Blind spots in the eye keeps coming up (also with enlarged natural blind spot)

Hello doctor and friends,
A little background about my right eye: I am 34 and very near-sighted. I've had subretinal neovascularization (similar to wet macular degeneration) since October 2001. Before that, I had MEWDS ("white dot syndrome") and it last for a couple of weeks and then disappeared. Then I started to see a dark spot in my center vision, so I went back to the doctor (who diagnosed me with MEWDS), and he said it was nothing to worry about and it would go away. I waited a little bit but the dark spot wasn't going away, so I seeked a second opinion, that's when I was diagnosed with subretinal neovascularization and was given my first PTD right away. That was 9 years ago.

Then I moved to KC, MO, and I've had many episodes of new/leaking blood vessels and had PDT done for about 7 or 8 times. So now my right eye's center vision is very limited due to scarred tissues. It has stayed stable for a couple of years, however, since last week, I noticed that the natural blind spot in my right eye became pretty dark and a lot bigger (like 3 times bigger than the one in my left eye). I made an appointment with my opthamologist because I'm afraid that my eye is leaking again... They ran FA, OCT, visual field on me but couldn't see anything wrong. He told me to go back in 2 months and keep an eye on it and to go back sooner if I see dramatic change. and the doctor couldn't tell me why I am seeing a large blind spot, but he couldn't tell me what it is or why am I seeing a huge blind spot. Also on top of that, I've had small little blind spots popping out here and there. They usually start as faint little grey spots, but then they become bigger and a really noticeable blind spots. It's very weird because it doesn't feel like before when I had leaking blood vessels (those are more concentrated in the same area)... but it's more like scattered little blind spots. I am very worried and frustrated because the doctor couldn't tell me what's wrong, but I keep having blind spots coming up and I can see them on the grid as well... What can this be? I am going to another doctor tomorrow for second opinion, but I am wondering if any doctor here can shine some light in my situation? Thanks!!!

[John C Hagan III, MD, FACS, FAAO]

Since NV or bleeding around the optic nerve or swelling of the optic nerve can caused an enlarged blindspot I think your plan to get a second opinion is wise

JCHMD

[doodle_girl]

Thanks, Dr. Hagan!
But can it be spotty like mine? The doctor I saw didn't think my eye is bleeding...
Also I just noticed your clinic. The second opinion appointment I'll have tomorrow is actually with a retina doctor in your clinic (Leawood location) tomorrow. Will post back about what he says. Thanks!http://www.medhelp.org/posts/Eye-Care/Blind-spots-in-the-eye-keeps-coming-up-also-with-enlarged-natural-blind-spot/show/1157196#

[doodle_girl]

Also I forgot to ask, Doctor, could it be happening due to totally different reason other than NV? My first doctor thinks my NV was due to previous episode of MEWDS.
I researched online and found some MEWDS patients have enlarged natural blind spot.
I've also heard yeast or fungus can possibly cause problem similar to MEWDS... Is it true? If so, how can a doctor detect it? Would they be able to tell from looking into the retina or from FA?

[John C Hagan III, MD, FACS, FAAO]

If you're going to the Leawood Discover Vision Center than you will see Tim Stout MD a very good retina-vitreous ophthalmologist. Hope that he can help you. He's the Eye MD that I refer my retina to. Good luck.

JCH MD

[doodle_girl]

YES! I will be seeing Dr. Tim Stout tomorrow. Hope he can find something or at least gives me some kind of explanation. Thank you so much for your time, Dr. Hagan, really appreciate that you're spending your time to help people over here.

[John C Hagan III, MD, FACS, FAAO]

So how did things turn out?
JCH MD

[doodle_girl]

Thanks for checking on me, Dr. Hagan.

It's the same. Dr. Stout checked my eyes and said there is no leaking or inflammation, also he couldn't see the blind spots I am seeing, other than my old scarred tissues from the past. (We did have a very quick OCT but didn't do an FA because he didn't think it's necessary.) So at this point he doesn't know what is causing it, and there is nothing he can do about it... He told me to keep an eye on it and go back in 2 months. It's frustrating since it seems like quite a few people in this forum have similar blind spots issue but nobody knows why it's happening and no doctor can see the spots during the exam.

[John C Hagan III, MD, FACS, FAAO]

Lesions at the molecular level can cause spots or field defects but are too small to register by direct exam and even with FA or OCT.

As long as they do not represent active disease and get worse than it may just be one of those things you live with.

JCH MD

[doodle_girl]

To me, this thing is active because new blind spots are still popping out here and there. At first it starts off as a small gray area but soon it will enlarge to a bigger darker blind spot. How to I know if it represent active disease or not? Is there anything that can detect lesions on the molecular level, and if so is there anything can be done to stop it? Also does lesions are the molecular level causes scarred tissue on the retina? Do the blind spots I see actually are scarred tissues on the retina?

Thank you, Dr. Hagan, I really appreciate it. I was also thinking, if you would like to check on my eye I can make an appointment with you.

[John C Hagan III, MD, FACS, FAAO]

The  range of tests done should identify active leasions that need treatment (for example active NV).  Your problem needs a retina MD to monitor.  I do not think it worth the time/money to have me look at your eye. As I said I refer that type of retina work to Dr. Stout. By review of the archives and search feature you will notice other people with similiar problems. Many have had repeated eye MDs look at eye without finding a lesion.

If you are not doing a daily Amsler you might use that.

JCH MD