Straight lines appear curved

When I close my left eye, Straight lines appear bent or curved in the right eye, or more like someone hit it with a hammer, a big dent. My eye doctor sent me to a retina consultant.He said he did not see any thing that would be the cause of my symptoms. He sent me to Duke University eye center. They only found a few small hard drusens that they felt would not be the cause of my problems. Doctor Said lets just keep an eye on it.I still have a lot of anxiety about my eye and can not quick closing my other eye which may be the cause of the pain and blurry vision late in the day.Do you recognize any thing that would cause my symptoms other than the retina, could it be the lens? If not will drusens go away over time?  I am a white male 58 years old.Duke center recap:                        
Yes you do have a few hard drusens on the back of the eye.  However there were no wet macular degeneration and no abnormal blood vessels growing.
I felt the drusens could be causing the waviness or Metamorphosis.
Drusens are sometimes a sign of dry macular degeneration.
You have a few small hard drusens, not a lot, which means they were too small to say you had dry macular degeneration. You do not have a clear diagnosis of macular degeneration.
I thought it would be worthwhile given the fact that you did have a few small drusens to put you on the vitamins anyway.(One A day & 20 MG Lutein)
If your eyes are burning or tired at the end of the day they probably need artificial tears.

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

5234    Your symptoms indicate a macular problem. A lens abnormality such as a cataract would not normally cause distortion (the most common cataract symptoms are blurred vision, night vision problems, glare, ghost images). You have seen a retina specialist and been to the ophthalmology department of a world class medical school. The two things that they would primarily look for are fluid in the center of your eye (Macula) or abnormal blood vessels leaking or bleeding (Neovascular membranes). Neither found these so I would accept their assertions that surgery or the new wet macular degeneration treatments (intra-ocular Avastin, Lucentis or steroids, Visudyne light treatment) are indicated and try and relax. There is no generally agreed definition of what constitutes early, mild macular degeneration. Some of the findings that are often seen: soft drusen, pigmentary clumping, increased/decreased pigmentation, loss of foveal reflex and atrophy or wasting of the tissue under the macula.

Ongoing evaluation is important and you should be regularly re-evaluated by one or the other of these two ophthalmologists that evaluated you. Hopefully they have given you an Amsler grid and explained how to test each eye individually on a daily basis. If not Google 'Amsler Grid' and you will be given instructions for testing each eye and you can also print an amsler grid off the web. I instruct my patients to tape the grid to their refrigerator and test each eye at mealtimes.

Given your description of your problem early dry macular degeneration is the most likely cause. To slow macular degeneration down: eat fruits, vegetables, nuts, fiber, fish, berries and lutein rich food (dark leafy greens eg spinach). Reduce fatty foods and do not become major over-weight or obese as these have been shown in the last year to increase the risk of AMD. Don't smoke, protect your eyes from sunlight with a hat and UV blocking sunglasses. Take a multi-vitamin + an AREDS (age related eye disease study) supplement (eg Ocuvite, Preservsion, Eye-cap) note that these supplements are 2/day or 4/day. If you smoke (shame-stop it) you should not take any extra Vitamen A (beta-carotene). If the AREDS does not contain lutein take 20 mgm lutein (this latter is not supported in exisiting research-its intuative. The study to see if this is useful will take 6 years to complete). Note also that some multi-vitamins advertise they contain lutein but the amount is miniscule (1/4 mgm).

Macular degeneration doesn't have to get worse, especially if you follow all the above recommendations. There are no restrictions on using your eye and macular degeneration is not caused by over-use of the eyes.

Stay close to your ophthalmologists, they've got you pointed in the right direction.

JCH MD

[circumspect]

Neither found these so I would accept their assertions that surgery or the new wet macular degeneration treatments (intra-ocular Avastin, Lucentis or steroids, Visudyne light treatment) are NOT indicated and try and relax.

My response contains an error, the above is correct. I left out the important word "NOT"

Sorry for that error. Wish I could type as fast as I think.

JCH MD

[5234]

Thanks for the response,If you feel that the drusens are the  cause of my symptoms is this common or very rare?Could the pain and redness be my anxiety by closing my good eye.And can dusens go away over time? THANKS

[circumspect]

Drusen causing distortion: hard drusen not common  soft drusen: common
Drusen do not go away and with time and age generally increase.
Drusen do not cause pain or redness.
If you were told by an ophthalmologist that the pain/redness was dry eyes I would go with that explanation.

JCH MD

[5234]

sorry this will be my last post ;could I have this problem and just not noticed it,the ony way i noticed it was after a new set of glases i was seeing if both lens look the same looking out one eye at a time ,when i noticed it. My regular eye doctor said my file showed small hard drusens 5 years ago. THANKS

[circumspect]

I suspect that at age 58 and with multiple eye examinations over the years that it is a new symptom. It would be unusual for something that obvious to slip by you and your previous examiners all these years.

This morning in clinic I saw at least 10 patients with drusen. None of them complained of distortion.

JCH MD