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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3164
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Hi Doc: I am right now bothered by this weird condition.

Customer Question

Hi Doc:

I am right now bothered by this weird condition. Partial visual field loss

My eye condition history:

when I was in high school, I had a blunt trauma directly in the face by a football, I lost vision for about 2 hours and gradually regained my vision after emergency treatment, I was treated for about 2 weeks then I got all my vision back, doctor told me that the trauma caused bleeding and increased pressure in both of my eyes. My vision was back to normal about a month later.

After about 7 years, on a typical day around end of December, 2012, I started seeing lots of black dots and floaters appearing in my vision while I was staring at the blue sky in my friend's car. Prior to the floaters, I was seeing white moving flashes around the corner of my eyes, after that, I began worrying about my eyes again because since that day I see white slow moving flashes moving in the corner of my eyes.

I went to an optometrist in February 2013, she did some tests and said I had nearsightedness about -1.5 and I had probably PVD in my eyes, but she wanted to be sure so she referred me to an ophthalmologist.

March, 2013, I had the appointment with an ophthalmologist, he checked my eyes and he said I was fine but he wanted to do visual field test and then he referred me to a retinal surgeon to check on my retina.

End of March, 2013, I checked in with my retinal surgeon, I told him about the everyday white flashes and I felt like there was blackness started to appear at corner of my eyes. He checked my eyes and he found a very small tear on my retina in my right eye and he proceeded to do a laser surgery to seal the tear the next day.

After the surgery, I still see some occasional big long floaters and white flashes (Like camera flashes) in my vision, not a big deal. But one day, I was looking at the sky and the sun was quite big, so I closed my eyes a little bit, suddenly I noticed so many black dots in my right eye which I had the surgery in, I started worrying again, after that day, I tend to look at the sky to check floaters, yep, those small black dots are still there and the white flashes haven't stopped appearing especially at night.

Today, I got a call from my first ophthalmologist, he said he needed to see me, I went there he told me that my visual field test indicates that I have glaucoma in both of my eyes, in my left vision, the right corner close to my nose is blacked out, in my right vision, the left corner close the my nose is blacked out as well, I told him that I did see blackness around both of those corners as well. Then he started checking my eyes, after checking, he was a bit confused, he said that my eye pressure is very normal and my optic nerve has no damage and no pathological changes anywhere that he can find so glaucoma was very unlikely....
So I told him about the small black dots and white camera flashes I see after the surgery, he checked my eyes again but he didn't tell me anything and seemed confused. And then he said my problem may still be retinal problem and I have to check with my retinal surgeon again.

Now I feel like the blackness (the blackness is at the left vision close to the the corner of my nose and right vision close to the corner of my nose as well) in both of my eyes is worse than before and my docs seem like they couldn't find the problem, I'm so confused and scared that I may lose all my visions...

Please tell me what's going on? I have normal blood pressure around 115/70, non-diabetic, normal BMI profile and I'm pretty healthy.
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Dan B. replied 1 year ago.

Doctor DanB : Hello and thanks for your question. As you might could guess, if you've seen an optometrist, a comprehensive ophthalmologist, and a retinal specialist; they've all had the opportunity to examine you personally, and conduct extensive testing on you, and there is still doubt as to what is happening to you, I am at a severe disadvantage in being able to concretely tell you what has happened. If I cold insert myself in their place, I would have a fighting chance. However, let me tell you what I think are the possibilities and what are most likely.
Doctor DanB : If you had bilateral retinal tears (in both eyes) in the upper half of each eye, and each retinal tear was associated with a fair amount of sub-retinal fluid, or a small part of the retina was detaching, this could produce this picture of bilateral nasal, inferior, visual field defects seen on the visual field testing your ophthalmologist did--however, you stated you only had a retinal tear diagnosed and treated in one eye, so I do not believe the retinas are responsible for your bilateral visual field defect. The fact that you had trauma to both eyes, have increased pressure in both eyes, and have visual field defects that sound like they are typical for glaucoma, I would expect that these are glaucomatous related visual field defects that you are noticing and that showed up on the visual field test.
Doctor DanB : As to why the optic nerves don't look like there is glaucoma going on, I can't say conclusively--although I will tell you that it is not uncommon to occasionally see a patient with distinct glaucoma occuring where the optic nerves look relatively healthy.
Doctor DanB : Does this all make sense?
Doctor DanB : Do you have any other questions about this?
Customer: Yeah that makes sense, I'm actually thinking that my ophthalmologist told me that it's glaucoma at first then declined after exam. I'm worried about what if it IS glaucoma but I can't get to be treated, what should I do?
Doctor DanB : Glaucoma is a slow moving disease--damage happening over many months to years so not being able to get in for a few weeks is not going to make a significant difference to your vision.
Customer: By the way, doc, is it possible that, can eye fluid be sealed underneath retina after my laser surgery to close that small tear?
Doctor DanB : Yes, typically when there is fluid underneath the retina that is sealed by the laser then this fluid may be there for a few weeks, but ultimately gets absorbed into the body and vanishes. Usually the fluid does not persist in the retina.
Customer: So, is it possible that those black dots showering and white flashes I see everyday are the fluid inside my retina?
Doctor DanB : No, those are inherent forces in your vitreous and retina--they don't represent the fluid in the retina.
Customer: Should I be worried about those symptoms? Because I feel like my right eye feels like tunnel vision where periphery vision is getting black...
Doctor DanB : Not if there are not any changes to these symptoms since last having a dilated eye exam.
Customer: Ok ok, one last question, since my left eye visual field is impaired, but no glaucoma or tear was found, could that be neurological problem?
Doctor DanB : Yes, with significant head trauma, this could represent a traumatic optic neuropathy (one-time damage to the optic nerve) or it could represent damage to the part of the brain related to vision from the head trauma. I think these possibilities are less likely, however.
Customer: Thanks doctor for your answers, greatly appreciated.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3164
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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