Flicker/pulsating grey spot just off center - only in brightly lit situations

[xltjim]

Hello, I recently posted this in the marathon post we have regarding "bright spot when blinking".  I am not sure if what I am experiencing is the same thing.  I am curious as to what may be causing these symptoms in my left eye only.  The left eye had one occurrence of Iritis 6 years ago and hasn't happened again.  This eye had to have a vitrectomy 14 months ago to repair a detached retina (mac on) and recovery included a scratched cornea (healed fine), 2 months to get inflammation resolved with durezol, finally cataract surgery 7 months ago and the vision has been fine corrected with glasses.

What I am experiencing is something I had prior to the vitrectomy.  The eye md had me monitor my blood pressure and its low in the mornings (100/70) pulse around 60.  My exercise consists of walking 5 miles + - a day.  No cause has been found.  Dilated exams/OCT have been done a few times.  I seem to notice issue on brightly lit days -- especially now with snow on the ground w/bright sunlight.  Seems to be aggravated by the bright snow on the ground.  Last time I had this was last winter.  The problem is never present when I have had the eye md check me out.  By the time I see the MD its not occurring.

1).  I wake up in the mornings and take a look out the window.  When I blink I get a small grey spot (about the size of a pea if I held one up) which rapidly pulses or flickers just off to the right of my center vision.  This is not a light flash.  If I keep my gaze and don't blink it stops, I blink and it will pulse/flicker again.  Again, only in brightly lit situations.  I wear sunglasses on my morning walks, if I take them off sometimes I will get the situation again.  Not visible if I close my eye.

2).  I take out my trusty amsler grid to check it and its fine - no missing boxes or curvy lines that I can tell.  

3).  As time goes by maybe after an hour the issue is gone.  I cannot duplicate it again until the next morning although Its not experienced every morning.

4).  I had this the last couple of years, it will go away for months and not detected again until bright situations (like bright day with snow on the ground).

5).  No headaches after these.

Note - only other history is for my other eye which is healing from a vitrectomy now as well to fix retinal tears.  No issues with that eye other than needing a cataract removed in a few months.

I will mention this again when I have my followup on my other eye.  I would go sooner if there was a change or it gets worse. Has anyone else experienced this?  Or is this one of those "things"?  Sorry for the long post...very hard to describe.  Regards, Jim

[JohnHaganMD]

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[xltjim]

Well I had my followup for my other eye that had a vitrectomy.  Good news in that I have been cleared and referred back to the cataract surgeon for that eye.  The other eye I reference in my post above continues to have the issue.  Retina Dr. didn't see anything and didn't have an explanation.  Its seems to start after I have been up for a couple hours and lasts for maybe an hour - almost daily - then never happens again that day.   Going outside or brighter environments seem to initiate it.  My plan is to bring it up with the cataract surgeon (who had done the cataract removal on that eye).  After that, I guess I may try to ignore it watching for changes and then seek out a neuro opthalmologist.  Sound like a plan Dr. Hagan?

[JohnHaganMD]

Sounds like a plan. I'm assuming the retina surgeon looked at the macula of both eyes and also did a macular OCT on both eyes. If so I would move on unless things change and/or new symptoms develop. Good luck with your cataract surgery.