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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7906
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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hii have weird movments in my eyes for the past 9 years,

Resolved Question:

hi i have weird SHAKING in my eyes for the past 9 years,


 


i have done MRI and ct scans, nothing wrong is showing, i have tried to be treated for anexiety, it helpped to relax my self of the fear i got from all this, but did not help at all for the actual problem,


 


 


also i see little dots, sometimes just one  sometimes many, also my eyes feel tight and moving them is always pain, all this is ongoing for 9 years, 24/7 never stopped  even for a minute,


it all started one morning, didnt had anyting going on that i can associate it with,


i got use to to live with it and already gave up of finding a solution, 


 


 


recently i read about "Oscillopsia" i wonder if my ilness might belong there? and if there is really a cure for it, i understand that Oscilopsia is more of seeing things moving, i ha ve more of a shaking issue, obvioulsy i see things shaking too but i actually FEEL the shaking, not just a visual thing, i can close my eyes and feel the shaking at all times.


 


 


 


 


your help is appriciated.


 


thank you


Yoel

Submitted: 11 months ago.
Category: Eye
Expert:  Dr. Rick replied 11 months ago.
Yoel,

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

It sounds like you may have two things going on. The first is myokymia and the second is a posterior vitreous detachment. Let me give you a bit of information on these two issues:


1. Myokymia is an involuntary, local twitching of a few muscle fibers in the body of a muscle. This twitching, if it occurs in a limb, is not strong enough to actually move a joint but can be felt and sometimes seen as an area of quivering.

Myokymia commonly involves the eyelids and muscles around the orbit. It often appears and resolves for no apparent reason and has not been linked to any underlying significant pathology. What causes myokymia? Studies have shown that it is associated with anxiety, stress, lack of good sleep, high caffeine intake and the use of some drugs.

The best way to treat myokymia is to get more sleep, decrease caffeine intake and decrease stress. The good news is that myokymia is not a sign of serious underlying pathology and often resolves on its own.
Here is an excellent article on this topic:

http://emedicine.medscape.com/article/1213160-overview

2. You are likely experiencing a PVD or posterior vitreous detachment, a common event that happens in many people.

You have a thick gel material in the middle of your eyes called the vitreous. Over time as it liquefies, this gel material collapses on itself, forms little clumps that you can see as dots, lines or bugs. As these clumps form the vitreous pulls away from the wall of the eye. In the process it can stimulate the retina -- causing the flashes that you may see.

It is recommended that you see your ophthalmologist to look at the retina to make sure there are no problems such as a retinal hole or tear. In most cases, there are no problems, but this exam is precautionary and allows for preventative treatment of any lesions that are found.

If you notice a sudden increase in floaters, flashes of light (like a lightning storm), or a shadow/veil in the periphery of your vision, this can be worrisome for a retinal detachment. You would need to contact your ophthalmologist promptly in that case.

What can you do about the floaters? Well, floaters don't go away, and they don't really get worse. Over time they tend to "sink" out of your central vision and you brain "filters" them out so you don't notice them so much anymore. They almost never cause significant visual problems except, of course, if they cause a secondary retinal detachment as discussed above. The only way to decrease or remove the floaters is with a major surgery called a vitrectomy. As a retinal specialist for almost 2 decades I've only done this procedure to remove floaters in a handful of cases.

Here is a video of the actual surgery to remove floaters:
http://www.retinavitreous.com/video%20files/intro_floaters.html


In January 2013 a new drug, called Ocriplasmin, was approved by the FDA to dissolve vitreous strands in a particular eye condition called vitreomacular traction. Perhaps someday this drug could be used to also remove floaters…. Only time will tell.

From what you have posted I do not believe you have Oscilopsia nor is this a sign of something terrible, like a brain tumor.

And, of course, your overlying anxiety just makes things worse :(

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS



Customer: replied 11 months ago.
Hi Dr,

Your answer was defiantly a help and I feel you have put strong afford and thought to figure the right diagnostic,
The medical terms are little tough to understand, if you could more explain in level one language....

Based on what I feel I rather say it's the first one, Myokymia, it makes more sense, the other one I don't think so, it's not dots that are always there, it's coming and going, if I'm under son I can see tons of little dots in the dark I won't see any, I rather relate the dots to stress, correct me if I'm wrong,

Since I have this for 9 years, not getting better or worse, have not seen an Eye Dr for 6 years, but before that I visited minimum 10 good eye and neuro doctors, and neuro-ophthalmologist as well, did MRI and other exams and they all agreed it's stress related since nothing was showing, I agreed I feel stress and have a tough life in my marriage,
At that point I was home doing nothing, no work no talk to anyone, was so stressed of THIS issue going on,
I started Prozeg which helped a lot on releasing the stress I had and the anexity, and was able to get back to my life and to work, I am still on it I have tried to stop but I got dizzy and couldn't function, so I'm still on it, but a lower doze, however it NEVER helped at all the original eye problem, the eyes are shaking since day one! Same exact not less or more, and the fact it never stopped even for an hour even when I was stress free and happy makes me think it is a medical serious issue, and something is really wrong here,

Therefore your saying it's Myokymia (whatever that means) makes sense but the question that I didn't get an answer is how do I go from here? What's my next step? I want to finish the 9 years of pain!! Of living a life that is without normal vision, I CANT read whatever, if I read after 2 minutes i'm totally dizzy, I feel it's time to an end, and if you Dr can guide me and get me the right cure, I promise to rate you as the top medical doctor in the US, because if Dr Gandelbaum the top neurologists on Mt Sinia hospital couldn't figure what's wrong with me and you can than you are on of the top!

Hoping to hear back,

Yoel
Expert:  Dr. Rick replied 11 months ago.
Thank your for that extra information about the dots you are seeing. If may be that you are experiencing a normal viewing of your own white blood cells. I can, at times, see them myself. Here is information on this:

What you are experiencing is called entoptic phenomenon. These are images whose source is actually inside the eye itself. There are different manifestations of entoptical effects, depending on how they are generated. Blue field entoptic phenomenon looks like tiny bright dots, or bugs, moving along a wiggley racetrack. These are easier to see when looking at a uniformly lit area such as the blue sky, an illuminated wall in your home or a field of pure blue light. What you are actually seeing in this case are white blood cells racing through the capillaries in front of the macula, or central part, of your retina.
The Purkinje tree is another example of an entoptic phenomenon. This is an image of your blood vessels, located above the retinal photoreceptors, inside your eye. It is best seen by shining a small bright light against your closed eyelids, against your eyeball, or obliquely through your pupil, and wiggling the light quickly back and forth. You may have experienced this image when being examined by your ophthalmologist with the bright light she has on her head. You don't normally see this image as your retina is adapted to the shadow they cast however, when you shine the light from the side, the adaptation is defeated and you see the vessels.

http://en.wikipedia.org/wiki/Entoptic_phenomenon

I'm glad that I could help you...now, please don't forget to mash the positive feedback button for me :)

Have a good weekend.

Dr. Rick
Customer: replied 11 months ago.
Of course I won't forget,....
One more thing, I did not get your advise on how to go from there on the elite eye shaking issue, what am I doing next? Should I see again a eye doctor? Treat it more as stress?
Expert:  Dr. Rick replied 11 months ago.
Jay,

You should have a complete eye exam by an ophthalmologist. Sorry, I forgot to mention that :(

See the pretty excellent feedback button? It really likes to be pushed.......

Let me know if there is anything else I can do for you in the future..
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7906
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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