vision problems

[williamkancir]

Hi all,  I'm an engineer and on June 22, 2008 I had a third fall, this one was from 13 1/2 ft platform that I was working on, to the cement where I hit the side of my head. My vision is all messed up since. I suffered severe concussion and aggravated some old injuries. I'm told I have vertigo, tinnitus, etc...When I fell, initially I suffered amnesia and lost consciousness. Gradually I felt my eyes playing tricks on me and the pressure in my head like it was going to explode. The eyes became sore and I felt a tremendous pressure pushing in the back of my eyes as well. Overlapping vision developed into perfect double vision( fine when your looking at your bank account and horrible when your looking at the dishes). Seriously, I feel my eyes pulling, I think the left eye to the right side mostly. Both eyes tend to wander and sometimes shake. I'm told the spinning is vertigo(they spin too). A team of different types of neurologist's are looking at me and need to do further testing. My optometrist knows I'm unstable(I could have told him that long ago) but, can't find anything wrong. Does vertigo do all this with the eyes? Does anyone have similar symptoms? Please share with me if you can, any help would be kindly appreciated. Smiling on ahead.

Daniel

[starman6600]

To: Dr. Flavius Pernoud
Dear Dr. Pernoud,

I have read some of your postings and appreciate the good information that you share with others.  I do not have cataracts but am interested in improving my vision.  Please allow me to elaborate.

I am a 67 y/o male who has had RK (15 years ago) for myopia correction in my left eye, my dominant eye for distance, and Lasik (8 years ago) also in my left eye.   I also had RK (15 years ago) in my right eye, for a monovision outcome.  I was very satisfied with the outcomes of these procecures.   In the past eight years since my Lasik, I have become farsighted (+1.50) in my left eye.  At this time, I am interested in determining the best procedure for improving the distance vision in my left eye.  I have communicated with Dr. Hagen somewhat and he has been very helpful in sharing his thoughts.  I would like your thoughts as well if I may.  Here are my questions:

1.  What is the best first step ( Lasik, IOL, etc.) to take so that I can possibly keep my options open in the event that the first step is not successful?  

2.  If you recommend an IOL as my first step, I understand that prior RK patients are not good candidates for a multifocal lens.  Do you agree?  Do you have any suggestions as to how I can determine which monofocal lens would be appropriate for me.  Dr. Hagan is positive about the Tecnis.  

3.  Would there be any point in waiting for a year or so in order to see if a lens with better technology becomes available?

4. Do you have any suggestions as to how I can find a very good physician to perform the surgery?

Thank you in advance for any thoughts or suggestions that you may be able to share with me.  

Frank
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[williamkancir]

Thank you, The audiologist did not like the MRI that was done nor the CT scan and he is the one that is getting the ball rolling with the team of specialists(neurotologist, ENT specialist, neurologist-neck, neurosurgeon). In the few tests that they did, they found the things that I had mentioned in the post and I am waiting further testing and diagnosis. What I have been hearing and reading about, led me to believe it was more than what has been already diagnosed. Would the above also cause eye wandering and eye pulls? I see double even with one eye closed, have you ever seen that before? It seems as if the same image happens close or further away, it just moves back.

[williamkancir]

Thank you, The audiologist did not like the MRI that was done nor the CT scan and he is the one that is getting the ball rolling with the team of specialists(neurotologist, ENT specialist, neurologist-neck, neurosurgeon). In the few tests that they did, they found the things that I had mentioned in the post and I am waiting further testing and diagnosis. What I have been hearing and reading about, led me to believe it was more than what has been already diagnosed. Would the above also cause eye wandering and eye pulls? I see double even with one eye closed, have you ever seen that before? It seems as if the same image happens close or further away, it just moves back.

[williamkancir]

Thank you, The audiologist did not like the MRI that was done nor the CT scan and he is the one that is getting the ball rolling with the team of specialists(neurotologist, ENT specialist, neurologist-neck, neurosurgeon). In the few tests that they did, they found the things that I had mentioned in the post and I am waiting further testing and diagnosis. What I have been hearing and reading about, led me to believe it was more than what has been already diagnosed. Would the above also cause eye wandering and eye pulls? I see double even with one eye closed, have you ever seen that before? It seems as if the same image happens close or further away, it just moves back.

[Flavius G Pernoud III, MD]

You need a neurology, or neurosurgical workup. You may have a cranial nerve palsy--perhaps a 3rd, 4th, or  6th nerve causing double vision. If the double vision is horizontal--side by side--and is worse in the distance than up close, it is probably a 6th nerve palsy. This can be caused by the brain banging into the 6th nerve at the base of the cranial cavity during the injury but it can also be a harbinger of increased intracranial pressure. You didn't say whether you had an MRI. You may need one.