Home | Contact Us | FAQ | Search & Site Map | Link to Us
Sign In | Join | Other 45 Sites in Network
Home
Discussion Groups
General
GeneralCardiologyVisionDentistryPharmacyLaboratoryNutritionAlternative
Diseases and Disorders
AIDSAlzheimer'sArthritisAsthmaCancerBreast CancerDiabetesEpilepsyGlaucomaHepatitisHerpesLupusProstate BPHProstate CancerProstatitisSinusitisTinnitus

Medical Forum / General / Vision / June 2005

Tip: Looking for answers? Try searching our database.

Why would vision worsen throughout the day?

Thread view: 
Enable EMail Alerts  Start New Thread
Thread rating: 
Mike - 30 May 2005 12:30 GMT
I've been having a somewhat strange vision problem for about the last
two years: the near and far vision in my right eye is fine for about
the first 1-2 hours after I wake up in the morning, but after that, I
tend to see double images out of that eye (and only that eye). An
ophthalmologist tested me (in a late afternoon appointment) and found
that the standard eye machine (whatever it's called)wasn't able to
correct the problem, but that it could be somewhat corrected through
the use of some prisms he had me look through, which seemed to help
sort of align things better in my right eye. He also suggested that
pencil push-ups might help.

But I still don't understand why this problem wouldn't be present for
the first few hours of every day. I initially thought it might have
something to do with computer use, but this happens regardless of
whether I sit at a computer. Any thoughts?

Thanks,
Mike
Mike Tyner - 30 May 2005 14:45 GMT
> I've been having a somewhat strange vision problem for about the last
> two years: the near and far vision in my right eye is fine for about
> the first 1-2 hours after I wake up in the morning, but after that, I
> tend to see double images out of that eye (and only that eye).

In young healthy people, most monocular diplopia comes from irregularities
in the shape of the cornea.

With the eyes closed overnight, the cornea swells slightly. Its inner layer,
the endothelium, is constantly removing water from the cornea and it slows
down when the eyes are closed, with less oxygen.

In your case, it appears that the normal diurnal swelling makes your cornea
smoother.

People who have problems with too much swelling use hypertonic solutions (or
a hair dryer) to remove water from the cornea. You might find that these
treatments, early in the morning, bring on the diplopia faster.

>An
> ophthalmologist tested me (in a late afternoon appointment) and found
> that the standard eye machine (whatever it's called)wasn't able to
> correct the problem, but that it could be somewhat corrected through
> the use of some prisms he had me look through, which seemed to help
> sort of align things better in my right eye.

Prism wouldn't affect monocular diplopia. Refracting lenses
(sphere-cylinder) might well make it less noticeable.

> He also suggested that
> pencil push-ups might help.

PPUs are a cookbook treatment for _binocular_ diplopia. I'm not sure he
understood that you are seeing double with one eye closed.

> but this happens regardless of
> whether I sit at a computer. Any thoughts?

Diurnal tissue variation.

-MT, OD
John Yasar - 30 May 2005 15:10 GMT
I was going to ask about this topic also since I have something similar
in one eye, however it is not always double image, it is sometimes
double image and not completely same images, for example it is usually
noticeable when looking at vertical objects like light posts, and one
image is foggy, hazy, every blink it comes and goes, every blink it
changes the clarity of the image in that eye, I would blink and see a
perfectly clear and sharp image and blink the next second, this time,
same image and a faint double of it slightly conjoined. Am I describing
astigmatism or this is more serious issue. I would like to start a new
thread for my symptoms though, thanks...

Signature

PV2 Yasar, M
U.S. ARMY
AH-64D "Armt Dawg"
A Co/602d ASB/2ID/EUSA - South Korea
Monday, 30 May 2005 / 23:10:34 Korea Standard Time (+0900)

Mike Tyner - 30 May 2005 17:30 GMT
> same image and a faint double of it slightly conjoined. Am I describing
> astigmatism or this is more serious issue.

Technically, yes. "Astigmatism" literally means "lack of a point."

In common usage, though, it's assumed we mean _regular_ astigmatism, a
smooth surface, slightly bent more in one direction and less in the other, a
"football" shape.

But in real life, not all astigmatism is "regular". Look at a corneal
topograph and you'll see steeper and flatter areas, hills and valleys, that
aren't entirely correctable with lenses.

-MT
Tom - 30 May 2005 17:56 GMT
>> same image and a faint double of it slightly conjoined. Am I describing
>> astigmatism or this is more serious issue.
[quoted text clipped - 4 lines]
>smooth surface, slightly bent more in one direction and less in the other, a
>"football" shape.

A football is round.  What do you mean?

Tom

>But in real life, not all astigmatism is "regular". Look at a corneal
>topograph and you'll see steeper and flatter areas, hills and valleys, that
>aren't entirely correctable with lenses.
>
>-MT
Mike Tyner - 30 May 2005 18:52 GMT
> A football is round.  What do you mean?

Even though it isn't spherical, a football (American) is "regular" meaning
the curves are consistently symmetrical everywhere.

If you shaped a crude football, freehand, in clay, it would have
irregularities, bumps, departures from "regularity."

So it is with the eye, small departures from ideal shape that aren't
"coaxial," meaning they don't focus to the same neat point. It's obvious
from topographs of normal cornea. The bumps and valleys give rise to
monocular diplopia.

Look through a pinhole, or wear a rigid contact, and the diplopia goes away.

"Regular" astigmatism is a football. "Irregular" astigmatism is non-uniform,
which can apply to either football-shaped or spherical surfaces.

-MT
Tom - 30 May 2005 19:29 GMT
>> A football is round.  What do you mean?
>
>Even though it isn't spherical, a football (American)

Okay..  we aren't all from America.. ho hum!

Tom
B. Janse - 30 May 2005 19:39 GMT
>> Technically, yes. "Astigmatism" literally means "lack of a point."

Ah, so yesterday the header of my thread should have been 'mirror cylinder
axes' instead of
'mirror astigmatic axes'.
The Real Bev - 31 May 2005 01:48 GMT
> >In common usage, though, it's assumed we mean _regular_ astigmatism, a
> >smooth surface, slightly bent more in one direction and less in the other, a
> >"football" shape.
>
> A football is round.  What do you mean?

American footballs aren't round, they're, um, football-shaped.  Take a
circle.  Cut out a chord.  Make a mirror image of that chord and put the ends
together.  Sort of an ellipse or oval with points on the ends.

Carry on...

Signature

Cheers, Bev
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Why should I be tarred with the epithet "loony" merely
because I have a pet halibut?           --Monty Python

Tom - 02 Jun 2005 20:40 GMT
>> >In common usage, though, it's assumed we mean _regular_ astigmatism, a
>> >smooth surface, slightly bent more in one direction and less in the other, a
[quoted text clipped - 5 lines]
>circle.  Cut out a chord.  Make a mirror image of that chord and put the ends
>together.  Sort of an ellipse or oval with points on the ends.

I know.  Rugby ball shaped.  I'll read it again now.  :-)

>Carry on...
Mike - 30 May 2005 15:50 GMT
Thanks much for the speedy and informative reply. Is this a treatable
condition, or am I more or less stuck with it as is?
Mike Tyner - 30 May 2005 17:14 GMT
> Thanks much for the speedy and informative reply. Is this a treatable
> condition, or am I more or less stuck with it as is?

Theoretically, wavefront-guided LASIK could give permanent relief, but it's
expensive and drastic for such a subtle problem. Most surgeons would
probably not want to attempt it.

Rigid contacts (or perhaps even soft lenses) could improve the problem but
only while you wear them. Rigid contacts used to "reshape" the cornea could
give more lasting results but that treatment is somewhat unpredictable and
expensive.

The most practical treatment is glasses, prescribed late in the day. That
won't give perfect results but will probably reduce the appearance of double
vision when you need it.

-MT
dumbstruck - 30 May 2005 20:02 GMT
If your doc doesn't find clear evidence of a problem and can only
speculate about unappealing treatments, there is a possible simple
alternative you can test yourself.  These descriptions of come-and-go
cloudiness and multiple images are something I also get from time to
time, and can snap out of it by covering up the "good" eye for an hour
or so.

I forget the tech term for the problem... something about poor
binocular coordination leading to your brain tiring of resolving the
two images and  just giving up the fine tuning of one of your eyes
focus.  A vernacular term used to be lazy eye, and you would see kids
long ago with an eyepatch (over good eye) to correct this.  The
underlying problem of the bad eye may be negligible and you might work
on just stopping the shutdown once in a great while.

My doc used to treat this with eye exercises, including using prism
glasses to intentionally seperate the images.  A simple approach is to
close one eye while watching TV for a while, but it doesn't work well
straining like that in a passive environment.  Rather cover the good
eye in some comfortable fashion and do a (safe!) task that requires
some medium distance acuity yet takes your mind off your situation.
You may find a 15-30 minutes later, POW! things snap back in perfect
focus, but may want to do it longer or the good results may be
temporary.  I have to do this sometimes twice a year, and there is a
lot of possible speculation about underlying reasons, but on the other
hand the solution is so darned simple...
Mike Tyner - 30 May 2005 20:06 GMT
> I forget the tech term for the problem... something about poor
> binocular coordination leading to your brain tiring of resolving the
> two images

Yes, but the OP concerned diplopia with _only one eye._

Whole different kettle o' fish.

-MT
dumbstruck - 30 May 2005 21:10 GMT
> Yes, but the OP concerned diplopia with _only one eye._
>
> Whole different kettle o' fish.
>
> -MT

Dunno what you are referring to; the original post described exactly
the type of things I have experienced.  As if the brain gets tired of
resolving the images, and gives up driving the focusing of one of the
eyes and tries to rely mainly (but imperfectly) on a dominant eye.
Seems to make a fresh effort for the weak one some mornings, but then
fades.  In OP case, the underlying cause may have been a pointing
issue, where his doc thought a prism would make it easier to get a
straight-ahead image that could resolve easier with the other eye.

Of course the underlying conditions can hardly be diagnosed online, but
sometimes they can't be perfectly diagnosed in person either.  Thus
some simple experiments may show that the problem can be overcome by
employing natural capabilities.  Try vacuuming your house with the good
eye closed.  This isn't a great experiment since it should employ
longer vision and more time, but may just give a clue whether the bad
eye is capable of snapping back...
Philip D Izaac - 31 May 2005 06:43 GMT
The original post also said that prisms helped somewhat. a little confusing,
huh

Roland J. Izaac

> > I forget the tech term for the problem... something about poor
> > binocular coordination leading to your brain tiring of resolving the
[quoted text clipped - 5 lines]
>
> -MT
Mike Tyner - 31 May 2005 07:08 GMT
> The original post also said that prisms helped somewhat. a little
> confusing,
> huh

Yes.. I guessed it was combined in the phoropter with pl-050.

-MT
 
Sign In
Join
My Latest Posts
My Monitored Threads
My Blog
My Photo Gallery
My Profile
My Homepage

Start New Thread
Enable EMail Alerts
Rate this Thread



©2008 Advenet LLC   Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.