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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: 2415
Experience:  MS Ophthalmology with 13 years of surgical expereince
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Background: I am a 49 year old male, in good health, ex-smoker,

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Background:
I am a 49 year old male, in good health, ex-smoker, with high-normal ocular pressure (19 and 20). Posterior vitreous gel detachment has resulted in a small retinal tear; the tear and additional lattice have been treated by laser wall-off procedure (tear is in left eye). Optic nerve head drusen have also been identified in both eyes.

Condition:
Recently I've noticed a slight warping of my vision in both eyes (I don't know how long this effect has actually been present, I noticed it about 2 months ago when I got a wider computer monitor and noticed the edges looked bowed; and started investigating with vertical lines). The warping is localized on the nasal side very close to the normal blind spot of each eye. The effect is such that vertical lines will appear slightly bowed out (away from the center of vision; toward the normal blind spot) when they are very near the blind spot. Central vision appears to be unaffected.

I've asked my ophthalmologist about this during a routine follow-up examination. After taking a second look she said that she didn't see anything out of the ordinary that would account for the effect near the blind spot.

Question:
Are there any conditions that would account for this effect that wouldn't be able to be diagnosed by a visual observation?

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, I am able to chat.

Dr. A.S. Desai :

I need a small clarification here- When you say that " the warping is on the nasl side very close to the normal blind spot" , does it mean during a visual field test? Because normally we do not appreciate the blind spot except during a visual field test.

Dr. A.S. Desai :

nasal

Customer:

No, I simply noticed that strait lines are bowed during normal activity. The bowing only occurs near the blind spot... no where else in the visual field.

Dr. A.S. Desai :

I would suggest that you get an Amsler grid test done( It is a self test which you can do at home after getting the grid sheets from your ophthalmologist). If there is significant deviation of the lines from normal then it is better to get an opinion of a retina specialist.

Customer:

I have see those on the web, after printing and following the directions, I've determined that typically the warping effect is slightly outside of the typical grid pattern, at the distance suggested. There doesn't appear to be any distortion of the pattern itself.

Dr. A.S. Desai :

A visual field test can be done to know if there is any peripheral visual field loss/abnormality. Though most of the times macular ( centre of the retina) lesions are detected on dilated fundus exam ( dilated eye exam), the macula might appear normal or almost normal in case of early age related macular degeneration or a thin epiretinal membrane. These conditions can be easily diagnosed with OCT(optical coherence tomography) test which is a non-invasive office procedure.

Customer:

Wouldn't the laser treatment invalidate the results of the visual field test?

Dr. A.S. Desai :

Not really. Only extensive laser given to the entire periphery as in case of PRP(panretinal photocoagulation for diabetic retinopathy) can cause a constriction of the visual field. You have had focal laser to a small area in one eye only. So that would not explain the visual distortion in both eyes.

Dr. A.S. Desai :

One of the possibilities is that of a peripheral floater due to posterior vitreous detachment(PVD). Such a floater is not picked up on eye exam but likely to be causing the visual distortion.

Customer:

Ok, thanks, XXXXX XXXXX track of the distortion and give my ophthalmologist a visit if I notice anything changing. I'll also ask about having the OCT test performed my next visit. I suppose that my main worry is that there might have been some odd condition that may have been overlooked during an routine exam which could have been caught very early. (I do tend to pay more attention to my vision than most poeple)

Customer:

Thanks again for your help.

Dr. A.S. Desai :

You are most welcome. Have a good day!

Customer:

You too

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