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Ask Dr. Dan B. Your Own Question
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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over the pasfew weeks, my vision in one eye has deteriorated

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over the pasfew weeks, my vision in one eye has deteriorated from 20/20 to 20/80+. There is no visible tear in the periphery as noted by my optician but scans reveal a significant MER with modification to the macula. THe earliest possible appointment with a opthomologist is in 3 weeks. Is it advisabel to wai this long? What are the possible reasons for this condition? I had lasic surgery in 1997 for severe myopia.

Doctor DanB : Hello and thanks for your question. Do you have diabetes, high blood pressure, high cholesterol, heart disease or do you smoke?
Customer:

no diabetes,no high blood pressure (actually very good), no high cholesterol, or heart disease and no I do not smoke. Full medical exam and blood work done in December 2012. Am in otherwise good physical shape. Exercise regularly and at 5'5" weigh 125 lbs.

Doctor DanB : This may seem like a strange question, but do you consider yourself a type A personality or do you consider yourself fairly relaxed and easy-going? Also, how high was your myopia or nearsightedness before LASIK?
Doctor DanB : Are you still there?
Customer:

Type A and my pre lasik myopia was +/- 10.

Doctor DanB :

Okay, then. I think there's a decent chance that this is something called central serous retinopathy. Let me elaborate...

Doctor DanB :

This is a disorder of the choroid (tissues underlying the retina) where there is a small, pinpoint leakage of fluid that collects under the retina that can cause a discoloration to the vision and/or centralized blurring or blind spot. The etiology of this is unknown; there are no identifiable causes, but it tends to happen in the Type A personality for some reason. This diagnosis can be verified by your ophthalmologist who can do a fluorescein angiogram test (a test where some dye is injected into an IV in your arm and pictures are taken of your retina as the dye flows through the retinal blood vessels, enabling documentation of where there is leaking). Thankfully, CSR is a problem that usually fully resolves on its own over the course of 2-3 months without any treatment and the resolution can even be hastened with the use of a laser if absolutely essential.


 


There are other much less likely causes, but any of these diagnoses can be assessed for by your ophthalmologist.

Doctor DanB :

Regardless, this is not an emergency and will likely be just fine for 3 weeks.

Doctor DanB :

Does that all make sense?

Doctor DanB :

Do you have any other concerns or questions about this topic?

Doctor DanB :

I'm sorry. I need to step away from my computer for about 5-7 minutes. I promise I will be right back to continue this and to answer any further questions or need for clarifications you have. Please bear with me.


 


If you feel like this discussion has been satisfactory to you and you have no further questions, then your feedback is important to me and will help me improve my encounter with future customers. Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied.


 


My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry!

Doctor DanB :

Okay, I'm back to my desk if you have further questions...

Customer:

Hi

Customer:

Is it possible that this could be age related macular degeneration (dry or wet)

Doctor DanB :

Yes, it certainly is possible, though at your age it is not the first or even second thing on my list of things I suspect. Is there a family history of it?

Customer:

no but with my previous severe myopia, I thought I was at risk particularly as I am over 50

Doctor DanB :

You are moreso at risk for a myopic retinopathy (which is the second thing I suspect).

Doctor DanB :

I think the odds are that this macular degeneration are definitely much lower than CSR or myopic retinopathy.

Doctor DanB :

Do you have any other questions or concerns about this that I can address?


 


 

Customer:

I am not sure what this is can you explain

Doctor DanB :

Myopic retinopathy is associated with a thinner than normal retina which can allow for the growth of new blood vessels beneath the retina (in the choroid) to penetrate through to the retina and cause leaking/bleeding into the retina, causing swelling (edema) of the retina and poorer vision. Likely if there was any bleeding into the retina this could've been seen by the optometrist, so I think this is much less likely CSR (the first problem we discussed).


 

Customer:

Thank you Dr. DanB. I will, at least being a more "informed' patient when I see the specialist.

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