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Dr. Tom
Dr. Tom, Board Certified MD
Category: Eye
Satisfied Customers: 263
Experience:  30 years experience treating patients with eye problems
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I am experiencing constant dizziness when standing..like a

Customer Question

I am experiencing constant dizziness when standing..like a cheap drunk...and cannot turn 180 degrees without fearing to fall. All started when I had left eye cataract operation in Sept. 2012. Right eye was performed in March 2006. Ophthalmologists have declared the problems are not my eyes, ear doctor have ruled out ear problems. I am 81...female...lost 30 lbs. last year and signs of Type II diabetes have gone = 0 medication. Only medication is for allergies (Zyrtec) and Micardis for mitral valve prolapse. Short of seeking a neurologist what is my next step?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Tom replied 1 year ago.

Dr. Tom : Hi, I'm online now and would be happy to help you with your question. Just reply and we'll get started. Dr. Tom
Dr. Tom : Are you available to chat about your balance problems now?
Dr. Tom : The indicators states that you have gone off-line. I will stand by for a few minutes to see if you come back online. I would be delighted to give you some thoughts that may be helpful.
Customer:

yes

Dr. Tom : Okay great, give me just a couple of minutes to type some information for you and then we can exchange questions.
Dr. Tom : The first thing I would like for you to know is that your situation is a common one. The second thing for you to know is that there is help and I will discuss that with you in just a minute . Please standby while I type out some information for you.
Customer:

This is my first online "chat".....

Dr. Tom : We will presume to start with, that your primary care physician has been made aware of your balance and dizziness problems and has taken the routine steps to ensure that you do not have any other general medical conditions. Knowing that you have seen an ophthalmologist and an otolaryngologist is helpful information. i would like to reassure you that your cataract surgery would not have been a cause. In fact it is a benefit. As we age there is an aging of the overall balance system. The balance system is composed of inputs from many sources. Yes, the eyes were certainly important, and so arethe semicircular canals of the inner ear, But these can be normal and we can still lose some of our balance compensating Control. It is very important that you get to work on this. As you probably know, falls which leads to fractures are significant potential problem. There are physicians who specialize in balance medicine. Also there are specialized physical therapist who work in balance rehabilitation centers. When we have finished our chat I'll see if I can help you find the appropriate type of therapy in your area. I'll stop for a minute and let you read over this and standby to chat with you further..
Dr. Tom : The indicator states that you were typing, so I'll just standby.
Customer:

It IS comforting to learn what I am experiencing is "common", however startling to me! Did not realize there are physicians who specialize in balance medicine....puzzling question is how this problem started in the first place...I thought it seemed to start with the cataract operation...yet that is not the cause. Am anxiously awaiting whatever information you can provide. Primary care physician is aware of my problem. Have not seen her in a few months. I will see her again to update her on steps I have taken so far. Could it be the medication I am taking?.

Dr. Tom : You are correct, There are not many physicians who is totally specialize in balance. Most do it as part of their relative specialties. Your question about medication is a good one. However, since you are on a relatively low number of medications that is probably not a significant factor. What I would like to do for you is hook you up with a really good website that will give you excellent information On vestitubular disorders, that's a fancy name for the aging of the balance system. Also, if you will give me the name of the largest city near you, I will do a little research and find a clinic that might be of value to you for you to check out. Would you like me to do that?
Dr. Tom : The indicator says that you are still in the chat room. Please let me know if you have anything else you would like to ask?
Dr. Tom : Now the indicator states that you were off-line. So I will switch over to the question and answer format where I will be able to place a link to a website that I think will be useful to you. Please let me know if you have any additional questions. The good news is that You can get help and improvement with your balance.
Expert:  Dr. Tom replied 1 year ago.

Hi Irena,

 

Take a look at this website, and get back to me if you would like for me to look up a clinic in your area for you. Best wishes . I'm glad that you asked the question. So many people need more education about this. Fall prevention is extremely important. I'm glad I could help you.

 

https://vestibular.org/understanding-vestibular-disorder

Expert:  Dr. Tom replied 1 year ago.

Hi Irena,
Take a look at this website, and get back to me if you would like for me to look up a clinic in your area for you. Best wishes . I'm glad that you asked the question. So many people need more education about this. Fall prevention is extremely important. I'm glad I could help you.

 

https://vestibular.org/understanding-vestibular-disorder

Expert:  Dr. Tom replied 1 year ago.

Hi again Irene,

 

Please reply so that both I and customer services knows that you are receiving my help answers.

 

Please remember to click a happy face rating.

 

I must go off duty now for a family calling, but if you have other questions, I will check back in first thing in the morning.

 

Thank you.

Dr. Tom, Board Certified MD
Category: Eye
Satisfied Customers: 263
Experience: 30 years experience treating patients with eye problems
Dr. Tom and other Eye Specialists are ready to help you
Customer: replied 1 year ago.


Dr. Tom, as an aside, I forgot to mention what I think may be one of the causes of my imbalance: depth perception. when closing each eye separately, there is a difference of 2 feet, i.e. left eye sight reveals object 2 ft. closer than when looking from right eye. Also, individual eyes change shade of color....right eye showed walls, grey, right eye had wall a bright cream! This was told to the ophthalmologist and dismissed. Are these all part of vestibular disorder?


 


I went to provided web site: vestibular.org and located a PT clinic across the street from our condo!!!: Jackson Clinic! Before I contact them, I need your opinion re depth perception problem.


 


What troubles me is that two ophthalmologists swore my vision is 20/20 yet my vision seems blurry without wearing glasses. Dizziness is worse when wearing glasses ( I've worn my entire life) and less so without them, but blurry vision! yet I am told I have 20/20! Frustrating!


Any insight?


 


Irena


 

Expert:  Dr. Tom replied 1 year ago.
Hi Irena, i am glad to answer your follow-up questions. In the clinic we test visual acuity both corrected and uncorrected. If your ophthalmologist said you had 2020 vision it is possible that your 2020 vision is with a proper correction. However some people are happy with slightly less than 2020 vision And may choose to differ glasses to achieve that final sharp 2020. Regarding depth perception. Yes it certainly has a role to play in balance. But remember when you were a kid you could play blind man's bluff all day with your vision totally blocked and not have a bit of trouble with your balance. Sent you mentioned that you have some blurry vision, and that you are used to wearing glasses, a question is have you had your eyeglass prescription brought up-to-date recently. If not , that should be done. Just remember, the aging decrease in balance is a combination of all of the inputs into the balance center. Even as we age, we continue to have some degree of ability to compensate for diminishing components I'm the various inputs. This is where your vestibular physical therapist will be able to assist you. I hope that helps with your follow-up question. Best regards.
Customer: replied 1 year ago.

Thank you for your prompt reply Dr. Tom. I was unable to answer until today. So, tho' I "hate" to admit it....this aging process is for the birds! Glad to have you say the physical therapist can help in the balancing and


in the process the depth perception problem may correct itself.


 


As to new glasses....Ophthalmologist prescribed new glasses immediately after cataract surgery...twice..still dizziness. 2nd ophthalmologist has prescribed new right eye lenses...since original cataract eye has changed in time. It is not the glasses., nor eyes....it is "all in my head"! I am hoping the PT can help me. Is it normal to suspect that something is pressing on my optic nerve? Thank you Dr. Tom for listening.

Expert:  Dr. Tom replied 1 year ago.
Hi Irena
Since you said in your original posting that you have been examined by two ophthalmologist. It would be almost unheard of for two ophthalmologist to not pick up some abnormality in your optic nerves if that were the case. When we started our conversation, it was presumed that you have discussed your dizziness with your primary medical doctor. I did not specifically ask you if you had seen your family doctor regarding your dizziness. If you have not, it would certainly be a prudent thing to do as you work through the other causes of imbalance with the vestibular PT. If the primary physician has completed his assessment of your balance and dizziness problem, another consideration would be for you to schedule an appointment with a neuro-ophthalmologist if this question regarding pressure on your optic nerves continues.
Customer: replied 1 year ago.

Dr. Tom, I have discussed my dizziness w/ primary care doctor...that is where I started this "adventure". I will return to her once again with all the info I have learned. THANK YOU. I will return to you when I have seen her and the vestibular PT. This is so frustrating!

Expert:  Dr. Tom replied 1 year ago.
Great best wishes.

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