Avatar universal

Distorted vision in left eye but all the test are fine

Hello, I have distorted vision in my left eye. I am 33 years old.

The doctors have conducted extensive test - OCT, FA, Corneal thickness and of course Fundus examination.

According to doctors my eyes are completely fine and they can’t seem to find the cause of the distorted vision.

Also was referred to a neurologist but MRI scans came out just fine.

On a side note

I have lattice degeneration which I was told is something not to worry about. Soon after going through extensive checks for distorted vision I did develop floaters in my right eyes and the opthamologist decided to seal the retina with Laser. But the laser was done after detecting  Metamorphopsia so laser surgery did not result in this.

The Metamorphopsia seems to be progressing in the left eye (tracking through AMSLER grid) but doctors don’t know what could be the reason. Any lead would be helpful.

Thank you so much!
3 Responses
233488 tn?1310693103
It's "ophthalmologist" and you need to see a different one for another opinion.  Some of the tests you may need besides a fresh opinion: cornea topography to rule out irregular astigmatism,  another look at your lens,  macular OCT/OCTA, fluorscene angiography, visual fields.  There is a cause and more digging needs to be done.
Thank you correcting the typo. I have been to 4 ophthalmologist and all of them have the same view. All the test you have mentioned have been conducted as I pointed in my question. Only test pending is visual field but doctors don’t think that is needed since my optical nerve is absolutely fine.
Then you have two choices.  Use 'watchful waiting and careful observation" to see if new symptoms appear or present symptoms worsen. Or bundle up all your results and head for a 5th ophthalmology ideally a neuro-ophthalmologist associated with a medical school.
Avatar universal
Thanks Doctor Hagan! To conclude in addition to 4 opthalmologist , I have consulted a neurologist ophthalmologist and a neurologist. The symptoms seem to be worsening off but again no one knows why. I think I will get the visual field test done as well, just to get it out of the way. I am seeing another ophthalmologist today.

Though I have been told by couple of ophthalmologist  that’s maybe because I am under too stress this is manifesting. I find it difficult to believe but they are one of the best in the country I come from.
Visual field and Amsler grid testing definitely indicated
Dr Hagan, visual field test also came back absolutely normal. I started noticing a little curve in the right eye but that maybe psychological or didn't notice earlier. So I went for the visual field test and the reports came back normal , also they did another Oct and it came back completely normal.

I'm stressed if this could be done dystrophy or any of the other dystrophies but none of the opthalmologist think that is necessary and no need to get an ERG done. I'm a little stressed.
Sorry I meant cone and not done
The fact that none of the Eye MD s think this is serious now and have found no problems is encouraging.   There are always other tests.  A new one is Macular OCT angiography,   it is not expensive and you might ask about it. You might ask about the cost or ERG.  If insurance not cover you might consider paying for it yourself if it would bring you peace of mind. There is also a new version of that call mfERG.
Thank you Dr Hagan! I'm currently based in India and these test aren't that expensive. MfERG is not expensive here. Their suggestion is not from a resource perspective. One of the reasons provided to me was that if there is any abnormality in MfERG it would only add to the stress while there isn't a normative database to check the condition against which will be suitable to check in my case. These are some of the most finest doctors in India and thankfully I have access to them but they just don't think anything is needed except lowering stress and not worry about it. Was also suggested to stop looking into amsler grid every day and to stop reading about this everywhere.
Then perhaps start working on their suggestions.  Consider seeing a psychologist or psychiatrist. Try meditation.  I have found personally and for my patients CBT Cognitive Behavior Therapy extremely helpful.  "Biblio-therapy" or reading various books about anxiety, depression, hypocondriasis is effective for many.      Our practice retina specialist is from India and a superb physician.
Thank you so much Dr Hagan! I'm hoping and praying that this resolves and I get back to living.  

May I ask you one last thing and I promise I won't bother you again. Does Epilepsy or rather the reasons that cause epilepsy can be behind it. My metamorphosia is mainly unilateral and constant. I did have epilepsy attacks , a couple of them as a child but I never realised what they were and never bothered to inform my parents instead imagined them to be something magical (ignorance at its best) .
Certain seizure disorders can cause visual changes including distortion but would not be present all the time.
Thank you so much Dr Hagan!
You are welcome.
Hello again Dr Hagan!

I was doing my reading again and came across something called macular microhole. Looking at the picture of these microholes on OCT they seem eerily similar to mine. I was hoping if you can have a quick look at this? Would that be a possibility?

Left eye - http://imgur.com/XBiKHx2
Right eye - http://imgur.com/U7bbhcX

Metamorphosia is in the left eye.

Thank you so much!
First you said your macular OCTs are normal.  Neither one of those macula OCT show significant macular holes.  Are what you posted yours?  The LE has an area off the macula that isn't quite normal but if symptomatic would cause distortion away from fixation not on fixation.
Dr Hagan, I said my OCTs are fine based on what I was told by the doctors. I have been educating myself every day on this (unfortunately I’m an economist by training, given how much grief my eyes are giving me I would have better studied medicine) and to my I did see an issue with my OCT and hence decided to seek your opinion.

I think now maybe my OCT requires another opinion. Will see a doctor soon.
Oh and yes these are my OCTs. Started educating myself and reading about it this morning. Thank you so much
And sorry on the same topic two things

What do you think is the abnormality on the left eye so I can check with the retina specialist on the specifics for that?

And apologies for my lack of understanding- what do you mean by distortion away from fixation and of on fixation.

Thanks you so much for your help!
It's not possible to do a reading/interpretation of OCT without seeing the entire print out with multiple views and the numbers such as macular cube volume. But look at left eye. Macula is hill/valley/hill and looks good.  To the left there is a elevation not seen on the other side or on the right eye. It could be an artifact but if an abnormal area of the retina it could cause some distrotion on the nose side of "fixation" or exactly what your eye is looking at.  Read about Amsler grid test, print out a amsler grid and monitor your eyes. If grid looks normal both eyes not likely any macula or para macular pathology.
Hello Dr Hagan!

Firstly, thanks a ton for your valuable input, as I do have distorted vision in lifer we on Amsler Grid and otherwise from left eye which is the cause of my concern.

What would be the medical name of this situation? If any. And also is there a cure or cause of this elevation? So I can bring up with the my retina specialist next week.

Best Regards
Sorry there was a typo in the above sentence - “as I do have distorted vision in lifer we on Amsler Grid and otherwise from left eye which is the cause of my concern” should read “as I do have distorted vision in left eye on both Amsler Grid and otherwise, which is the cause of my concern”
I assume you are now comfortable with testing you vision with Amsler. First make sure you are seeing distortion in the LE and not in the RE.  Second if the problem is in the macula the distortion will be in the center of the grid where the dot is.   With the limitations I outlined your macula looks okay and I would expect the center of the LE grid to be normal.  If the distorted area is not it the center then the cause in around the macula. It will be 180 degree away from the distortion. So if in the LE the distorted area is to the right of the dot (nose side) it indicates the lesion is on the ear side of the LE macula Same thing apples to up or down.  Print a grid out for each eye. Use pencil on each eye and outline where you see the distortion and the relative size. Take that in to the retina surgery it will be helpful.    There is a very thin line in the vitreous cavity but it looks more like the posterior vitreous face than a epiretinal membrane.  That's about all I can tell. Good look with your retina consult
Thank you so very much! Immensely helpful! Best regards
Hello Doctor Hagan! Just an update

So I went to see my retinal specialist.

I proved on a lot of points, pretty much took the print out of our conversation above. Also probed him on this potentially being a case of resolved CSC or pachychroid - which he believes this isn’t.

But this time round he has made a diagnosis of solar retinopathy since he can see a very small minute red spot near the fovea. I insisted him to do my another OCT (paid from my pocket in my country) but he thought it wasn’t needed.

Oh and I have never watched solar eclipse or welding arc or anything.

Not really know if to believe this or not.
pachychroid     don't know what that is.   Solar retinopathy is right in the center of the macula not off center.    Solar maculopathy occorred in the days to weeks post total eclipse not later.    Might be time for a second opinion from a different retina specialist eye MD
Firstly Dr Hagan thank you for the time you provide. I'm also not entirely convinced with the diagnosis. Junior doctor with the specialist couldn't see any lesion and also recommended an OCT but the doctor over ruled. I will have another opinion soon, will try to see a doctor outside India now.  
Okay, good luck. To make the consult productive take your old records and OCTs.
Avatar universal
I am 68 years old and get a wavy or mirage like condition in the corner of my right eye.  It only lasts about 15 to 20 minutes and appears to move.  It used to happen once every 6 months or so, but for the last month it happens almost  every week.  I have not had a headache in years and feel no pain from this condition.  It always affects my peripheral vision and occasionally affects where I am trying to focus until in moves to my peripheral before disappearing.  It almost always happens in the morning.
There are many causes of this.   In younger people the most common cause is migraine especially visual or ophthalmic migraine. However disease of the eye, brain, heart and blood vessels can cause this especially in someone your age.  You need to work through excluding this other causes with an ophthalmologist and your personal physician and maybe a cardiologist.
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