Eye pain and slow pupil dilation

[hazymazy]

Hi
Can anyone help me a with my eye trouble. Last year I saw my option and she thought I had Adies tonic pupil. My left pupil was larger and reacted slowly. I had noticed this myself and had short sharp stabbing pain. She asked had I had a virus  (not aware of any) and maybe I had some optic nerve damage. Pressure in left eye was 22 and 21 in right. Referred to an ophthalmologist and by the time I saw him my eye had settled down and he decided it may be medication. He only looked at my eye but didn't carry out tests. He did see the enlarge pupil though. Throughout the year my left pupil continued to constantly fluctuate. Since last year I have noticed in both eyes ( about 5 weeks ago) what looks like a small contact lens which sits over the pupil and will also appear to move so that it is covering part of my pupil and the iris, as if I have placed a small lens there and I'm able to move it. Another way to describe it is it looks like I have a hole in the  clear gel of my eye. When I move near the mirror the hole gets bigger and small as I move away. I stopped my medication to test if this was the cause 4 weeks ago and since then I am aware of pain in my left eye. I don't know how long my eye has hurt as I am on pain medication for Thoracic and lumbar  (wear and tear with bone spurs) pain, cervical spondylosis, fibromyalgia and hip impingement.. This hole can cover the pupil and half the iris. Now my right eye goes large and has the same hole but that hole is smaller and not much eye pain. I went back to my doctor who said they were fine but was unhappy as I know they are not, to be fare  to my doctor in bright light they do look fine although they are now light sensitive. At the second options appointment  the preasre is 25 in left 21 in right. Over the weekend the pain grew worse I phoned a helpline and was advice to pop to the casualty department. There I was told to go back to my doctor and ask for this second referral to be speeded up if I was worried.The doctor there did see a speck of light in the pupil centre which I have also seen many times but as usual the pupils go tiny in bright light and did not enlarge and dilated. I call them fish eyes but am very worried as I have to wait for an over the phone symptoms check and then be given an appointment for the referral which could take months. I am worried that I wont be believed as the pupils have a mind of their own but are behaving oddly more often.Please can someone help I hate this . Thankyou.

[hazymazy]

Hello
Good news (I think?) I had my eye appointment at the eye casualty yesterday and had a couple of tests. Nothing could be found wrong with the back of the eye which is a big relief. Typical though my eye pain stopped almost completely the night before. Also my eye pressure had gone down in the left eye from 25 to 21 which is great. The trouble is because the eye pain had stopped I wonder what the pressure would of been at the peak of the pain??? Also because drops were put in to dilate the eye the consultant didn't get to see the "fish eye effect". I go to see the original ophthalmologist for more hypertension test. I don't know enough about glaucoma, wonder if it is this and so dread any more episodes? At least the pain has faded. Still know there is a problem and want to get the to the bottom of it as it has changed my vision. Thank you for your previous answers and advice.

[hazymazy]

Its heartbreaking to here such news but sadly doesn't surprise me. Money is wasted randomly and doesn't go to those who desperately need it. The knock on effect of not saving someone's eye sight because certain medication or treatment are classed as to expensive is that in the long run the now blind patient will need help and assistance for life which cost more in the long term and such unnecessary suffering to so many people. I complained to my old GP surgery for a period of over ten years about back pain and then hip pain. Just given pills and cream. It was a temporary doctor who sent me for an x ray and that's when they discovered I had femoral head and neck deformities and shoulder arthritis plus more. Thank heavens for that Doctor. Hence you can imagine why I feel that I am not believed because it took so long to get this far. That was 2006. My hip surgeon even thought he had done my op when one day I went into his office and he said "oh I thought I had already done you". The hopeful news at present is tomorrow I have an appointment at the eye casualty. Cant believe it. Will keep you posted. The doctor I saw today didn't know what was wrong with my eyes but said he could see how worried I was an acted on that. also read my last report from a year ago. Never did get the phone call back from the ophthalmology department lucky I kept the doctors appointment I guess.

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

If you look back on responses from the UK and Canada there are an overwhelming number of complaints about difficulty seeing specialists, getting MRIs, scheduling surgery, find a GP, etc.

I was deeply deelply upset when I recently read that in the UK use of Lucentis and Avastin are restricted to one in five indications for using it and then only it one eye. That means that literally tens of thousands of people go legally blind because its "too expensive" to use one of the most important medications to come along in ophthalmology in the last two decades.

JCH MD

[hazymazy]

Hi
I live in the UK. After your message yesterday I waited to see how things developed over next few hours. After still more pain last night and on waking with my left eye blurred (misty) which did pass I'm unable to see details in family photos like features clearly etc and the pain is still hovering around at different levels. Right eye is not perfect either  but not as bad as left. My pupils presently look small. I have a doctors appointment today but I also phoned another hospital and spoke to the receptionist at the ophthalmology department who said they have received the letter of referral and said it was in the hands of the consultant and It had not yet been read but she would give details of my concerns and call me back when he had read it. I have been distressed after seeing my optician on the 14 July that her referral letter had not reach my doctors (opticians said it was absolutely sent) and when I enquired about this they sent a fax which was also not received at the doctor, opticians hand delivered the second letter to my doctors. I don't suppose I will know who is to blame for the delays but this has already put back any appointment by a month. That is why I took the initiative and  phoned the other hospital and chased up matters myself. As an extra precaution if I don't receive a return call from the ophthalmology department I will ask my doctor to hurry up an appointment for me. I hate to make a fuss and wouldn't if I wasn't so worried. Just having your contact has been helpful. Have had to write most of this with left eye closed as the pain is rising so hope it is readable, taken me ages. I have also made sure that I'm not being paranoid and looked at this problem in a manner that is calm and tried to eliminate what  has caused this. Has anyone else had this problem. Many thanks.

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

Where do you live?
JCH MD

[hazymazy]

Thank you for your reply and your time. I am unable to pay for private treatment and will go back to hospital or my doctors but feel they will just say to wait my turn on the list. The symptom check phone call is due on the 18/8/09. Hopefully I will be seen shortly after that. When the doctor filled in the referral form  I noticed he had put non urgent down. Well its not his eyes .Tonight there is still pain in left eye but it fluctuates and the small lens is still visible.Your advice is very much appreciated.

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

You should see a neuroophthalmologist. Find one near you at www.aao.org


JCH MD