Go see a neuro-ophthalmologist just to be sure.
When I got the first one in my right eye I decided to make that appointment with the neuro-ophthalmologist and I saw him the other day.
Note, I am a very stressed person with OCD which has also turned my life into a very sedentary one in the past few years. I do graphic design at home and do not go out very often.
I am female, 43. Healthy weight with a history of anemia (iron). I also used to have high cholesterol but eat healthier now and last time I was checked it was normal (although that was a while back).
So I explained my symptoms to the specialist and gave him my history. I had a field vision test which shows areas of a scotoma on the upper and lower fringe of my left blind spot and a large area of defect in my nasal area in my right eye. On examination he noticed a slight paleness in my temporal area of each optic disc, but less so in my left eye. I asked him why another ophthalmologist had not noticed (as I worried that it was new), but he said that because it is mild he does not believe many would notice.
He then gave me an OCT of the RNFL and the ganglion cell layer of my macular and optic discs.
"The OCT showed thinning of the temporal retinal nerve fiber layer (RNFL) of both eyes (right greater than left). The ganglion cell complex (GCC) showed
thinning of the temporal parafoveal region in both eyes. The macular fitness showed thinning of the superior nasal region of the right eye in the 6-degree zone. The OCT findings of the thinning of the parafoveal ganglion cell complex (GCC) for both eyes matches the "box" visual field defect that she has experienced in both eyes on Amsler grid visual field test"
He has concluded that these findings are from the car accident as my distorted vision has been there for over 10 years. Is this likely? He did say that the thinning is mild (he had not put that in the report though).
Also, if the thinning is in the parafovea, then would this make sense that my actual distortion in in the very center of the amsler grid and actually does not extend far past the first set of lines on either side of the central dot (and the sharpest distortion which actually looks like the horizontal line is turned and then suddenly goes down and then up again (like a heartbeat sign) is to the very left of the dot in my right eye and the distortion in my left eye is the opposite but there is no sharp line and the distortion is very slight.
I thought that the parafovea would have to correspond to further out in my vision.
I think my fear is if this is actually new and degenerative and not related to the distortion, although he thinks it is the latter.
Secondly, the blind spots found in the visual field tests are new, but he was unsure whether they are (he is being sent my past VFT results so this should clear this up). I believe that these areas are just part of the new blind spots that I have been getting, but he was stating that the blind spots that I am getting are more a brain issue trying to fill in for these blind spots which he seems to think are older). He thinks that the 'unformed visual hallucinations' are sometimes on a rotational axis (so they can appear anywhere around the vision), and that any others that are more central would be migraine and will not result in permanent blind spots. I tried to tell him that I DO have blind spots as a result of the ones I have been getting,the first of which is within the Amsler grid, but they do not show on the field test as I think that maybe they are too small and also some are slightly translucent.
He wants me to come back in 6 months for repeat testing, but right now I fear that I may get a blind spot in my central vision, or even more elsewhere and I wonder whether I should seek further help, or just wait.
He is a very kind and knowledgeable doctor, but I just have concerns that he did not realise that I think the blind spots are newer in the nasal region of right eye and around the blind spot in my left eye and that although I hope the degeneration found in my optic disc and macular are old and stable (please let me know if you think it sounds as if it is related to the old distorted vision), I am concerned that the newer scotomas are something else and even if they are all migraine related then they are still causing permanent vision loss which is great concern for me.
Thank you and I apologise for my very long explanation.
Hello and thank you. He was a neuro-ophthalmologist and the only one in my insurance network. :) I should also say that I have slight snowy vision and after images, to the point where I pale blue sky will look grey unless I cover my eyes for a few seconds and look at it again. Then it will look blue for a short time until the image tires. This does not happen if the blue is more than grey/blue.
Also, if I look through a pinhole and move it, I see the veins which I know I should, but also little grey bubble shapes to the left of center of my left eye and more random in my right eye. In addition I see the pulse in my peripheral vision, especially when stressed or active. I have always had regular eye pressure and also my blood pressure has always been pretty low (like 105/70 although at the ER it was about 120/78.