Stars in one eye & pupil larger. Doppler shows elevated peak systolic velocity.

I occasionally see bright spots, kind of like little sparks or dots that appear in my right vision mostly outside of the centre of the visual field. They appear and travel a short distance and disappear and new ones appear. I know they are only in my right vision because last time this happened I covered my right eye and they were gone, I then uncovered and they were back. These 'episodes' last about 15 to 30 seconds and are mostly brought on if I turn my head over my right shoulder, for example to try to look at my back. When my head turns back the 'episode' begins.

My right eye also frequently feels somewhat puffy or swollen.

An opthalamologist couldn't find anything wrong in either my eyes.

Other's have noticed my pupil being larger than the other and mentioned it to me (that's when I first noticed). It does not seem to be constant as the GP and opthalomoligst did not notice it.

I had a carotid doppler ultrasound earlier this month. The report in its entirety says:

"CAROTID DOPPLER ULTRASOUND

Clinical details: Patient reports bright spots in the visual field on and off for a number of months as well as seeing right pupil larger than left but not observed by GP.

No atheroma could be identified in the carotid bulbs or proximal internal carotid arteries.

Although the peak systolic velocity in the right ICA is slightly elevated to 130cm per second, there is normal ICA/CCA ratio measuring 0.95. Normal doppler spectrum. On the left, there is no elevation of peak systolic velocity with a normal ICA/CCA ratio of 0.84.

No external carotid artery stenosis is demonstrated.

There is normal antegrade flow in both vertebral arteries.

CONCLUSION

Slight elevation of peak systolic velocity in the right ICA is most likely physiological with a normal ICA/CCA ratio. No haemodynamically siginificant internal carotid artery stenosis could be identified by dopper ultrasound criteria. Normal antegrade flow in both vertebral arteries."






***What does all of this mean?
***Why is the PSV in my right internal carotid artery elevated or what are the possible reasons?
***What happens now, do I need to get follow up tests or treatment?
***Do I have a brain tumour or is is possible or likely?

[AusFrog]

FYI I am a 24yo male.

[S. Kaul, MD]

Hi there!

-This is essentially a normal carotid Doppler study.
-Slight elevation in PSA is unlikely to be of clinical significance.
-I would suggest a review with your treating ophthalmologist or seeking a second opinion with another ophthalmologist for a detailed evaluation. If a specific cause is identified, it can be managed accordingly.
-Neither the symptoms nor any of the tests are particularly suggestive of a brain tumour.
Hope this is helpful.

Take care!