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I had a car accident this summer. I have been suffering from

anasocoria, spots in my right...
I had a car accident this summer. I have been suffering from anasocoria, spots in my right eye and blurred vision that comes and goes. I am being treated for post concussion syndrome. I have an appointment to see ophthalmology at the end of this month
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Answered in 12 minutes by:
1/2/2013
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,659
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Verified
Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

What can I do for you this evening?

Customer:

Hello. I had a high speed car accident this summer. I have been treated for post concussion syndrome and see a neurologist. I was told to make an appointment with an ophthalmologist and now I am just trying to get a glimpse as to what could be causing my problems: Anisocoria (left pupil larger than the right), spots out of my left eye, intermittent stabbing pain behind left eye; intermittent blurry vision out of right eye. I have pain & pressure behind my nose. MRI showed no lesions. It has been 6 months and I am just wanting to figure this out so I can get better.

Customer:

Sorry spots are out of my right eye, stabbing pain out of right eye, blurry vision out of left eye.

Dr. Rick :

I can understand your concerns. The anisocoria may be physiologic and you are just now noticing it or it may be secondary to your brain trauma. A complete eye exam by an ophthalmologist will be able to figure out if it is significant....there is no way to do that without actually having you, and my toys, in front of me.

Dr. Rick :

The spots might be from a posterior vitreous detachment. Would you like some information on this issue?

Dr. Rick :

While you type, let me give you this information on a PVD:

Dr. Rick :


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.

Customer:

Ha, I figured as much. Well I am a nursing student and I had a full physical to get into school, my eyes were PERLA. I also know they were the same because I loved playing with my pin light. I have an appointment at the end of this month. It takes forever to get an appointment for anything.

Dr. Rick :

Intermittent blurry vision may be related to your anisocoria or it might just be from the most common cause of this condition: Dry eyes, allergies and blepheritis. Let me give you information on this issue, and a home therapy you can try while you are waiting to get in to see the ophthalmologist. Here it is:

Dr. Rick :

When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.

Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.

The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.

Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.

Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.

Customer:

You know I have seen something like a lightening storm but it is so quick so I just never paid much attention. I am used to the floaters but it is the stabbing pain that gets me when it happens. Can the pressure behind my face be related to the eyes? I appreciate your time. I just really dislike going to the Doctors and have avoided it....

Dr. Rick :

As to the stabbing pain behind your left eye and pressure behind your nose, this type of pain is usually from either the sinus cavities, tooth, jaw or facial area. Only rarely does it have to do with the eyes or the orbits.

Dr. Rick :

I know what you mean....I am a doctor and still hate to go see the bums lol!

Dr. Rick :

Does this make sense to you?

Customer:

It sure does make sense! Thanks Dr. Rick! I feel better now, I have some baby shampoo so I will try that tonight. I will follow up with my appointment to get them looked at but really feel better about it after talking to you. Have a great New Year!

Dr. Rick :

My pleasure. Have a Great New Year too!

Dr. Rick :

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. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,659
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Verified
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Dr. Rick
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,659
11,659 Satisfied Customers
Experience: Ophthalmology since 1994 with Retina sub-specialty interest

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