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Seasonal blurred vision
For the past 7 years, I have experienced blurred vision ONLY during the winter months, specifically October through April. I am 35 years old in otherwise excellent health and have visited several opthamologists, optometrists and even a neurologist (MRI). Everyone states I am perfectly healthy and they can not find anything wrong. I feel tortured 6 months out of every year! When I wake up everything looks fine and within one hour the blurred vision occurs. If I start reading everything is fine for a few minutes and then the blurriness occurs. I have never been depressed nor have I suffered from migraines, headaches or sinus infections. I have carbon monoxide detectors at home and no one else in my household suffers. If it were a permanent condition I would wonder about diabetes, stroke, macular degeneration...the list could go on but this is not the case.
Does anyone have a theory/diagnosis or know of any conditions that could possibly be related to?
Thank you,
sandy1972
Does anyone have a theory/diagnosis or know of any conditions that could possibly be related to?
Thank you,
sandy1972
MEDICAL PROFESSIONAL
Thanks Nancy and Happy New Year to you and tanks for your contributions to these Eye Forums.
JCH III MD
JCH III MD
Dear Dr. Hagan,
Thank you for the perspective. The more we learn about the world (the body, the environment, the universe, etc.), the more we realize that there are ever more intricate layers of complexity, ever more astounding variety, and always, always more to learn. You cannot open a newspaper without seeing daily examples of this, nor attend a science lecture without your mouth hanging open at what is being discovered.
I used to be surprised when my doctors seemed not very interested in things they couldn't explain. Now I realize that, as you said, they see such things every day!
It takes time for patients who've been healthy all their lives and then start having health issues to realize the error of their naive but perhaps understandable perspective that it always works like this: (1) you tell the doctor what's wrong subjectively, (2) the doctor tells YOU what's wrong objectively, and (3) the doctor cures the curable, alleviates the incurable, or sends you on to the lofty heights of a specialist who can. It all used to be so simple!
Your analogy of the puzzle is good... because we ARE puzzled! :) Thank goodness for good doctors, anyway.
A very happy New Year to you, and thanks as always.
Nancy T.
Thank you for the perspective. The more we learn about the world (the body, the environment, the universe, etc.), the more we realize that there are ever more intricate layers of complexity, ever more astounding variety, and always, always more to learn. You cannot open a newspaper without seeing daily examples of this, nor attend a science lecture without your mouth hanging open at what is being discovered.
I used to be surprised when my doctors seemed not very interested in things they couldn't explain. Now I realize that, as you said, they see such things every day!
It takes time for patients who've been healthy all their lives and then start having health issues to realize the error of their naive but perhaps understandable perspective that it always works like this: (1) you tell the doctor what's wrong subjectively, (2) the doctor tells YOU what's wrong objectively, and (3) the doctor cures the curable, alleviates the incurable, or sends you on to the lofty heights of a specialist who can. It all used to be so simple!
Your analogy of the puzzle is good... because we ARE puzzled! :) Thank goodness for good doctors, anyway.
A very happy New Year to you, and thanks as always.
Nancy T.
MEDICAL PROFESSIONAL
To practice medicine you have to accept uncertainty and also that there are things you see every day that you cannot explain or diagnosis.
I always tell people that many illnesses are like word or picture puzzles. Early on which onely a few letters or just a tiny part of the picture is visible no-one can tell the answer. As more letters and more of the picture becomes visible at a later time the answer is obvious.
JCH III MD
I always tell people that many illnesses are like word or picture puzzles. Early on which onely a few letters or just a tiny part of the picture is visible no-one can tell the answer. As more letters and more of the picture becomes visible at a later time the answer is obvious.
JCH III MD
MEDICAL PROFESSIONAL
This is some information on dry eye treatment.
General Information on Dry Eyes
a Schirmer test of zero indicates that you have severe dry eyes. I'm assuming from your posting that you have tried both preserved and unpreserved artifical tears, gels or lubricating ointments at bedtime, environmental modification, etc. Don't discount eye drops. There are over a 100 different brands of artificial tears and they can't all be lumped together. Sometimes one will find the perfect drop. Because the problem is so prevalent the pharmaceutical compies are coming out with new products all the time. Some of the newest are Systane preserved and unpreserved drops and Optive drops.
If you took Restasis you have used the best prescription medication. A "trial" of Restasis is a minimum of 8 weeks of therapy using one drop in each eye twice/day. Because of the way Restasis works, it takes two months to "start working". I have found that many patients use it for a few weeks then conclude it won't help. The medication often stings when therapy is begun--it usually gets better by week three or your Ophthalmologist (EyeMD) can prescribe a mild steroid drop for a couple of weeks. If you did not take for 8 weeks you need to restart therapy. Improvement often continues for up to 6 months.
If you have tried tear duct plugs you should have had all for tear duct openings (puncta) plugged with a permanent plus (not a disolving one). Usually just the lower lids are done with mild dry eyes. If your problem is as bad as you say, you and your ophthalmologist should discuss permanent closure of some or all four of the tear duct openings with cautery.
Additional things that can help include a diet rich in fatty fish (eg salmon, sardines, etc). Fish oil taken by mouth usually 2 to 4/day has been show to help some patients. In addition there are non-prescription pills for dry eyes available at most major drug stores or by direct order from the companies. Thera-tears formula for dry eyes is probably the most widely used. You can use any search engine to pull up the websites of the companies that see these.
In dry eyes associated with corneal damage, moisture retaining goggles are used for sleeping. Be absolutely certain you do not sleep under a fan, heating outlet or situation where air moves over your face during sleep. Make certain you home is humidified in the winter, put a humidity gage in the bedroom. If you cannot maintain a 50-60% humidity put a room humidifier in the bedroom. Run the A/C or heater of your car through the vents on your feet not in your face. Long car or plane trips put your tears in every couple of hours.
If you are menopausal or post-menopausal be sure you and your gynecologist maintain optimal hormonal balance. (Many women with dry eyes have dry mouth and dry vaginal canal). If you have joint pain have that evaluated to be sure you don't have Sjorgren's syndrome. Many medications eg antihistamines can make dry eye worse. You might review your medications with your ophthalmologist.
If you reach a point of exhausting all the above see an ophthalmologist that specializes in "Cornea and External Disease". This is their special area of expertise. A final new treatment that they can often do is “Autologist Platelete-rich plasma” therapy. This uses eyedrops made out of your blood products. (reference Ocular Surgery News: November 1, 2007 page 46 lead author Jorge Alio MD.
Keep digging and moving forward. I suspect you have not exhausted all the ways you can be helped.
JCH III MD
General Information on Dry Eyes
a Schirmer test of zero indicates that you have severe dry eyes. I'm assuming from your posting that you have tried both preserved and unpreserved artifical tears, gels or lubricating ointments at bedtime, environmental modification, etc. Don't discount eye drops. There are over a 100 different brands of artificial tears and they can't all be lumped together. Sometimes one will find the perfect drop. Because the problem is so prevalent the pharmaceutical compies are coming out with new products all the time. Some of the newest are Systane preserved and unpreserved drops and Optive drops.
If you took Restasis you have used the best prescription medication. A "trial" of Restasis is a minimum of 8 weeks of therapy using one drop in each eye twice/day. Because of the way Restasis works, it takes two months to "start working". I have found that many patients use it for a few weeks then conclude it won't help. The medication often stings when therapy is begun--it usually gets better by week three or your Ophthalmologist (EyeMD) can prescribe a mild steroid drop for a couple of weeks. If you did not take for 8 weeks you need to restart therapy. Improvement often continues for up to 6 months.
If you have tried tear duct plugs you should have had all for tear duct openings (puncta) plugged with a permanent plus (not a disolving one). Usually just the lower lids are done with mild dry eyes. If your problem is as bad as you say, you and your ophthalmologist should discuss permanent closure of some or all four of the tear duct openings with cautery.
Additional things that can help include a diet rich in fatty fish (eg salmon, sardines, etc). Fish oil taken by mouth usually 2 to 4/day has been show to help some patients. In addition there are non-prescription pills for dry eyes available at most major drug stores or by direct order from the companies. Thera-tears formula for dry eyes is probably the most widely used. You can use any search engine to pull up the websites of the companies that see these.
In dry eyes associated with corneal damage, moisture retaining goggles are used for sleeping. Be absolutely certain you do not sleep under a fan, heating outlet or situation where air moves over your face during sleep. Make certain you home is humidified in the winter, put a humidity gage in the bedroom. If you cannot maintain a 50-60% humidity put a room humidifier in the bedroom. Run the A/C or heater of your car through the vents on your feet not in your face. Long car or plane trips put your tears in every couple of hours.
If you are menopausal or post-menopausal be sure you and your gynecologist maintain optimal hormonal balance. (Many women with dry eyes have dry mouth and dry vaginal canal). If you have joint pain have that evaluated to be sure you don't have Sjorgren's syndrome. Many medications eg antihistamines can make dry eye worse. You might review your medications with your ophthalmologist.
If you reach a point of exhausting all the above see an ophthalmologist that specializes in "Cornea and External Disease". This is their special area of expertise. A final new treatment that they can often do is “Autologist Platelete-rich plasma” therapy. This uses eyedrops made out of your blood products. (reference Ocular Surgery News: November 1, 2007 page 46 lead author Jorge Alio MD.
Keep digging and moving forward. I suspect you have not exhausted all the ways you can be helped.
JCH III MD
I'm afraid I'm clueless.
All I can say is that the doctors cannot explain everything, no matter how hard they try to help the patient. I know that from personal experience.
I have been surprised how many people (in my personal life as well as on forums like this) have things going on that the doctors have never heard of and can't explain. For example, my daughter has totally unexplained lymphedema in one leg--been through all the tests, no reason for it whatsoever. My sister-in-law has bizarre dizzy-spinning episodes that not the biggest expert neurologist in the area could explain (or at least prove the cause). My husband totally mystified his doctors when he had a nondisplaced nose fracture but somehow a piece of bone emerged out the bridge of his nose--the ENT could not believe such a thing, but I saw my husband tweeze the bone fragment out myself, and the lab confirmed it was bone. I get vertical ghosting when I read but only looking down, which the biggest expert eye doctors in town had never heard of. So--lots of weird things do happen that can't be explained!
Even if it appears to the docs, and seems to you, that you don't have dry eyes, maybe your eye still reacts in some unusual way to some kind of seasonal difference in the air that no one can identify as yet.
Maybe you could try a good internist to see if you have any undiscovered systemic issues going on?
Sorry you haven't been able to get an answer--hope you do eventually!
Nancy
All I can say is that the doctors cannot explain everything, no matter how hard they try to help the patient. I know that from personal experience.
I have been surprised how many people (in my personal life as well as on forums like this) have things going on that the doctors have never heard of and can't explain. For example, my daughter has totally unexplained lymphedema in one leg--been through all the tests, no reason for it whatsoever. My sister-in-law has bizarre dizzy-spinning episodes that not the biggest expert neurologist in the area could explain (or at least prove the cause). My husband totally mystified his doctors when he had a nondisplaced nose fracture but somehow a piece of bone emerged out the bridge of his nose--the ENT could not believe such a thing, but I saw my husband tweeze the bone fragment out myself, and the lab confirmed it was bone. I get vertical ghosting when I read but only looking down, which the biggest expert eye doctors in town had never heard of. So--lots of weird things do happen that can't be explained!
Even if it appears to the docs, and seems to you, that you don't have dry eyes, maybe your eye still reacts in some unusual way to some kind of seasonal difference in the air that no one can identify as yet.
Maybe you could try a good internist to see if you have any undiscovered systemic issues going on?
Sorry you haven't been able to get an answer--hope you do eventually!
Nancy
Nancy,
The blurred vision is consistent - every day. Sometimes throughout the day things will look (people and large objects) clear but it always feels like there is something uncomfortable wrapped around each eyeball. Every doctor has said I do not have dry eyes. They recommended those magnifying glasses which, as you know, do not help with blurred vision (of course I tried them anyway). I live in Chicago so it's very cold during the winter and we do have a humidifier attached to the furnace. This condition occurred while I was single with no pets and no humidifier and even now 7 years later with one pet, a different home and a family.
It is bizarre which is probably why no one has been able to help. I have used the eye moisture drops in previous years from B&L and even used Refresh gel to no avail.
I read on the internet that sometimes eye problems are connected to an issue with the liver or a deficiency in Vit A but since it's only seasonal, I continue to be at a loss.
If you have any thoughts as to other physicians that might be able to help (other than optha, optom or neuro) I would greatly appreciate it.
Sincerely,
Sandra
The blurred vision is consistent - every day. Sometimes throughout the day things will look (people and large objects) clear but it always feels like there is something uncomfortable wrapped around each eyeball. Every doctor has said I do not have dry eyes. They recommended those magnifying glasses which, as you know, do not help with blurred vision (of course I tried them anyway). I live in Chicago so it's very cold during the winter and we do have a humidifier attached to the furnace. This condition occurred while I was single with no pets and no humidifier and even now 7 years later with one pet, a different home and a family.
It is bizarre which is probably why no one has been able to help. I have used the eye moisture drops in previous years from B&L and even used Refresh gel to no avail.
I read on the internet that sometimes eye problems are connected to an issue with the liver or a deficiency in Vit A but since it's only seasonal, I continue to be at a loss.
If you have any thoughts as to other physicians that might be able to help (other than optha, optom or neuro) I would greatly appreciate it.
Sincerely,
Sandra
MEDICAL PROFESSIONAL
I believe Nancy T is correct. In winter months the air is dry and your body loses water to the air. I would suggest you get a relative humidity gage and put one in your bed room and living area. Make sure you have a humidifer on you furnace that works and keep the humidity about 50%. If you can't keep it up there with furnace get room humidifier. Make sure you do not sleep under a fan or with warm air blowing across your face.
Read the previous postions about dry eyes and treat your eyes with artifical tears 3-5 times day and at night instill Genteal Gel.
Dry eyes and allergies to things like dust, mites, animal dander and fibers that you would be more exposed to with your indoord more are the only things I can think of right now.
JCH III MD
Read the previous postions about dry eyes and treat your eyes with artifical tears 3-5 times day and at night instill Genteal Gel.
Dry eyes and allergies to things like dust, mites, animal dander and fibers that you would be more exposed to with your indoord more are the only things I can think of right now.
JCH III MD
That is totally bizarre! Can you describe the blurred vision more specifically? Is it consistent, like every day? Every time you read?
Do you live in a climate where the air is dry in wintertime? Could you be having a dry-eye issue? Although if you've seen that many doctors, they surely have thought of that possibility, I imagine.
Nancy T.
Do you live in a climate where the air is dry in wintertime? Could you be having a dry-eye issue? Although if you've seen that many doctors, they surely have thought of that possibility, I imagine.
Nancy T.
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