Does Anyone Have Experience With Sudden Oscillopsia With No Known Cause?

[bcarrizzo]

Last summer, I was just minding my own business when, all of a sudden, I felt an unusual pressure behind my eyes. I dismissed it as sinus pressure, as it came and went sporadically. But one day it happened again, and this time, I lost the ability to focus my eyes on a fixed point.

From morning to night, my eyes literally felt like they were moving. I couldn't keep them focused on a word while I was reading. They'd dart over to something else. They'd oscillate and pulsate. To understand, take your mouse and move it around any word in this sentence in a slow, semi-counterclockwise manner. That was my vision constantly, and it freaked me out.

I've been to more than a handful of doctors, and I've had a ton of diagnoses: Nystagmus, Ocular Myokymia, Benign Essential Blepharospasm, Disorder of Vestibular Function of the Right Ear, etc. I've tried beta blocker pills, beta blocker eye drops, benzodiazepine and pregabalin, and none of these have worked. So far, the best explanation is that it has to do with sporadic nerve firing which resulted from stress/anxiety. I mitigated my stress levels over the past several months, which hasn't worked. It seems to be getting better on its own, but the process has been painfully slow. It's been a year since its onset. The sensations are less pronounced, but it's far from gone.  

I am a 24 year old male with no other symptoms or health conditions. If anyone can identify what this is, I'd appreciate it. Thank you!

Best,
Benedict

[JohnHaganMD]

I would be certain that one of the physicians you saw was a neurologist and that you have had a MRI/MRA of the head. If you have had all that then I would head to a tertiary referral/diagnosis center like in the USA Mayo Clinic, Cleveland Clinic, Washington U in St. Louis etc.  Anxiety should not cause that kind of problem.

[bcarrizzo]

Thank you for your response! Yes, I've had an MRI & it came back normal, aside from a trivial sinus problem. I've seen a neurologist and two neuro-opthamologists. What can these tertiary referral/diagnosis centers find that these specialists couldn't? Any additional help would be most appreciated.  

[JohnHaganMD]

Those of us in private practice have good expertise and familiarity with about 95% of the things we see regularly. However rare diseases or unusual presentation of common diseases are seen infrequently, they tend to be referred to  tertiary medical centers, often large medical schools, which is a collecting point for these rare problems.  Physicians at these centers have the rare 5% make up most of their practice. I was in the service with a physician that went on the faculty of Mayo Clinic. He said in a month he sees problems that most doctors in his specialty (pediatric cardiology) see once in their career.  Given the tests you've had and having seen 2 neuro-ophthalmologists its not likely serious at this time. Another less expensive, less intrusive approach would be expectant observation where you don't do any more testing unless things get worse or new symptoms appear.

[bcarrizzo]

Hi Dr. Hagan, I'll go to a tertiary medical center if my condition fail to improve. A few more things: what is the viability of acupuncture for a condition like this? And what do you think of botox? That is what my last neuro-ophtalmologist recommended. Thank you.

[JohnHaganMD]

Nothing at all scientific on either subject has been published in reputable journals.  Botox is used for migraine therapy. You could ask the neuro-ophthalmologist if he/she thinks it is a migraine variant.