Ocular Histoplasmosis & Opthalmic Migrane

[ARMork]

Eight yrs ago I was diagnosed with occular histoplasmosis (left eye - affecting my central line of vision).  With time, it seemed like my brain adjusted for the distortion; I had to look at an Amsler grid just to remember which eye was affected.  Last week, I started to notice a flashing light in my right eye. An eye exam found no detached retina, and all histo spots remain unchanged in every aspect.  Dr. gave me a diagnosis of ophtalmic migrane.  However, the most severe symptom is now visual distortion from the histo spot - exactly as I remember it being like at age 19, 8 yrs ago.  I have to constantly cover my left eye to avoid the double/disorted vision that leads to headaches.  It appears that my brain has "forgotten" how to adjust to the spot.  I've been under an increased amount of stress lately, but am otherwise healthy.  Any suggestions?

[Sandy Feldman, MD, MS]

Dear ARMork,

I would recommend that you perform an AMsler grid immediately.  If it has changed from what you remember, you might require treatment for the ocular histo. Seek the care of an eyeMD  specializing in retina.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[Michael J Kutryb, MD]

My first thought was - no, I really have nothing good to suggest.  I get questions sometimes from patients who report that the poor vision in the bad eye is messing up the overall vision in the good idea.  In these cases, I suspect that the bad eye may have initially been the dominant eye, years ago, before the problem that caused the loss of vision.  I don't have any magic answer here in this case, sorry.  I would focus your thoughts on the good news that the right eye is still in good shape and make sure to keep close follow up with your ophthalmolgist to make sure everything is taken care of, there.  I hate to tell  you to patch or cover the bad eye for fear that you would not be able to monitor it properly for any vision loss.  I suppose as long as you checked your amsler daily, you could try patching the bad eye while you read, but not when driving or other essential tasks.  You may just need to work through this, but keep the focus on the overall health of both eyes and be thankful for your stable condition.

MJK MD