puzzling question

I had a visual field test and dilated exam and an OCT after the technician found I had spots on a grid she showed me. Nothing to explain the spots on the grid was found though. Could it be something harmless that causes me to see these spots on the grid, since everything else was normal?

[romanam]

What I mean to say, is it possible to have problems with that grid but nowhere else.

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

Yes it is possible to have minor blur, doubling or distortion without it due to serious problems. The exam you had with Visual Field and macular OCT should exclude the very serious type. If something changes or new problems develop you can return for a repeat exam.

Glad things turned out well. Often it's better to have a minor problem that defies explanation or exact diagnosis rather than a serious problem that is diagnosed with certainty.

JCH III MD Ophthalmologist

[romanam]

Oh, my sentiments exactly, although the "not knowing" leads to the "what ifs?" are a LOT of anxiety!

I have basically convinced myself I have something really terrible though the doctor assured me there is no VISIBLE sign of disease RIGHT NOW.

What makes me just I'm sooo scared of what MIGHT happen.

I think I need medicating ...

[romanam]

I forget my question - does a problem with the grid mean it's always a macula problem? Or can it be someone else, like in your lens?

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

Yes it is possible to have minor blur, doubling or distortion without it due to serious problems. The exam you had with Visual Field and macular OCT should exclude the very serious type. If something changes or new problems develop you can return for a repeat exam.

Glad things turned out well. Often it's better to have a minor problem that defies explanation or exact diagnosis rather than a serious problem that is diagnosed with certainty.

JCH III MD Ophthalmologist

[romanam]

Sorry to bug you again, but could you please tell me if the amsler grid is only for macula problems or would it pick up things elsewhere in the eye, eg on the lens etc

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

The amsler grid is mainly for the macula but could pick up problems like astigmatism, corneal scars, corneal keratoconus, lens opacities or cataracts, blood in the vitreous, retinal detachment.

JCH III MD

[romanam]

So if there was a serious disease causing this, the doctor would be able to see it and tell me? I am driving myself crazy with worry.

[romanam]

Oh, I just thought of something. Maybe the reason the visual field test was OK is because the grey/blanked out areas on the grid aren't true blind spots, but i can see through them???
Is the field test I had (it was the close-up one) as sensitive as the grid test? I mean kind of on the same scale?

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

The visual field test the peripheral vision primarily and the Amsler Grid checks the central vision primarily.

JCH MD III  Eye MD

[johnmanj]

oh, ok. i checked and it was a 10-2 test - they said it would check my macula?? is that not right?

[romanam]

(Sorry, it's still me, romanam - i forgot my password)

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

The 10-2 program is a modification of the standard visual field (usually a 30-2) in which the central 10 degrees is tested. They are correct with this modification they are primarily checking the macula and the para-macular area.

JCH III MD

[romanam]

do you have any idea how the amsler grid problem can be explained in light of a negative 10-2 field test? is one more sensitive than the other? (sorry for all the questions - i'll get out of your hair after this)

[rottfriend]

let me rephrase that - which of the two tests has the final say, so to speak?

[romanam]

Um, thanks for your input rottfriend, lol ...

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

I would put more stock in the 10-2 and more stock still in a fluoriscene angiogram or macular OCT.  I have many patients that test somewhat abnormal with an Amsler and all their other tests are negative.

Amsler is cheap, simple, quick and lends itself to taking the test daily at home to check for changes.

JCH III MD Eye Physician