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pippistrellodaqua
pippistrellodaqua, Optometrist
Category: Eye
Satisfied Customers: 134
Experience:  Specialty in contact lenses, medical eye management, LASIK
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Dear ophthalmologist, I have a problem with one of my eyes.

This answer was rated:

Dear ophthalmologist,
I have a problem with one of my eyes. If i look in the mirror straight on, my eyes seem perfectly aligned but if i keep looking straight ahead and tilt my head down, my left eye wanders up in a diagonal away from my nose. If i cover my right eye, the wandering eye behaves normaly.

The vision in my affected left eye seems a little blury or weaker compared to my right eye.

My question is.... are you able to tell me what this sign is called and could it be Neurological in nature?

Thanks

pippistrellodaqua :

I am happy to help you today.


 

pippistrellodaqua :

I often see patients who have concerns such as yours.


 

pippistrellodaqua :

Is this the first time you have noticed this concern?


 

Customer:

Hi, yes it has been like this for over a week


 

pippistrellodaqua :

Have you ever tried looking for this problem in the past? I want to determine, if possible, if this is truly a new concern or if it has been there for a long time and you're just now noticing it.


 

Customer:

I've never noticed it before, when i was very young i had surgery in both eyes but that is all i know. I honestly believe this to be a new symptom


 

pippistrellodaqua :

Did you have surgery for a muscle correction (or a realignment) of the eyes?


 

Customer:

yes


 

pippistrellodaqua :

It may be a new problem, but if you had muscle surgery when you were younger I strongly suspect that this problem has been there for a long time. In almost every case I've ever seen of strabismus (eye turn) which has been corrected at a young age we will almost invariably still see some misdirection of the eyes.


 

pippistrellodaqua :

This misdirection can increase when looking in different positions of gaze.


 

Customer:

my eyes have been fine for many years up until now. I've had reason to suspect multiple sclerosis in the past but that is a long story


 

pippistrellodaqua :

Your ophthalmologist or optometrist will perform a test called a cover test and he should do it in 9 different positions of gaze to see if the deviation you are describing only occurs in up gaze (when you tilt your head down) or if it happens in other positions as well.


 

pippistrellodaqua :

The most important question I have is do you notice double vision at any time?


 

Customer:

whilst looking in the mirror the only direction i had problems with was straight up


 

pippistrellodaqua :

Do you notice double vision when looking up?


 

Customer:

i don't have double vision but i'm under the impression that i only look with the good eye


 

pippistrellodaqua :

Good. It is rather normal to suppress the image from the deviated eye. You've described it accurately.


 

pippistrellodaqua :

The absence of double vision is a very good sign.


 

pippistrellodaqua :

Without an examination it would be impossible to rule out with certainty a neurological condition such as MS


 

pippistrellodaqua :

But, I suspect this problem is a remnant of your strabismus from a young age.


 

pippistrellodaqua :

I will be available to answer any follow-up questions you may have.

Please don't forget to offer a positive rating once your question has been answered fully.

Also, please note that the information here does not replace an examination and should be used as educational purposes only.


 

Customer:

i understand that it would be impossible to tell without an eye exam but asuming that my problem isn't post surgery related. is this kind of problem ever seen in ms or is it different?


 

pippistrellodaqua :

MS could manifest as an eye turn. It often does. Double vision, however, is almost universal. If it were MS it would likely go away within a few days or weeks. We would not be able to diagnose it as MS on the first occurrence and it would have to return for it to be MS. In MS we usually have an inability for the eye to move outwards, which is opposite of what you are noticing. It is certainly worth obtaining an examination, but from what you have described everything points to your surgery.


 

Customer:

Good answer, thanks for your time


 

pippistrellodaqua :

You're very welcome. Please don't hesitate to contact me again if further follow-up questions arise. Please consider leaving a positive rating for this answer. Thanks again.


 

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