Growing Vision Spot

    
      Re: Growing Vision Spot
    


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Posted by ccf neuro M.D. on April 14, 1997 at 22:14:48:

In Reply to: Growing Vision Spot posted by KGT on April 08, 1997 at 09:39:33:

: This Message was posted by: KGT -  4/8/97 12:59:40 AM
  Message:
  I have a strange vision spot that is about the size of my fist when held at arms length. I can see through it 95% of the time. It is
  visible to me when I blink. It appears as a bright halo with a dark center. It used to be circular. It is now becoming ovalish. It is
  getting bigger. I have had it for two months. It distorts straight lines on a grid in the shape of itself, like it is warping the field.
  Today I noticed that it has started to dim my vision in the spot. It makes the area within it yellow and dim. I get sparkles in the
  middle of the spot and I also get intense flashes in the direct center of my vision. I have the flashes about every minute - all day
  long. I see the spot all day, every day. It is always located in the same area: just off to the right of center vision. I only see it in
  my right eye. I have seen two doctors (opthamologists). No one can spot any reason for what I am experiencing. I am getting
  worried. It is getting worse.
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KGT,
Your story is somewhat worrisome in that you describe a progressively enlarging spot of missing or abnormal vision called a "scotoma". This is typically associated with some sort of progressive disease process either in the optic nerve (the nerve that connects the retina of your eye to your brain) if the problem is confined to a single eye, or in parts of the brain itself that are involved in processing visual information of the problem is in the same part of the visual field of BOTH eyes. Probable causes in the former case include abnormal swelling and inflammation in the optic nerve, often associated with an underlying disease process that may affect other parts of the body and/or nervous system, many of which are treatable but may leave behind permanent damage if not promptly treated. Another possibilty would be an unusual tumor of the nerve called an "optic glioma". I would wholeheartedlt agree with the suggestion posted by the optometrist who kindly also has replied to your question that you see a neuro-opthalmologist preferably, or a neurologist alternatively to search for problems in the portion of the nerve within the brain. Tests that can detect subtle abnormalities that might be missed by direct examination include one called a VISUAL EVOKED POTENTIAL, and/or a special MRI scan called an MRI of the ORBITS nad/or brain, usually with contrast material. Depending on the findings of these tests, additional testing such as blood tests and/or spinal fluid testing might have to be performed. I would suggest you make an appointment with either a neuroopthalmologist (these are physicians who specialize in sorting out whether visual probles are secondary to eye or nervous system diseases) or if none is available, a neurologist with a specific interest in multiple sclerosis and/or optic neuritis, who may have significant experience in cases like yours. I would suggest the nearest large, teaching hospital or medical school-associated medical center. If you are near the Cleveland area, we do have one neuro-
opthalmologist named Dr. Gregory Kosmorsky. You can call 1-800-223-2273 and ask to be connected to his office. He may be able to suggest someone close to you that has special expertise in this area. I would reemphasize, however, the need to do so PROMPTLY before your visual impairment worsens and/or becomes permanent.