center and clock degrees, like two inches toward 3 oclock, shaped like a pear

Customer:

About at the 8 inch mark all the way around and getting darker the further out you go.

Customer:

4 inches from the center

Customer:

My vision in tat eye is also not clear


 

Dr. Rick :

Does it change with blinking?


 


Are you blind in this space or can you see but it is just different. Try looking at the spot on the page and moving the tip of your pen into the affected area. Can you see the pen?

Customer:

Ok - I jsut noticed while reading your reply that at the center of the screen I could read as I follow to the right and left it gets blurry - I cannot read it

Customer:

And eys I can identify the pen

Dr. Rick :

does it seem like there is a curtain across the left side of your vision?

Customer:

Yes not eys

Customer:

Nothing that is sudden just just gradual

Dr. Rick :

OK Well, this is not just a migraine......the persistent vision loss is very unusual and needs further workup.

Customer:

At one focal point I can read moving my head up (read down). I move my head down and it gets blurry

Dr. Rick :

I would suggest going to a different ophthalmologist. I would like to see a complete eye exam done with an extended evaluation of the retina in your affected eye.

Customer:

I was thinking it was pressure from my sinus cavity. Could that be?

Dr. Rick :

You may even benefit from a formal visual field test and, possibly fluorescein angiography.

Dr. Rick :

Nope. The pressure feeling you are having, as well as any issues with the sinus would not do this to your vision,.

Customer:

I am in the middle of moving (with family) house to house 1,200 miles. Is this urgent or can it wait a week?

Customer:

I have had melanoma. Could this be a tumor. I have ankylosing spondylitisand take humari.

Dr. Rick :

Where was your melanoma? What stage? Nodes? How long ago?

Customer:

Left shoulder. It was stage 3. They took out nodes under neith my arm. I have followed up with no more signs. About 2 1/2 years ago.

Customer:

Sorry satge 2. It was not in my nodes.

Dr. Rick :

It could be a melanoma but, as you know, melanoma's usually show up in the liver first.


 


I was wondering which part of your statement was wrong :) Glad it was stage 2

Customer:

OK does this require urgent treatment or can it wait. With AS I am used to living uncomfortably.

Dr. Rick :

I would rather that things be checked out sooner rather than later, but since you just had a complete eye exam by a MD and if your vision stays stable a week should be OK.


 


But have a low threshold for getting right in.....does this make sense to you?

Customer:

Yes - I would rather get treated than wait. I will get treatment/examed only if it gets worse in the mean time.

Dr. Rick :

Sound like a good plan. Have a safe move and enjoy your new home and location.

Dr. Rick :

Please remember the top 3 ratings are positives and Excellent service is my goal. Your positive feedback is how we are compensated. If you aren't 100% satisfied, just click "reply." I will be happy to discuss your issue in more depth and do everything I can to provide you with the information you require.


Otherwise, a high positive rating is very much appreciated, bonuses are great, and find me anytime for follow up.



Let me know if you have further questions.

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7853
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Rick replied 1 year ago.
Hi Charles,

I was just thinking about you today and wonder how your eye is doing and how the move went. I hope your vision has improved and the new location works out well.

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