 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / Vision / August 2005Eyes Suddenly Diverged
The other day, I noticed that after rubbing my eyes, my vision suddenly diverged. I thought it was temporary, but since then when I look straight up or up to the right, my vision diverges vertically, the higher I look up the more it diverges. Since it occurred suddenly, I can't help but think I either overstrained some muscles behind the eye or else broke the muscle tissue altogether. I have had some minor soreness in the eye area (at least I think I have). Is this a temporary condition in that it will fix itself over time, or is this something that will require medical attention? Thanks, Brightstar65 Get your eyes looked at, followed by a complete physical. The alignment of the eyes depends on six muscles (for each eye) that need to work together to avoid double vision. While rubbing your eyes hard enough to break fusion sounds pretty bizarre, an amazing number of diabetics find out that they are diabetic because they cannot hold fusion. The nerve ganglion that co-ordinates the eye muscles is sensitive to blood sugar, so an undiagnosed diabetic can have sudden onset double vision. There are some types of tumors and cysts behind the eye that can break your alignment as well. The rubbing might have been " the straw that broke the camel's back" by breaking down your body's ability to hold alignment. What do you mean by "diverged"? Double vision? When you say "the more it diverges" do you mean two separate images moving farther apart, or do you mean something else? w.stacy, o.d. > The other day, I noticed that after rubbing my eyes, my vision suddenly > diverged. I thought it was temporary, but since then when I look [quoted text clipped - 9 lines] > Thanks, > Brightstar65 Yes, diverged where the two images are stacked one above the other, increasingly diverging as I look more up and to the right. Another thing I noticed at lunch today is that depending on how I hold my posture and how my neck is positioned in relation to my head, I can resolve most or all of the divergence with some effort, but not under the most extreme angle of looking up and to the right. I also notice at that point that my muscles on the right side of my head are straining to compensate and make the image whole. I don't know if this all helps, but I imagine everything is a clue as to what the problem might be. Thanks, Brightstar65 > What do you mean by "diverged"? Double vision? When you say "the more > it diverges" do you mean two separate images moving farther apart, or do [quoted text clipped - 15 lines] > > Thanks, > > Brightstar65 > Yes, diverged where the two images are stacked one above the other, > increasingly diverging as I look more up and to the right. This indeed sounds like a damaged extraocular muscle, or damaged innervation to it. Needs to be evaluated. Am I to assume you never experienced this before? > Another thing I noticed at lunch today is that depending on how I hold > my posture and how my neck is positioned in relation to my head, I can [quoted text clipped - 5 lines] > I don't know if this all helps, but I imagine everything is a clue as > to what the problem might be. Yes, and it will be very helpful to whomever evaluates you. Assuming it's a new problem, I'd consult a neuro-ophthalmologist ASAP. w.stacy, o.d. > Thanks, > Brightstar65 [quoted text clipped - 18 lines] >>>Thanks, >>>Brightstar65 As in my other posting, I personally would recommend a strabismus specialist rather than a neuro-phthalmologist for this. This is most likely not a complex brain problem, and the strabismus specialist would be in a better position to evaluate the eye movements and recommend the best treatment. In any case, if a neurologic problem is then suspected, the MRI is the diagnostic test, which generally replaces the neuro-ophthalmologist these days for finding a nerve lesion in the brain. On 7/15/05 4:54 PM, in article a1YBe.2876$mN1.1802@newssvr13.news.prodigy.com, "William Stacy" <wstacy@obase.net> wrote: >> Yes, diverged where the two images are stacked one above the other, >> increasingly diverging as I look more up and to the right. [quoted text clipped - 40 lines] >>>> Thanks, >>>> Brightstar65 > As in my other posting, I personally would recommend a strabismus specialist > rather than a neuro-phthalmologist for this. I concur with that. Thanks for the correction and the Dx info. w.stacy, o.d. Vertical diplopia on right gaze, increasing on right-up gaze, is either an elevation overaction or an elevation limitation. It is more common to have this caused by a problem in the left eye - the superior oblique vs inferior oblique. On examination, one can determine if it is an undershoot or overshoot situation. If the superior oblique is weak, the eye won't go down as well as it should, and the stronger inferior oblique then overshoots the up upwards. That would account for vertical diplopia on right gaze, getting worse in right-upgaze. On the other hand, if there is limitation in the superior oblique, the eye won't elevate well (undershoot rather than overshoot), and be worse on right gaze and right-upgaze. Superior oblique won't get suddening weak after rubbing the eye. The thoughts about damaged muscle or damaged innervation is possible, but very unlikely. Yes, a 4th nerve palsy will cause the superior oblique weakness, but the odds of it happening just when rbbing the eye is small, as it occurs usually intracranially, typically from microvascular reasons such as diabetes or hypertension. On scenario this is more likely is an sudden acquired Brown's superior oblique tendon syndrome. I have seen this before. The superior oblique muscle goes through a bony "pulley" on its way to the eye. The tendon sheath can "hang up", especially if there is a tiny knot in the tendon and if not totally smooth, it hangs. Thus, then called upon to glide smoothly through the trochlea (pulley), it can't, and limited the eye movement , so it has trouble with elevation, more in right gaze, and most in up-right gaze. Sometimes you have some pain in the trochlea area. Inflammation form injury or sinus problems can bring it on, but sudden stretch of the tendon, caused by retropulsing (pushing the eye back in the socket) can pull the tendon through the trochlea and cause a hang-up situation. Firs the condition needs to be diagnosed correctly, to rule-out the issues of neurologic problems that can cause muscle weakness. Brown's syndrome is easy to recognize, by the elevation pattern, and forced-ductions (using a q-tip or forceps to move the eye and feel the muscle forces). If the muscle is strong and can't move the eye up, it is a restriction, not a muscle weakness. If the muscle is weak, and the eye can easily be pushed up and in, where you are having trouble looking by yourself, then it is weak (paretic). Brown's superior oblique tendon sheath syndrome can spontaneously heal itself over several weeks. Sometimes forcefully pushing the eye in a particular way can free it up. Sometimes a local cortisone injection to the trochlea area can help. You should see an ophthalmologist who specializes in strabismus, as many general ophthalmologists will be unable to diagnose this correctly. Most are "pediatric ophthalmologists" since most strabismus occurs in kids. Most do adult strabismus, too, but some do not. I know, because this is my specialty, and I see these kinds of cases regularly. Les us know what you find out... David Robins, MD Board certified Ophthalmologist Pediatric and adult strabismus subspecialty Member of AAPOS (American Association of Pediatric Ophthalmology and Strabismus) On 7/15/05 7:27 AM, in article 1121437645.714743.193480@z14g2000cwz.googlegroups.com, "fiertek@gmail.com" > The other day, I noticed that after rubbing my eyes, my vision suddenly > diverged. I thought it was temporary, but since then when I look [quoted text clipped - 9 lines] > Thanks, > Brightstar65 Interesting. My doctor surmised it was probably indeed Brown's Syndrome and has put me on steroid eye drops. I have not yet begun to take them, so I do not yet know if thsi will correct the problem. She did say, if it does not seem tocorrect the problem, she will refer me to a pediatric opthamologist because they usually have more experience in this. thanks for all the comments. I hope Brown's turns out to be the problem after all. I do have minor discomfort in the eye area and I have had bad allergies recently, which might be a cause for imflammation of the tendon. brightstar65 Steroid drops probably won't help an acquired Brown's. A steroid injection to the troclea (tendon area) might, and is easy to do. May be a result of sinusitis, in your allergy case. On 7/19/05 3:47 PM, in article 1121813228.059158.28000@o13g2000cwo.googlegroups.com, "brightstar65" > Interesting. My doctor surmised it was probably indeed Brown's > Syndrome and has put me on steroid eye drops. I have not yet begun to [quoted text clipped - 9 lines] > > brightstar65 Original post #3 reposted below: ----------------------------------------------- Yes, diverged where the two images are stacked one above the other, increasingly diverging as I look more up and to the right. Another thing I noticed at lunch today is that depending on how I hold my posture and how my neck is positioned in relation to my head, I can resolve most or all of the divergence with some effort, but not under the most extreme angle of looking up and to the right. I also notice at that point that my muscles on the right side of my head are straining to compensate and make the image whole. I don't know if this all helps, but I imagine everything is a clue as to what the problem might be. brightstar65 Original post for this thread is below: ---------------------------------------------------- The other day, I noticed that after rubbing my eyes, my vision suddenly diverged. I thought it was temporary, but since then when I look straight up or up to the right, my vision diverges vertically, the higher I look up the more it diverges. Since it occurred suddenly, I can't help but think I either overstrained some muscles behind the eye or else broke the muscle tissue altogether. I have had some minor soreness in the eye area (at least I think I have). Is this a temporary condition in that it will fix itself over time, or is this something that will require medical attention? brightstar65 |
Reply to this Message |
 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.