visual distortion

[Rachel_W]

Hello,

I was in a car accident in the beginning of 2004.  It was quite a severe accident in the way it happened, as I was run off the road by a hummer, and then went over quite a few curbs, down a 2.5 ft drop, through a 1ft high brick wall, and then through a wooden picket fence.  I did not lose conscience, but the airbag deployed and I had a slight burn to my lower face from it.  
I was out of work for a month, mainly because of injuries to my arms from holding the steering wheel and also dizziness and nausea.  I went to the ER straight after to check for any back injuries, but nothing was broken, although I did have to go to rehab for the back.
Once I began work, the feeling of being off-balanced, increased motion sickness and memory issues continued.  I had gone to my GP a few times and had a complete physical and he thought that it may be due to post concussion syndrome.  I also remember having an eye test at the doctor's office.  I had not had a vision test done for years as no problems, and I read the chart to 20:20, however, I felt that my right eye was not as clear as it should be but thought that it was due to my hand just having covered it (I remember this quite clearly), but not sure how long after and also this happened the next time I had a complete physical 1 or 2 years later.

My dizziness did not go away, and so after 4 months I was sent for a brain MRI.  Everything looked fine (but I am not sure if it had contrast), but the neurologist was certain I was healthy in that respect and referred me to an otolaryngologist.  I had a balance test done (standing on balance platform and also in a spinning chair) and he believed that I had some right vestibular damage and I went through rehab.  There was some improvement but intermittent vertigo still occurred, especially time of the month or when tired.  

I remember going to WA in the summer and also feeling that my vision wasn't acute but nothing was blurry so thought that maybe when you get older this happens before needing glasses.

I did not think of this for the longest time, but after a number of years (2008), my boyfriend thought that I should go for a second opinion to another otolaryngologist, and he suggested that I also have my vision field checked to make sure that this was not adding to my vertigo, especially as being in busy environments also did not help.

I had a field vision test and an eye exam and all was well.  He did mention that I had a few freckles in my eyes, but this was normal and as I was young and a non-smoker he felt that macular degeneration was not the cause.
The problem was that during the eye test I once again noticed the strange vision in my right eye and this time I had not been pressing on it.  I tried to explain but the guy who was doing the basic tests took it as blurriness as i did not explain it well.
The next day I do research online and come across an amsler grid and realise that I have some distortion in my right eye, perhaps a tiny bit in my left but no where as perceptable..  Of course I panic after I read about it mostly being caused by MD.  I called the hospital back in a panic and they rushed me in that afternoon.  I was convinced, but they examined my eyes and did a complete retinal scan for both and took photographs of my retinas and told me that they could not be any more perfect (textbook normal).  they told me that if I was seeing a neurologist about my dizziness I could mention it but they did not seem concerned.

I ended up going to a neurologist because I was scared about MS and then ALS (the worry brought on twitching), and I briefly mentioned the eye issues but I was completely checked for other neurological issues and got a clean bill of health (I was so scared at the time that my vision was the least of my worries).

Now it is 18 months later, the vision is the same, and I now believe that it has been like this at least since the accident, and has not gotten worse, even though now I am conscious of it, the slightly off-centered feeling I get, especially if I have been on the computer for a while, that I used to attribute all to vertigo is more obviously my eyes.  My left eye seems to get strained more as I think it is compensating.

I am in the UK right now studying, but would like to see someone about it again when I return to the US in the summer/fall.  Who would I see as my eyes have been shown to be healthy (or could it be astigmatism that was not picked up as they were looking at my retina? - would a normal eye exam pick this up?  I don't ever remember getting the symptoms of optical neuritis and have no loss of vision, blurriness or colour vision loss (and don't remember ever having these symptoms).  Could it have been cause by my car accident?  Is there anything that can be done to correct it?

I am sorry that this is a long post, but I wanted to tell the whole story.

Thank you.
Rachel  

[Rachel_W]

As it has not changed though, do you think it is okay to wait until I get back to the US?  There has been no change whatsoever.  There is no loss of vision, just the distortion, which I think seems bad because it is very central.  Do you think that it is plausible that it could have been from the accident?

If not could it be a mild central astigmatism or would that have automatically be found with the eye exam?

Thank you.

[Ray T Oyakawa, MD]

I can not be of help.  See an EyeMD, or a neuro-ophthalmologist.

Dr.O.