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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8493
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I got a black eye with no apparent trauma on Thursday and now

Customer Question

I got a black eye with no apparent trauma on Thursday and now my eyelids appear droopy. My vision is fine and no pain
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

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

Dr. Rick :

When you say that your eyelid appears droopy, does it seem to be due to the black eye/swelling or does your eye lid appear not to be functioning properly?

Dr. Rick :

Do you have any medical problems or take any medication?

Dr. Rick :

I see that you are offline. I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)

Expert:  Dr. Rick replied 2 years ago.

We have been experiencing technical difficulties with the chat system. Please allow me to retype my chat here for your review:


Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick : When you say that your eyelid appears droopy, does it seem to be due to the black eye/swelling or does your eye lid appear not to be functioning properly?
Dr. Rick : Do you have any medical problems or take any medication?

I look forward to your reply.
Customer: replied 2 years ago.

I take synthroid & detrol. No aspirin. I am healthy - jog 3x week.

Customer: replied 2 years ago.

Both eyelids are droppy

Expert:  Dr. Rick replied 2 years ago.
Thank you for that extra information.

Are both eyelids involved in the bruising?

When you look up, do your eyelids block your vision, or do they move out of the way like normal?

Are you able to gently relax your eyes and have your eye lids close completely or is there a gap?
Customer: replied 2 years ago.

Only one eye is bruised - the left one - both are drooping - the right more - I can close my eyes completely

Customer: replied 2 years ago.

My vision is not blocked

Expert:  Dr. Rick replied 2 years ago.
Ok. That means that the innervation and function of the muscles of your eyelids has not been damaged.

Would it be possible for you to upload a picture of your bruising? You should be able to attach it to this thread but, if that doesn't work, you can do it this way:


Save your picture on your computer, someplace easy to find it such as your desktop.
Go to www.tinypic.com
Upload your picture to the site tinypic.com by browsing for it as directed.
This opens up files on your computer. Double click on the picture you want to upload then hit open (bottom right of the screen). This will take you back to the tinypic page. Hit "upload now" then do the secret code thing and your picture will upload into the system.
Once you do that it gives you a bunch of links you can use, one of which says "direct link for layouts" It is important to use this box. It is the forth one down from the top of the page.
Copy the link from inside this box and then paste it into your justanswer dialog box and send it to your expert.


As they say: "A picture is worth a thousand words" (and that saves a lot of typing ;-)
Customer: replied 2 years ago.

Customer: replied 2 years ago.

I couldn't save the picture as you stated - but I saved & sent you in the reply box - hope you got it.

Expert:  Dr. Rick replied 2 years ago.
That image didn't come though. If you are on a MAC or other Apple system our computer doesn't play well with apple products yet :(

Do you mind trying the tinypic site?
Customer: replied 2 years ago.

http://i45.tinypic.com/2n04q2t.jpg

Expert:  Dr. Rick replied 2 years ago.
Got it! Let me take a look. Be right back :)

Expert:  Dr. Rick replied 2 years ago.
That is a great picture.

From what I can see, and from what you have posted, it looks like a fairly significant hematoma that has not caused damage to your eyelids or eyes.

Now. The big question. Why did this happen?

In most cases we never find out. As long as you are not having bruising in other areas of your body or any evidence of bleeding, no workup is needed at this point.

This bruise, however, will take a few weeks to resolve and will changes all sorts of colors while it does so. (

At this time, I do not think that you need to go to your MD for a complete clotting workup. The best thing to do would be to just give this bruise time to resolve on its own and come up with a good story on how the "other guy looks" to tell your friends :)


Does this answer your question to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8493
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 2 years ago.

I have to say that you missed the boat on my eye - the dropping eye was the biggest problem. I have seen an opthalmologist & a neurologist. Both seem to think that i have occular myathenia gravis - so off for more tests. I guess I didn't ask more questions related to the droopy eye.


Thanks for checking in again.


 

Expert:  Dr. Rick replied 2 years ago.
Deborah,

Thank you for getting back to me. I wonder why the bruising occurred? That is not something that we see in ocular MG.....

Sorry to have missed the boat on your condition but, I'm sure you can understand with internet "chat" as my only clinical diagnostic tool, I am somewhat handicapped when it comes to diagnosing medical issues -- especially complex ones like ocular MG complicated by spontaneous hemorrhage.

If you don't mind, I would be very interested on how your workup proceeds and what you final diagnosis is.

I wish you the very best.

Dr. Rick
Customer: replied 2 years ago.

Hi


I certainly understand that you were limited by just my words and picture of my eye. The hemorrhage is clearing up.


The ophthalmologist performed an ice test on the eye - he said it was a primitive test for occular MG - my eyelid did respond. The neurologist felt by exam that it seems that I do have occular MG.


I had blood work yesterday - to be followed by CT scans.


I guess the good thing is that the black eye made me look more closely at my eyes.


Will keep you posted.


I

Expert:  Dr. Rick replied 2 years ago.
Tensilon is usually better then the ice test.....I have used them both and, I will admit, the ice test is faster,safer and easier.

I look forward to hearing from you.

Customer: replied 2 years ago.

The ophthalmologist said it was the first time he had used it and it was positive. I could definitely see the difference.

Expert:  Dr. Rick replied 2 years ago.
If the ice test was that positive then your chances of having MG is fairly high. If your doctor elects to do further testing, I would expect you to have antibodies to Acetylcholine receptors as well, although single fiber EMG is the best indicator for MG in my clinical experience, especially if the eyelid is involved/tested.

I wish you the very best, Deborah and I look forward to hearing from you again.

Have a good weekend.

Customer: replied 2 years ago.

Thanks! Have a Happy Thanksgiving!

Expert:  Dr. Rick replied 2 years ago.
My pleasure. Have a happy Turkey Day too!
Customer: replied 2 years ago.

I am not sure if you were asking about my eyes again - I don't see a message - so maybe I am missing something. FYI- I don't have any of the results back - the eyes remain the same.


Thanks again!

Expert:  Dr. Rick replied 2 years ago.
Hi Deborah,

Nope. I didn't send you an new message -- must be the Gremlins who live in the Machine :) but it is good to hear from you anyway.....

Let me know what your tests show if you have a chance. Have a great day.

Go Pack GO! (I live in Wisconsin and just couldn't help myself, lol!)
Customer: replied 2 years ago.

Thanks for responding - I live in Michigan - so not much rooting for the Lions!

Expert:  Dr. Rick replied 2 years ago.
At least the Lions get first draft choice pick a lot..... lol!

It was blast being at the game today :)

Hope you are doing better.

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Dr. Rick
Dr. Rick
Ophthalmologist & Retina Specialist
5447 Satisfied Customers
Ophthalmology since 1994 with Retina sub-specialty interest