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Pineal Cyst Causing These Symptoms?

Hi Neurology,

Since Feb 2022 I have been having some strange visual symptoms which are hard to describe;

- I cannot focus my attention on something in particular to take in fine details anymore (for example trying to focus on a single letter in this sentence), nothing is blurry but I just kind of zone out and feel as if I can't process the same as I used to. The best way to describe it would be to say that my vision used to be sharp like a laser
when I focused on something, now it feels as if my vision is more diffused like the light coming from a torch.

- I get a kind of dizzy, nauseous feeling which 100% feels visually triggered, the feeling is around my eyes but is also hard to describe.

- I cannot wear my glasses anymore as my eyes just feel strained, this happens whenever I wear them no matter the time. Strangely I do not get the same strain with my contact lenses but I still get the other symptoms mentioned above.

I originally ignored it and thought it was just stress however it went on for so long I went back to my optician and he found that my eyes have developed 1 point of astigmatism which I have never had before, I was glad he found something and when reading that astigmatism is a refraction issue I thought it made sense considering my symptoms. I got astigmatism correction in my glasses but that did not resolve the symptoms and 3 months later I went back and he found 1 more point of astigmatism in each eye (he said it was slightly unusual to develop another point of astigmatism in a short space of time) but equally said it's nothing to worry about.

After getting a second set of lenses for the 2 points of astigmatism and still having the same symptoms I went to my GP and asked for an MRI to rule out anything sinister, I got a brain MRI which came back clear apart from a 7mm pineal cyst which was repeated with a contract injection and did not enhance. I then read that pineal cysts can cause visual disruption, vertigo etc I went to see a neuro-ophthalmologist who has seen many people with Pineal problems and was sure that I don't have a pineal problem (don't show signs of Parinaud's Syndrome) etc and referred me to an orthoptic for a binocular vision assessment and eye movement / convergence tests which he did not find any issues.

It has been 6 months since and my symptoms have not got better and I still can't even wear my glasses without immediate strain, I struggle to watch tv and comfortably drive as well as working on a computer. Someone said my symptoms could be jaw / TMJ related and I went to my dentist and he found a problem with my bite, got my top 2 wisdom teeth removed and saw a TMJ specialist who wasn't convinced I have an issue which could cause these symptoms.

I am beginning to worry again that my pineal cyst may be causing these symptoms as I feel as if I have tried everything now, would all vision related pineal problems be detected by a specialist in person or is there a chance that my eyes are fine but I have some processing issues?

Is there any other tests that may be beneficial for me or any over avenues to try which could be causing these symptoms?

Is there a chance that even with astigmatism correction I have symptoms which could potentially be resolved by laser eye surgery?

Should I get a second opinion from another neuro-ophthalmologist / orthoptic?

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