New information at opthamologist, need help understanding my retina problem.

[erica1991]

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Hello again,

I saw the opthamologist today who confirmed the k sicca and discussed possible punctual plugs. We talked in depth about my night blindness symptoms and I told him that the optometrist in Alabama said that the black spot was a nevus. He looked at it and then dilated my eyes and He did a different exam where he put a magnifying glass there and put a REALLY bright light in my eye and then said he wanted to do an ultrasound. He said that it was not a nevus but actually a pigmented change on the retina. He said I need to have yearly checkups to monitor it and explained to me the symptoms of a retinal detachment and told me I would need to go to the ER if I had them. He also said if I have an increase in floaters to go back and see him before my follow up. I have a follow up in two months to check on the dry eyes since they were really dry at this appointment. Can anyone help explain this a bit more in detail to me and in a way that I can understand it better?

[JohnHaganMD]

First read this article I wrote about treatment of dry eyes:  http://www.medhelp.org/user_journals/show/1648149/General-information-on-dry-eyes-tears-dysfunction-syndrome    Tear duct plugs are not terribly helpful as they generally fall out in 6 months or less. If you have severe dry eyes and are using artificial tears more than 4 times/day consider going on Restasis. Both my wife and I have are on restasis for severe dry eyes. My wife has the type (lipid deficiency) where her eyes watered all the time and I have aqueous deficiency where I have no tears at all. It takes 6 month to "kick in" but if you are mid-20s and having severe problems it will only get worse as you get older.  As for the pigmented spot on the retina its not likely anything serious. Whether you call it a choroidal nevus or retinal pigment is not much clinical difference. Retinal detachment is relatively rare occuring in about one in 7000 people without major risk factors or who have had cataract surgery. Floaters are ultra common.