MEWDS

[mel07green]

i was wondering whether MEWDS or AZOORS or related white dot condition would cause something that looks like the afterimage of a camera flash in one eye, then fades to a grey spot, then to a small permanent scotoma.

there is no loss of visual acuity and dilated exams have not found anything remarkable.

this has been going on for about seven years with up to 20 episodes in both eyes, though not concurrently.

about two and a half years ago, after one of these episodes, i have some kind of scan of my eye - not sure if it was an OCT or an A or B scan or an ultrasound of some type, but nothing significant was found, at least not that i was told about.

i was initially fearful of something like macular degeneration, but i have been told that is not what it is.

[JohnHaganMD]

Neither MEWDS nor AZOORS would cause those symptoms and are both extremely rare and rarely are recurrent. I think you can safely cross them off your list. A far more common cause would be Ophthalmic or "eye" migraine which may have no headache at all. Other causes could include poor circulation to the visual part of the brain (transient ischemic attacks TIAs or even atypical seizure disorder).

The length of time you have had them without something serious developing and the special tests you had being normal or likewise encouraging.

If something changes see a neuro-ophthalmologist. If things are unchanged have a medical eye examination yearly with an ophthalmologist (EyeMD).

JCH MD

[mel07green]

i really appreciate your taking time to answer these questions, doctor. as you can see, i am beside myself with worry over this and i guess goggling isn't helping ...

the reason i got stuck on the white dot syndromes is that i was reading a support forum and there were 47 (!) women on their diagnosed with this. and there were describing my symptoms exactly (flashbulb-like afterimages, photopsia, "grey blobs" etc). some of them had had many episodes over as much as a decade. i am not challenging your opinion in any way, but that is why i was convinced ...

here's a bit more about my hsitory.

my light spots>grey blobs>scotomas have been occurring since about 1999, up to three times a year, sometimes less.

when the first one occurred, and was still "active", i had my eyes dilated, had a fluroscein angiogram and an ERG or EVP (not sure which one, but there were black and white cubes and i had electrodes on my head). anyway, nothing showed up.

ditto the next time, though then i was only dilated and had a field test.

two and a half years ago i saw a retinal specialist at the Sydney Eye Hospital in Australia. Humphrey field test and some kind of scan or ultrasound of my eye. again nothing was noted.

then about a year ago, here in CA, i was seeing a strange grey arc-shaped area in my left eye along with some stars on eye movement. anyway, after my local optomitrist noted what he thought was a tear on my peripheral retina, i was sent urgently to the retinologist for laser treatment. it turned out it was a small scar and she said lots of people have them and it had nothing to do with my symptoms.

i subsequently noticed the arc thing to a lesser extent in my right eye and think it's probably some kind of entoptic (sp?) phenomenon, like when you put pressure on your eyeball.

but i digress. the main issue has always been these spots.

and i think my ultimate question to you is, if nothing has been detected thus far, is it safe to assume this is just "one of those things" and to put it out of my mind and stop obsessing about it and training my brain to look for it?

i was really hoping it was maybe some kind of psychogenic thing, but it's simply tooo specific for that.

[mel07green]

oh, i should add (and this will probably strike off seizures and TIAs) is that the lenght of time it takes for these spots to do their thing (flare as bright spots, fade to grey blobs, then to small scotomas) is up to three weeks and never under three or four days) ...

i would be so immensely grateful for any bump in the right direction with this ... when i do see specialialists, they simple don't have the time to listen to all this detail and i think it's really vital to any kind of diagnosis ...

[John C Hagan]

Mel    Unless something new develops I would stop worrying, call it "one of those things" and get along with your life. Virtually all serious progressive things would 1. Get worse  2. New symptoms would appear. Stable since 1999 AND have all those tests and examinations would make me feel real good about your prognosis.

I would just see an ophthalmologist (EyeMD) on a yearly basis. You might print out your symptoms off this forum and give to your ophthalmologist.

JCH MD

[mel07green]

Hello again doctor
I just read your final response to my question and was wondering if you could clarify for me ...

I have been getting new scotomas in both eyes for the past seven years, so in a sense it is 1. getting worse and 2. there have been new symptoms.

Do you mean if I get different, additional symptoms?

I recently had my annual eye exam and there was nothing remarkable when my eyes were dilated. is it possible to have a disease for nine years without any signs?

do you think i should just learn to live it with it and stop stressing, or keep looking for an answer?

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

If you have had a problem for 9 years and its not getting worse and new symptoms are not occuring it's a very good sign and unlikely to be something serious.

As I have said before if you can't put your mind at ease see a neuro-ophthalmologist at a nearby medical school to discuss this after an examination.

JCH III MD

[Mehdi6330]

Hello doctor,

I am from Morocco and I am suffering of symptoms that are comparable to Mel's. I had an accident at the age of 7 which blinded my left eye. The vision in my right eye was fine until about a year ago. I started seeing snow-like dots on white surfaces for example and in the sky sometimes. At the beginning there were only few scattered dots. After about 6 months the dots became more numerous. Along with that came halos around lights and once i put my finger between my eye and the source of the light I can clearly see what's around the light bulb otherwise I can't. I did several retinal exams where my eyes were dilated but nothing was found. Also I lately did an angiography where everything was normal except white dots on that appeared on the images in black and white (it is called a salt and pepper aspect in french) When I talked to my doctor she said that everything was fine and that I should stop worrying and that it was all in my head. Sometimes My eye hurts and I have the feeling it is going to pop out. And I becoming really scared I would lose sight in the other eye as well. What should I do? Please help me.

Mehdi

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

The best advice I think I can give would be to see a neuroophthalmologist or a different retina specialist for a second opinion. IF they also find nothing to worry about then I would try and reduce the normal anxiety you have about losing sight in your good eye.

JCH MD

[cekman]

I developed what they believe to be MEWDS 18 months ago and still have permanent blind spots in one eye.  I had complications which were neo choroidal vascularization.  

The 'flashing lights' are a sure symptom that my disease is 'active' and means it's time to get in to see my retinologist.  Otherwise my spots increase and get worse.

I am treated with injections - the same as used for macular degeneration. They, so far, have been very helpful in improving my vision when my symptoms 'flare up'.

I'm shocked that someone would tell you to ignore this symptom, because for me it's a sign that i need immediate attention.

If there comes a time when the injections stop working I may be faced with major sight loss in my right eye.

Of course there is no way for me to know what causes your flashing lights - and I have an increase in the size of my blind spots at the same time. But if it concerns you I would continue to have it checked until you are satisfied.

Good Luck