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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2412
Experience:  MS Ophthalmology with 13 years of surgical expereince
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An optometrist did a field vision test on me back in 2006 but

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An optometrist did a field vision test on me back in 2006 but I couldn't find the right opthalmologist to figure out the problem with the loss of peripheral vision in my left eye, and it was never suggested to me until I asked it here on JustAnswer that I should see a neuro-opthalmologist. I did see an opthalmic surgeon in 2012 who gave me a field vision test, but he didn't do much else that I knew of, I didn't get a clear answer on whether it was a problem or not (I did have an MRI back in 2007.)

During a routine annual this past summer with my PCP, he was following up on my 2012 concern I brought up with the loss of this vision and said I should see an opthalmalogist, but his referral is not in my insurance network, but when I asked for a referral to see a neuro-opthalmalogist, he gave me one. The opthalmic surgeon I saw in 2012 never suggested that I see a neuro-opthalmologist. Now the neuro-opthalmologist I'm the one initiating an appointment is asking for a referral from my doctor.

I'm wondering why no previous eye doctors had recommended that I see a neuro-opthalmalogist? What does loss of peripheral vision in one eye mean? Could it lead to blindness or something else?

Dr. A.S. Desai :

Hello, Thank you for the question.I am Dr.A.S.Desai and I look forward to assisting you .

Dr. A.S. Desai :

Are you available for chat now?

Customer:

YEs

Dr. A.S. Desai :

Is the peripheral loss of vision in the left eye restricted to any particular part of the field or it is all over the periphery? Is the vision in the right eye normal with normal visual fields?

Dr. A.S. Desai :

Did the eye exam by the ophthalmologist ( in 2012) reveal any eye problem which could have contributed to the visual field loss in the left eye? Do you have any known history of diabetes mellitus/ glaucoma/hypertension?

Customer:

The right eye is completely normal. Actually, all I can describe as a lay person is that hold my index finger up at a 90 degree angle from where I'm looking straight ahead, I can't see my finger until it is about 45 degrees, or almost halfway to my nose. I think the field vision showed some problems outside of this area, but I can't describe it exactly as I don't have it in front of me

Dr. A.S. Desai :

Ok.

Customer:

He didn't say anything to me about any of those things as affecting me, I am taking HCTZ 2-3x a week for prehypertension. I do have to take iron pills for anemia. Diabetes- my father had it, but I don't seem to

Dr. A.S. Desai :

I would have wanted to know if there was a local ocular cause for this visual field loss by doing a dilated eye exam. How did you get to know about the field loss? Was it only when the optometrist detected it in 2006? What made the optometrist do the field test?

Customer:

I really don't know why, it was part of a routine eye exam -- a new piece of equipment but I never got a straight answer from anyone about what it meant or what I should do.

Dr. A.S. Desai :

My guess regarding the diagnosis would be like sending a blind arrow as there could be many possibilities here . This could include glaucoma ( early phase can cause generalised peripheral constriction of vision), retinitis pigmentosa(RP), retinal peripheral lesions.

Dr. A.S. Desai :

To say that there is a neurological cause , the visual field loss would have a different presentation.

Customer:

It was part of a routine eye exam...I think he had new equipment, but never got a clear answer from anyone what it meant when I brought the test results in for someone to see.

Dr. A.S. Desai :

Neurological causes begin with optic nerve and can be seen upto the brain , visual cortex. These are called visual pathway lesions.

Customer:

Oh, so before I set up an appointment with a neuro-opthalmalogist, should I have them look at my records and the field exam first?

Customer:

Should I get the records so that I could know what diagnosis was made? I find it a bit frustrating that often the doctors don't tell me much!

Dr. A.S. Desai :

Yes, it makes sense. The neuro-ophthalmologist can have a look at your visual field records. Atleast I cannot think of a visual pathway lesion which can cause isolated peripheral field loss in one eye only. I wonder if there was some finding in the retina or optic nerve itself.

Customer:

I think he said something about the optic nerve, but I couldn't understand what any of it means, whether it's something I'd just have to live with, or whether it would get worse if not treated, or if it needed someone else to look at it. .

Customer:

Thank you very much, this helped immensely, in trying to follow up.

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