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eyedoctor29
eyedoctor29, Optometrist
Category: Eye
Satisfied Customers: 7
Experience:  I have been an optometrist since 2003. I have a private practice, and I work closely with eye surgeons and other specialists.
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Hi.. I am very worried and anxious because I have felt strange

Resolved Question:

Hi.. I am very worried and anxious because I have felt strange changes in my vision, what is bothering me is that I cant see well (I see hazy or cloudy like) when I read black print on white paper under bright office light (white light) and I dont recall this happening before. I was diagnosed with floaters about a year ago and with vitreous synersis, but I feel like if my vision has gotten worse. I went with a retina specialist two months ago and she said I was fine, but I didnt have this reading problem before directly under bright office light and I am disstressed. I also feel like if I am having problems now with my close vision that I didnt have before, It is now tiring for me to read and I have to hold the book at different angles. I am 40 years and a half and I have a 1.5 miopia (I was operated many many years ago with radial keratotomy). What is happening to my eyes??? Please help!!!
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

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

Dr. Rick :

I am glad that you were seen by a retina specialist and everything is OK in that department.

Dr. Rick :

We are not allowed to use Email on this system but I will change to Q&A which sends an email everytime something is posted.

Customer: replied 1 year ago.
Could you answe me via e-mail please?
Expert:  Dr. Rick replied 1 year ago.
Hi. I'm here and available to continue our conversation.

Do you wear glasses for near or distance tasks?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.

Customer: replied 1 year ago.
Yes but, I still feel worried because somehow at night I am afraid of the way I am seeing... I feel that it is not normal..
Customer: replied 1 year ago.
I use glasses for distance seeing (but usually only when I drive or go to the movies), though lately I am using them for reading since I feel like if I am seeing strangely
Expert:  Dr. Rick replied 1 year ago.
Ok. Thank you for that additional information.

I think that you have a couple of things going on. Presbyopia (need for glasses for reading, which starts around your age) and an anterior segment/dry eye issue.

Even though you are a -1.50 myope, and this should help with near vision tasks, I believe you are straining your eyes with your near tasks. I would recommend purchasing some cheap dime-store glasses of the +1.25 strength and see how they work.

Also I think you should try some home eye therapy:

Many times, for all sorts of reasons, the anterior surface of the eye starts to have difficulties. What can cause this? Well, there are a number of conditions but the most common are dry eyes, allergies and blepharitis....many times all three conditions act together to make you miserable. In order to solve your problem you need to address all of these issues at the same time.

When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.

Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.

The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.

Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.

Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.

I understand that this treatment seems a bit "too low tech" to be of value, but after 2 decades of clinical practice, I can assure you (even from personal experience :) that it, does indeed, work.

Is there anything else you would like to discuss at this point or have all your questions been answered 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
Customer: replied 1 year ago.
Thank you for your advice and I will do this, though I want to know if you think that the hazy reading under the flourescent lighting will get solved with the glasses. Is this a symptom of presbyopia? Does it have to do with the heavy floaters?
Expert:  Dr. Rick replied 1 year ago.
Hi Yleana,

I think that the hazy feeling you having will be best addressed by the home therapy I discussed. Glasses will help but I would bet that you need both.

Does this make sense to you?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Customer: replied 1 year ago.
Hi Dr. Rick:

Why do I suddenly have "dry eyes"? Is the blurry seeing a symptom of this. I had never had this problem before, and specially why do I see like this ONLY under direct white light? That is what is driving me crazy... I am sorry for being so insistant but it seems so strange to me..that this is happending only in this lighting...Have other people told you this symptom before (about the bright lighting problem)?
Expert:  Dr. Rick replied 1 year ago.
Yleana,

That is a very good question and these conditions often "smolder" just under the threshold and then, when some stress comes up you become symptomatic. I've seen this time and time again in my 30+ years of clinical practice.

And, yes, I've had a number of patients such as yourself with very similar problems.

Does this make sense to you?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Customer: replied 1 year ago.
Dr Rick;

I am sorry for being still so insistant but please tell me what do the bright lights have to do with the dry eyes...I dont understand this happening only in this situation...pray tell...and thanks
Expert:  Dr. Rick replied 1 year ago.
That is a good question. It is NOT the bright lights that are the issue, it is the fact that you have unhealthy tear film that will mess up your vision under bright light.

Does that clear things up for you?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here
Customer: replied 1 year ago.
Why would it be more noticible under bright lights?
Expert:  Dr. Rick replied 1 year ago.
that is a good question and, to tell you the truth, I really don't know the biology behind it...but it is true.

Try the home therapy and I bet you will improve.

If are really worried and would rather not do such a "low tech" treatment then I suggest you consult with a cornea/external disease specialist.


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
Customer: replied 1 year ago.
One last question, because somehow this doesnt make sense to me, Why do I see blurry with some types of white paper under bright office lights and not with others, wouldnt this happen with all types of paper?
Customer: replied 1 year ago.
Relist: Incomplete answer.
I dont think that this is my case and I dont feel any better....
Expert:  eyedoctor29 replied 1 year ago.
I am happy to have the opportunity to help. Please let me know if you have any additional concerns that I have not addressed. I believe that you have a combination of issues. I don't think anything dangerous is going on, especially since your retina has been deemed to be in good health. Your most prominent issue is likely visual issues caused by corneal irregularity due to previous corneal refractive surgery. This is very common, and largely ignored or at least minimized. Corneal refractive surgery is wonderful, but almost always leaves your cornea slightly irregular in shape causing visual disturbances that are worse in some lighting/contrast conditions than others. Your floaters are surely contributing to the symptoms. Less than perfect tears are very likely contributing. Imperfect glasses prescription is very likely contributing. Presbyopia, near vision/focusing issue that start around 40 years old, is very likely contributing. All these factors together eventually bring you to a point of symptoms. They were all likely existing before, but you are now at a level of noticing the effects. The good news is that there is a lot that can be done to help. Absolutely start with treating the ocular surface with warm compresses for 3-5 minutes followed by a drop of preservative free artificial tears at least twice daily. Forget the lid scrubs/baby shampoo advice. Have your vision tested after 2-3 weeks of this routine, and I believe that you will be able to get a more accurate prescription for glasses that will help tremendously. Start there, but more can be done if that is not adequate. These are very common, and largely under-addressed problems. Find a very good eye doctor. These problems are not elusive or complicated, so you need a doctor with a great attitude/reputation not necessarily a specialist.
Customer: replied 1 year ago.
I thank you for your advice. Tdoay I went to see a oculist (because I was very anxious). She dialated my eyes and said that my retina overall is okay but that I have some small lesions in the edeges (thin retina) due to the myopic nature of my eyes, she also said that these lesions are small and not worth putting laser right now, but that I should monitor them in three months. She agrees that the floaters could be producing those light refracions and she sent me some natural tears, so you gave a good avice. Do you think that the floaters and light refractions will stabilize with what you told me to do? Will it get worse?

thanks for listening...
Expert:  Dr. Rick replied 1 year ago.
What can you do about the floaters? Well, floaters don't go away, and they don't really get worse. Over time they tend to "sink" out of your central vision and you brain "filters" them out so you don't notice them so much anymore. They almost never cause significant visual problems except, of course, if they cause a secondary retinal detachment as discussed above. The only way to decrease or remove the floaters is with a major surgery called a vitrectomy. As a retinal specialist for almost 2 decades I've only done this procedure to remove floaters in a handful of cases.

Here is a video of the actual surgery to remove floaters:
http://www.retinavitreous.com/video%20files/intro_floaters.html


Is there anything else you would like to discuss at this point or have all your questions been answered 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
Customer: replied 1 year ago.
Last firing away question and I am satissfied with you answers!!! Then do you think that the light scattering has to do with the floaters or does this have to do with the thin retina that the specialist told me I had?

thanks again in advance.

Yleana
Expert:  eyedoctor29 replied 1 year ago.
The thin retina issue has nothing to do with the light scattering. The light scattering is a result of floaters, ocular surface irritations, and corneal shape irregularity. It will get better with time and ocular surface improvement from treating with warm compresses and artificial tears.
eyedoctor29, Optometrist
Category: Eye
Satisfied Customers: 7
Experience: I have been an optometrist since 2003. I have a private practice, and I work closely with eye surgeons and other specialists.
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eyedoctor29
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I have been an optometrist since 2003. I have a private practice, and I work closely with eye surgeons and other specialists.