Eye pain, vibration, flickering, etc

Posted by S. Tomlin on June 27, 1999 at 22:45:36
I am a 35 year old female with spinal muscular atrophy, osteoporosis, osteoarthritis, migraines, and was diagnosed with a neurogenic bladder and flashers and floaters last summer.
about three months ago the corner of my RIGHT eye ( white part included ) nearest my nose began to have a slight discomfort when I awoke in the mornings, gradually over a period of a couple of weeks the discomfort began to change to a strong aching sensation  which spread to the top and back of my eyeball and then to under my eyeball. I also began to experience a little bit of discomfort just in front of my eyebrow and the bony part of my nose closest to my eye. The pain would last most of the day. I also began to experience pain ( in my right eye ) when I closed my eyes to go to sleep at night this lasted about a month then dissapeared. I also get a strong aching pain in the corner up to my eyebrow or down from the corner of my eye to the bony area of my nose whenever I would stare at anything ( ie daydreaming ). After seeing my Family Doctor ( who felt it was not pink eye or sinusitis ) and opthomolgist ( who saw nothing wrong with my vision said it was 20/20 ) They decided to send me to a neurologist and for a CTscan ( they have been schedueled for next month, July ). After I saw the opthomologist I began to notice that my vision IN BOTH EYES was starting to vibrate gradually at first and now is VERY noticible, since then I have been noticing the following:
-flickering around the edges of my vision.
-That lights have become glarey.
-Light lettering on a dark background seems doubled.
-I seem to be getting a lot of afterimages even in dim places.
-When I close my eyes I can see anything from thin red darting lines, tiny dark shapes darting rapidly around, undulating shapes. It doesn't matter if it's night or day.
-When I first open my eyes in the morning and look at the ceiling, lately I can see a large greyish circular shape surrounded by a ring of rapidly darting light colored shapes, it disappears after a while ( several minutes ).  
-It takes my eyes a long time to adjust to the dark and I have noticed that when I open my eyes during the night in the dark I can see greyish shapes in my vision which even when I close my eyes I can still see them.
-I also have noticed that colors seem less bright ( darker ) when I close my left eye and look through my right.
These are just a few things that have been happening. My Family  Doctor thinks it may be neurological in nature. Can you tell me how many eye problems there are that are neurological in nature? I have had to wait so long for these tests ( Canada Health care system ) I don't have a clue what is causing my eye problems and am very worried, that with all this waiting that this problem will be exacerbated too.
What eye problems cause flickering?
Thanks very much for any ideas!!!  

Posted by HFHS MD -JL on June 27, 1999 at 23:18:30
You obviously have a complicated past medical history which may be the cause of most of your problems.  The pain around the eye is unusual if this problem is neurologic in nature except if this may represent an optic neuritis.  This could cause eye discomfort usually on eye movement and can be associated with other visual complaints including decreased vision.  This can be evaluated with an MRI and visual field tests.  I would assume the ophthalmolgist thought of this.  If the eye was red and assoc with pain that would bring up a different set of possible diagnoses.  Many neurologic conditions can be assoc with nystagmus which is a slow beating of the eye or jerky eye movements.  This may cause the flickering that you are describing.  If is really difficult to comment much further without seeing you or knowing what some of the test results showed.  You may benefit from a neuro-ophthalmolgy evaluation if you can get the referral.
If you are in the Detroit area, call 8003637575 to see a Henry Ford Ophthalmologist.  This information was provided for educational purposes only.
HFHS MD-JL

Posted by S. Tomlin on June 28, 1999 at 14:34:42

Hi, Again
I also forgot to mention that I suffer from rosacea ( facial "rash" ) and my eyes always tend to be bloodshot.
I have a few more questions:
optic neuritis: How long does the pain usually last? Can it last longer than 3 months? What causes the pain? Is it contaigious? Can one eye hurt and not the other even though they both share the same visual illusions? Can it be treated after three months if that is what it is?
I am going to have a CTscan done in a couple of weeks will the results show up the same as an MRI?
My opthomologist never suggested any visual field tests. He by the way is away all this week. Can the neurologist I am seeing next week  do the visual field tests?  
Can nystagmus cause the illusion that everything I look at vibrates ( like microscopic dots ) moving all the time ( 24 hrs ) even in the dark?
ISeveral months ago my cat was sitting on my chest purring and a drop of his drool landed in my right eye. Coincidently, my cat became blind last year from progressive retinal atrophy at the age of 6 + years. Is it possible for something in my cat's saliva that could have triggered this problem in my eyes?
Thanks again
Posted by HFHS MD-JL on June 28, 1999 at 17:01:23
It is unlikely your recent exposure to cat saliva has anything to do with this.
Optic neuritis causes eye pain because the eye muscles are connected to the sheath surrounding the nerve and as the muscles move it tugs on the sheath which causes pain.  Most people with optic neuritis present to the MD after only a few  days to weeks with this discomfort and assoc decreased vision.  Some people may suffer from chronic optic neuritis which may cause pain for many months.  The CT scan is not as sensitive as the MRI in detecting changes in the brain consistent with optic neuritis, but it is a good start.  I am not implying that you have optic neuritis, I only raised the possibility because of your symptoms.  This would be a n atypical course.
Some neurologists may be able to do visual field tests.  
Nystagmus may cause movement in your visual field at all times.  You may also be describing floaters which are little particles that move around in your visual field and are usually due to changes in the vitreous gel in the eye.
It is very difficult to conclude more without examining you.  I recommend writing down these questions and discussing them with your doctors.  Good luck.
This information was provided for educational purposes only.
HFHS MD-JL

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