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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Yesterday my friend came by at midnight and told me that he

Resolved Question:

Yesterday my friend came by at midnight and told me that he couldn"t see out of his right eye.
Everything looked normal to me and so he left . Today I saw him again and in fact he is here with
me right now and still can't see out of that eye. So I took a flashlight and shined it in his right eye
while he covered his left eye. The right pupil remained large and did not change size.Then I shined
the light in his left "working" eye and it reacted by getting smaller. The right eye also dilated the same
time as the left one did. But when he covered the good eye again the right one did not change size at
all with the light shining in it. There was no pain and he says nothing like this has ever happened. He has
had good vision all his life and now at 59 years old only used reading glasses. He has work as a welder
for the past 27 years and is in good health.
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 6 years ago.
Hello and thanks for your question. I'm here to help you. I've changed from chat mode to Q&A mode because the chat mode often times has glitches that make it so one of us can't see the other's answers. While you read this I will be responding to your question.
Customer: replied 6 years ago.
Ok we are waiting for your reply.
Expert:  Dr. Dan B. replied 6 years ago.

Unfortunately, it sounds as though the process by which your friend lost vision in his right eye has damaged his optic nerve. This is likely what is called an optic neuropathy or possibly optic neuritis (optic neuropathy much more likely given his age). An optic neuropathy can be caused by an episodic ischemia (lack of blood flow) to the optic nerve, nutritional / alcohol / tobacco abuse or a vasculitis called temporal arteritis (aka giant cell arteritis). Least likely is a hemorrhage in the eye, but this usually does not cause the pupil reactions you described.

Your friend should go see his ophthalmologist right away if he has one or if not, he should go to an ER where he know he will be able to see an ophthalmologist. For the most part, ER doctors will not know how to make heads or tails of your friend's problem. Most importantly if he has been having headaches, scalp tenderness, double vision, episodic vision loss prior to this, cramping in his jaw when he chews his food or talks or other constitutional symptoms such as fevers, weight loss, or night sweats, these could be signs of this vasculitis which can also cause blindness in the other eye, heart attacks and strokes and should be investigated immediately.

Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?

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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

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