How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Rick Your Own Question
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10493
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
Type Your Eye Question Here...
Dr. Rick is online now
A new question is answered every 9 seconds

I am female, in my early 60s, nearsighted, have cataracts

This answer was rated:

I am female, in my early 60's, nearsighted, have cataracts on the edge of the lens of the eyes. Other medical conditions are as follows: I have hypertension that is being treated along with Hishaimoto Thyroidisis. Recent blood work showed a slight elevation on the ANA test, which is under further evaluation at this time.

Three years ago I started to have afterimage problems. I can look at anything and I immediately see the ghost of it and it quickly disappears. I consulted a top neuro-opthamologis, who conducted various tests and he told me everything was fine. In April 2013, I went on my own and I spent an afternoon being evaluated at Hopkins Wilmer Nueuro-Ophtomology clinic. They conducted a battery of eye tests and a neurological exam and everything was fine. No further testing was recommended.

Recently, I started to have some balance issues so I consulted with an ENT doctor. At my request, in July 2013, he sent me for an MRI. The MRI with contrast showed a 4mm rounded focus of increased signal intensity within the posterior aspect of the right corona radiata with subtle enhancement. I am waiting for a follow-up MRI in September 2013, and then it will be determined if this was a sub-acute infarction, active inflammation/dmyelination, or a vascular lesion. The neurologist that I consulted with informed me that the MRI finding does not match my symptoms of the afterimage issue or my balance problem. He seems to think I had a mild stroke because my blood pressure has been elevated.

In the process, the ENT doctor also sent me for an ENG test last week (August 2013). The results were that that I have central vestibular pathology due to abnormal tracking and optokinetic and directional changing nystagmus seen during caloric testing. All the other occulomotor tests were normal. The ENT could not give me an explanation for this finding and he sent me along to see the neurologist. I have an appointment this week with the neurologist. From doing research, as best I can, it seems to me that the ENG test picked-up that my eyes go back and forth when looking at objects. I have a long standing problem that when I talk to folks I look all over the place and I cannot focus on their faces.

I don't know how to interpret the ENG findings in view of the fact that I do not have any eye diseases except for the conditions that I noted. The MRI results to me do not seem to support the findings on the ENG of pathology in the parts of the brain that affect the central nervous system such as the cerebellum. Any information that you can give me about interpreting the ENG results will be greatly appreciated.

Thank you.


Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

Do you have any problems with your vision, other than the cataracts?

When you were a child, did you have any eye muscle surgery, need to wear an eye patch or any other issues with your eyes.

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 3 years ago.

>Hi Dr. Rick,

The only problem that I have other then being nearsighted and the cataracts, is that I have the afterimage issue which I explained in my original question to you. As a child I did not have any eye muscle surgery or wore an eye patch. I was diagnosed as being nearsighted when I was about ten years old. This was corrected by wearing eyeglasses until I got hard contact lenses when I was 18 years old. I over wore the lenses in my early 20's and I temporarily had double vision and cornea abrasions for about a month. After my vision returned to normal, I wore soft contact lenses until I reached my early 60's. Contact lenses no longer work for me and I wear bifocals now. Although my close-up vision is excellent without glasses regardless of my age.

In 2002 I had eye surgery to remove extra skin from the top of the lids and bags under the eyes due to age.

>In 2012 I had pitosis surgery on the left eyelid to repair the muscle. This was an ongoing condition since 2005 that got progressively worse. I was told that it was a muscle issue related to age or to perhaps the wearing contact lenses.

Otherwise, all my eye exams have been normal throughout my life.

Thank you for that extra information.

MRI would be expected to supply any new data to your ENG test battery.

Also, from what you have posted, I think this abnormal test result is going to be a red herring....if you do enough tests -- and you have done almost all of them -- you will eventually get some abnormal results. I can not see how this has anything to do with your after image issues.

You have had an extensive workup by one of the best Neuro-ophthalmology departments in the USA and, possibly, the World. If they couldn't find a reason for your symptoms I do not believe that they are going to be found.

I would be very surprised if your upcoming neurology consult bears fruit. :(

So. What to do? You may have to just resign yourself to these after image problems for the foreseeable future.

I realize that this was not the answer you were hoping to hear but it would be unfair to you and unprofessional of me were I provide you with anything less than truthful and honest information.
Surely, you prefer that I tell the truth rather than what you wish to hear. Because it reflects very poorly on me unless you press one of the top three feedback choices, keep this in mind when rating my answer and please do not punish me for being honest. I understand that this may not be easy to hear, and I empathize.
Even though my answer was not quite what you were hoping for, please understand that my priority was to provide you with the most honest information. With that in consideration, I hope that you found my answer useful. Please click the excellent feedback button so that I can receive credit for my efforts.

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10493
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Previous | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland

Meet The Experts:

  • Dr. Dan B.

    Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
< Last | Next >
  • Dr. Dan B.'s Avatar

    Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
  • Dr. Stan's Avatar

    Dr. Stan


    Satisfied Customers:

    Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
  • Dr. Stevens's Avatar

    Dr. Stevens


    Satisfied Customers:

    Board Certified Ophthalmologist
  • Dr. Susan's Avatar

    Dr. Susan


    Satisfied Customers:

    Board Certified & Fellowship trained eye surgeon.
  • Dr. JP's Avatar

    Dr. JP

    Ophthalmology, Oculoplastic Surgery

    Satisfied Customers:

    Harvard Medical School, Massachussetts Eye and Ear
  • Dr-Trace's Avatar


    Board Certified Ophthalmologist

    Satisfied Customers:

    Board Certified in General Ophthalmology
  • Dr. Daniel Jewelewicz's Avatar

    Dr. Daniel Jewelewicz

    Board Certified Ophthalmologist

    Satisfied Customers:

    Glaucoma Specialist, Associate Professor FAU, Teaching Faculty Bascom Palmer Eye Institute

Related Eye Questions