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Medical Forum / General / Vision / March 2006Been to my GP
He can't do anything until the notes from the consultant get back to him. Whoo hoo. That'll be 2+ months. The original opticians notes suggested apparently I had a decompensating exophoria, which is exactly what the "consultant" said, except, she wouldn't go into any detail about the problems on the other tests saying they were normal. So... What's a decompensating exophoria? That means I presume that one is too high compared to the other, and at some stage I've been compensating for this deviation, but now Im having problems? That must mean, if I remember those websites, that I have had an arc? Why is it an exophoria, when on all of the other prism type tests, and especially the worth four dot test, I saw three dots in the left, two dots in the right, separate on the horizontal, not vertically spaced? And why do I seemingly compensate on most of everything, except for two specific instances at home and in the office, intermittently, but why does it always show up on this worth four dot test, or the Mallet test? Is that what those tests are designed for then, to force decompensation???? I just thought if Im compensating, then why wouldn't I compensate on the tests too??? Im probably on the wrong path, but am trying to learn... so anything you can offer would be highly appreciated. Also, I dont think i've ever had this answered, so I must ask again. What should you see as the results of a cycloplegic exam (and if you're slightly marginally longsighted)? I personally get severe double vision up close, but distance vision is fine. I cannot read anything up close, things take on an ethereal quality jumping out at me, severe blurriness on close objects, can't even read things at arms length unless I really really squint... a metallic key, stops being metallic, and actually gets toned down, and looks more grey like a water colour picture... I've always been very curious on that, because I've never known what one should see, and whether it is worth reporting that. i've always figured it was normal... but Im unsure. Incidentally, Im 28. Cya Simon > He can't do anything until the notes from the consultant get back to > him. Whoo hoo. That'll be 2+ months. [quoted text clipped - 46 lines] > Cya > Simon This is like my symptoms to, im longsighted and 21 and get what you get, my life is hell at the moment, my eye doc said it's all in the head, it's not!. Simon keep me updated. Thanks Ellis. > This is like my symptoms to, im longsighted and 21 and get what you > get, my life is hell at the moment, my eye doc said it's all in the [quoted text clipped - 4 lines] > Thanks > Ellis. There's only three things that's different for me since this came about... 1) I picked up a first pair of test specs for long sightedness (Im only tlaking about +1.25 in each eye IIRC), I've hardly worn them to be honest, only when I've had bad eye strain, and a second eye test, six months after being told my hyperopia had increased, consider getting a pair of glasses if there's a problem, six months after that my hyperopia was back down and apparently I was better than before! Which I can only put down to... 2) I am now on 150 mcg of Thyroxine... TSH is 0.5 and T4 is 16.1. I have an underactive thyroid. 3) Apparently I've been on Lansoprazole since September. I'll keep you filled in on any progress. Cya Simon > And why do I seemingly compensate on most of everything, except for two > specific instances at home and in the office, intermittently, but why does > it always show up on this worth four dot test, or the Mallet test? Is that > what those tests are designed for then, to force decompensation???? I just > thought if Im compensating, then why wouldn't I compensate on the tests > too??? The fusion reflex uses peripheral cues to superimpose the fields from each eye. In real life the peripheral vision is full of cues to stimulate fusion. > What should you see as the results of a cycloplegic exam (and if you're > slightly marginally longsighted)? At 28, maybe a half-diopter more. Sometimes it's two-and-a-half. > I personally get severe double vision up close, but distance vision is > fine. I cannot read anything up close, things take on an ethereal quality > jumping out at me, severe blurriness on close objects, can't even read > things at arms length unless I really really squint... a metallic key, > stops being metallic, and actually gets toned down, and looks more grey > like a water colour picture... "Metallic" appearance requires both eyes working together. Metal doesn't look as "metallic" with one eye only. Perhaps you're suppressing one eye. -MT >> And why do I seemingly compensate on most of everything, except for >> two specific instances at home and in the office, intermittently, [quoted text clipped - 8 lines] > In real life the peripheral vision is full of cues to stimulate > fusion. Ahh. Makes supreme sense. Thanks for the simple explanation. >> What should you see as the results of a cycloplegic exam (and if >> you're slightly marginally longsighted)? > > At 28, maybe a half-diopter more. Sometimes it's two-and-a-half. Oh, erm, bad choice of words I think. I mean, when you've had the cycloplegic drops for the eye exam, forget the end results, but what is it normal for you to physicall see in terms of vision? Should the following be normal? >> I personally get severe double vision up close, but distance vision >> is fine. I cannot read anything up close, things take on an >> ethereal quality jumping out at me, severe blurriness on close >> objects, can't even read things at arms length unless I really >> really squint... a metallic key, stops being metallic, and actually >> gets toned down, and looks more grey like a water colour picture... Cheers Simon > Should the following be normal? > [quoted text clipped - 4 lines] >>> really squint... a metallic key, stops being metallic, and actually >>> gets toned down, and looks more grey like a water colour picture... Absolutely, yes, all this would follow as a consequence of the cycloplegic drops. The trouble should all be gone by the next day. -MT >> Should the following be normal? >> [quoted text clipped - 10 lines] > > The trouble should all be gone by the next day. Within a few hours for me. But my pair of long sighted glasses do help slightly actually within that time period. I was just curious. I always took it for normal, but no one ever said what normal was. Now it is normal I shall ignore it. Thanks for your time. Simon >"Metallic" appearance requires both eyes working together. Metal doesn't >look as "metallic" with one eye only. Perhaps you're suppressing one eye. Well that's interesting. I've only got one eye and I can't say that I've noticed metal things not looking metallic.. Ann >>MT> "Metallic" appearance requires both eyes working together. Metal >>doesn't look as "metallic" with one eye only. Perhaps you're suppressing >> one eye. > > Well that's interesting. I've only got one eye and I can't say that > I've noticed metal things not looking metallic.. For you, metal looks "shiny," yes. But "metallic" is something slightly different. Because the eyes are separated by 65 mm or so, each eye gets a slightly different look at surfaces. This makes no difference for flat-textured objects and colors, but shiny surfaces never reflect light exactly the same for each eye. The difference in relative intensity gives finished metal a special "look" that goes away when two-eyed people close one eye. The same "metallic" phenomenon is used by color-blind people wearing the X-chrom lens. The X-chrom is a patented deep red contact lens worn in one eye only. It filters everything but red light, so red objects are seen roughly the same intensity in each eye. Green objects are much dimmer in the eye wearing the contact, but still bright in the non-wearing eye. The difference in intensity creates a "metallic" appearance that helps distinguish red from green. They don't "see" colors, but they distinguish between them better. Green objects look "metallic." -MT >>>MT> "Metallic" appearance requires both eyes working together. Metal >>>doesn't look as "metallic" with one eye only. Perhaps you're suppressing [quoted text clipped - 10 lines] >finished metal a special "look" that goes away when two-eyed people close >one eye. That's fascinating, but now I'd like to see it and I can't which is frustrating. Ann > The difference in > relative intensity gives finished metal a special "look" that goes > away when two-eyed people close one eye. Hrm. I can see metal perfectly fine with one eye closed.... Maybe there's another description? Exophoria means OUTWARD deviation. Phoria means that it displays when one eye is covered and returns to straight after the two eyes are unobstructed. By the way, you do not have decompensating exophoria, you have convergence insufficiency exotropia, which means that it breaks down at near. It is quite common and I fix these on a regular basis. Forget 4dot tests and crap like fixation disparity. What are your fusional reserves? Have your OD assess you with a prism bar (not rotary prism on a refractor head) to see at what level of base out prism your fusion breaks. Also what is your phoria? Is it in the 10-16^ range? There is a good chance based on this info that you simply need some vision therapy. You need to find a behavioural optometrist who can treat this. Try www.covd.org but unfortunately not too many behavioural optoms in the UK as they are very classical in their teaching. Cheers dr grant > Exophoria means OUTWARD deviation. Phoria means that it displays when > one eye is covered and returns to straight after the two eyes are [quoted text clipped - 3 lines] > convergence insufficiency exotropia, which means that it breaks down > at near. It is quite common and I fix these on a regular basis. I love this newsgroup. Just got to look up all those words now. > Forget 4dot tests and crap like fixation disparity. What are your > fusional reserves? I don't know. No one has told me yet. > Have your OD assess you with a prism bar (not > rotary prism on a refractor head) to see at what level of base out > prism your fusion breaks. Also what is your phoria? Is it in the > 10-16^ range? Hrm. Fusion breaking? Hrm. I know they performed a Bagolini test, white dot, white lines, and ran a bar of prisms up... dunno if that's the same thing, but they ran up about 4 or 5 segments before the lines split. No one's ever told me my phoria. From what the consultant has told me, it is apparently minor. I suppose now might be a good time to request all my notes from the hospital. > There is a good chance based on this info that you simply need some > vision therapy. You need to find a behavioural optometrist who can > treat this. A lot of people have said that. Apparently there's an ocular muscle consultant at the hospital... that's who Im waiting two months to see... but no one's giving me the information in the meantime. > Try www.covd.org but unfortunately not too many behavioural optoms in > the UK as they are very classical in their teaching. I'll have a look. Thanks Simon |
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