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Medical Forum / General / Vision / September 2007My New OCT
I visited today the retinologist, who examined my eyes after dilation and found everything to be OK -- my good eye is still good with no pathology, and the retina and macula in my bad eye are intact, hole closed and retina still attached. My corrected VA today was Left=20/20, Right=20/50. My combined vision flactuated between 20/20 to 20/25 -- not bad! My concerns were: 1. The condition of my good eye, which has already had posterior vitreous detachment -- I wanted to know whether my risk of retinal detachment is higher or lower as a result, since I have read two contradicting views re this matter (quite a few Internet articles listed PVD as a high risk factor, while others indicated that due to the reduction of traction on the retina actually reduces the risk). The doc reported to me that my PVD is complete and my risk of RD is reduced. He didn't seems to be concerned about it at all. 2. The reason for my reduced visual acuity in the bad eye -- I have a vague information about retinal/macular pucker or wrinkling, which I presume affects my vision. Again, the doc seemed to dismiss it and said that apparently my macular hole closure is not perfect (he said that it never is), and it should stay this way. 3. The reason for the foggy haze I see in my bad eye, which apparently plays a role in my impaired VA in that eye, despite having a new IOL after a cataract extraction almost 3 months ago. He said that there might be some retinal swelling, but he couldn't see it and ordered an OCT. Great! I love those OCTs. I have a colorful copy of it. The 2 eyes look different, but I don't know the meaning of the difference. The doc looked at my photogenic images and said -- "yes, there is some swelling," and sent me back to see the cataract doc, who is also a general ophthalmologist. My attempts to get more information from him, or to convince him that since the swelling is in the retina it should be in his department, were in vain. He was simply very stingy. The good eye appears to have blue to green color (ranging from 200 to 300 urr), whereas the bad eye image is yellow to red (ranging from 300 to 500 urr), but I have no clue of what this means. There are no explanations on the sheet. There are other numbers of foveal thickness and macular volume -- all are about 50% higher in the bad eye, but again I have no idea of what it means. And I would like very much to understand it Can anybody here help me? I can scan and email it to you privately if you know how to read this stuff. Please let me know. NOTE: Otis, Quasimambus, Lena, Andrew at al need not reply. I am not interested in any "second opinion" and voodoo advice. Only "majority opinion" professionals need apply, and I am thankful in advance. > I visited today the retinologist, who examined my eyes after dilation > and found everything to be OK -- my good eye is still good with no [quoted text clipped - 4 lines] > > My concerns were: > doc looked at my photogenic images and said -- "yes, there is some > swelling," and sent me back to see the cataract doc, who is also a > general ophthalmologist. My attempts to get more information from > him, or to convince him that since the swelling is in the retina it > should be in his department, were in vain. He was simply very stingy. It ain't his department, in my experience. If you need a fix to your retina, you generally get referred to a retinal specialist. > NOTE: Otis, Quasimambus, Lena, Andrew at al need not reply. I am not > interested in any "second opinion" and voodoo advice. Only "majority > opinion" professionals need apply, and I am thankful in advance. I'm no professional in eye care, but I answered anyway. > In article <1190182097.448004.130...@z24g2000prh.googlegroups.com>, > [quoted text clipped - 20 lines] > > I'm no professional in eye care, but I answered anyway. He IS a retina specialist. The swelling is in the RETINA. Why isn't it his department? Additional information: The OCT is entitled "Retinal Thickness Analysis Report". The figures for Foveal Thickness and Total Macular Volume indicate apparently higher thickness and volume in the bad eye (approx 50% higher). The color illustrations apparently represent these figures -- rec and yellow in the bad eye, compared to blue and green in the good eye. Trying to make sense of it, I would presume that "thickness" and "volume" indicate swelling. Am I correct? >> In article <1190182097.448004.130...@z24g2000prh.googlegroups.com>, >> [quoted text clipped - 19 lines] > He IS a retina specialist. The swelling is in the RETINA. Why isn't > it his department? Reading comprehension. In Dan's post, *his* --> *your cataract doctor's* > > In article <1190182097.448004.130...@z24g2000prh.googlegroups.com>, > > [quoted text clipped - 23 lines] > He IS a retina specialist. The swelling is in the RETINA. Why isn't > it his department? Sorry. My misunderstanding. Upon rereading your post, I realized that perhaps your lack of answers were from the RS, not the other doctor. "Ms.Brainy" <mikabrainy@gmail.com> wrote in message > Great! I love those OCTs. I have a colorful copy of it. The 2 eyes > look different, but I don't know the meaning of the difference. The > doc looked at my photogenic images and said -- "yes, there is some > swelling," and sent me back to see the cataract doc, who is also a > general ophthalmologist. This is very weird. Your retinal specialist found some swelling in the retina but sent you back to the gen ophthal. It is your retinal specialist that should handle the swelling, not the gen ophthal. >My attempts to get more information from > him, or to convince him that since the swelling is in the retina it > should be in his department, were in vain. He was simply very stingy. It seems that he doesn't like to be your doctor. > "Ms.Brainy" <mikabra...@gmail.com> wrote in message > > Great! I love those OCTs. I have a colorful copy of it. The 2 eyes [quoted text clipped - 12 lines] > > It seems that he doesn't like to be your doctor. Santa Klown, It appears that you are becoming a serious candidate for the infamous list of eternal trolls and/or idiots on s.m.v. Is this what you want? Your infrequent posting will not save you from this destiny, unless you keep your mouth shut from now on. >> "Ms.Brainy" <mikabra...@gmail.com> wrote in message >> > Great! I love those OCTs. I have a colorful copy of it. The 2 eyes [quoted text clipped - 20 lines] > want? Your infrequent posting will not save you from this destiny, > unless you keep your mouth shut from now on. I'm not a troll. I post only when I do have something to say. Sometimes, you have to look at yourself from a 3rd person's viewpoint. I don't post in this NG frequently but I am familiar with the **tone** of your typical messages. Now, ask yourself.....if you were a retinal specialist, would you like to have a patient like you? I would NOT want to have a patient like you, for sure. The relationship between the patient and the doctor is mutual. I DO respect my doctors and behave accordingly and my doctors respect me. I have never had any kind of negative experiences with my docs including my retinal specialist. You know, it's give & take. There must be a reason why your retinal specialist behaved as you described. He's human and he has emotions. Next time you see him, try to be a good patient and he'll be a good doctor. I know you won't follow my advice. But I wish you the best luck. > >> "Ms.Brainy" <mikabra...@gmail.com> wrote in message > >> > Great! I love those OCTs. I have a colorful copy of it. The 2 eyes [quoted text clipped - 44 lines] > > I know you won't follow my advice. But I wish you the best luck. You've singled her out for virtually ALL of your s.m.v. posts. I wonder why. Can you allow for the possibility that people here deal differently with their doctors, their spouses, their kids, their co-workers, and their friends than they might deal with people on the Internet -- particularly on a newsgroup so DOMINATED by trolls like Otis Brown and Rishi Gatti? I can. I've spoken to Ms. Brainy on the phone, at length. I find her bright, personable, affable, genial, and engaging. Pick on somebody else, instead, huh? Try Otis or Rishi. They're dangerous nuts, deserving of your sporadic ire. >I've spoken to Ms. Brainy on the phone, at length. I find her bright, >personable, affable, genial, and engaging. Oooo... Neil's got a crush! What will DJ think! You shouldn't flirt with other woman! >You've singled her out for virtually ALL of your s.m.v. posts. To be fair, she's singled him out as well. Looks like they had a grudge from another NG, already. >Can you allow for the possibility that people here deal differently >with their doctors, their spouses, their kids, their co-workers, and >their friends than they might deal with people on the Internet -- Klausk is right, you know. If you go to doctor and you are very rude, then why should you expect him for be kind back? Despite your belief, substance AND style are important. Sorry. Rishi Giovanni Gatti (Zetsu), Lena102938, and Otis Brown are trolls who haunt s.m.v. Rishi has published, and is trying to sell worthless books. Otis is pathologically dishonest and actually hurts people. Following his advice can induce double vision in those not working closely with an eye doctor. Lena102938 uses anti-eye doctor rhetoric as a substitute for ANY actual information. It seems she now has to wear glasses and has developed a pathological (and ILLOGICAL) resentment toward the industry that "foisted these glasses upon her." You'd do well to ignore them and wait for responses from the caring, compassionate eye doctors who DO also participate in this site. Hi, >Pick on somebody else, instead, huh? Try Otis or Rishi. They're >dangerous nuts, deserving of your sporadic ire. KlausK wasn't picking on anybody, he actually gave kind advice to Brainy. She should appreciate it, and also you. > >Can you allow for the possibility that people here deal differently >>with their doctors, their spouses, their kids, their co-workers, and [quoted text clipped - 5 lines] > him for be kind back? Despite your belief, substance AND style are > important. I wish my best luck for Ms. B. I can only judge her based on her postings here. Sure, I have never met her but she seems like a disgruntled lady, who loves to challenge her docs. Again, if I were a doc, I would not want her to be my patient. Life is short and you don't have to please people you don't like. > >You've singled her out for virtually ALL of your s.m.v. posts. > > To be fair, she's singled him out as well. > > Looks like they had a grudge from another NG, already. I never met this santa klown who came from nowhere for the sole purpose of stalking me. I am not on any other NG. But a few clicks of the mouse revealed a lot about him. Like Otis, he could not bet a job as a pilot after graduating aviation school, because of vision insufficiency. He is very frustrated. Under various screen names he browsed sex NGs and other questionable sites. And I suspect that he came to s.m.v. per your solicitation, Mr. Quasimodo. Obviously, you told him that I was your main obstacle in reaching your goal of converting everybody on s.m.v. to Bates, or at least purchasing "The Book". So now it's up to you to tell him that there are a few other obstacles. Like (for instance) scientific proof. > >I've spoken to Ms. Brainy on the phone, at length. I find her bright, > >personable, affable, genial, and engaging. > > Oooo... Neil's got a crush! > > What will DJ think! You shouldn't flirt with other woman! I think you are jelous, Zetsu. > >> "Ms.Brainy" <mikabra...@gmail.com> wrote in message > >> > Great! I love those OCTs. I have a colorful copy of it. The 2 eyes [quoted text clipped - 46 lines] > > - Show quoted text - Dear Santa Klown, You don't know me very well, but I thank you for your valuable advice. I really needed it. You see, I never told you a big secret about my life: I was raised by wolves! Growing up with wolves was fun, but I now realize that I lack the basics of human behavior. We wolves speak too loudly and waive with our hands. We wolves have no table manners. We wolves expose our teeth when we smile. We wolves don't lift the toilet seat. We wolves visit our friends unannounced, we just walk in without ringing the doorbell, and we don't leave until after midnight. We wolves don't leave tips at the restaurant. We ask too many questions. We have too much time on our hands. We use 4-, 5- and even 6-letter words on the Internet. When in the waiting room for the retina doctor, we run back and forth across the room and make strange noises. We demand answers to our concerns from the retina specialist by pounding on the retinoscope. And on our way out we don't even say 'thank you'. It is a long learning process, and not easy. But with your caring guidance maybe we will, some day, be able to get a prescription for anti-inflamatory eye drops and be accepted into human society. So thank you again, and again, and again. Ms. Brainy, Don't get me wrong. I've had my share of vision problems and I hope you'll be able to have good vision. However, it occurs to me that you are not a good patient as far as your docs are concerned, on the basis of your posts. Life is simple: as Paul McCartney once sang, the love you take is equal to the love you make. Try to have good behaviors and attitudes, and your docs will respect you. Ms. Brainy, First off, I am not a professional and could be subject to correction. Your PVD in the left eye, if it has successfully detached, then I don't think there is any problem of tugging (or traction) on the retina. It is only when the detaching process is in progress that problems can occur. Incidentally, a PVD in progress (not completed) can be see on an OCT and the status of where it is and the pull, if any, on the retina. I am a little surprised at the combined (2 eyes) acuity test. I would have guessed the better eye would overide and you would have at least 20/20 with both. I suppose the variance of reading the charts the second time could produce this. It seems that what you have in your hands are the topograph maps of the retinal thickness. When you take the OCT, there are scans at 0 (horizontal), 30, 45, 90 (straight up), -30, -60 degrees. These are the slices of the scans that go through your (the) macula. These are the typical scans. These allow the ophthal to view the cross section of the retina where those scans have occurred. (It is a sampling process). The round (I suspect) thickness drawing you have, has been interpolated from these 6 scans, and adjusted for age (as I understand). To find out why some thicknesses are because they are, one would have to look at the cross section image slices. Also the pucker would show on these slices. Oh, your urr's are in microns, I guess. And how does your pucker do with the Amsler grid? I would ask the ophthal to walk me thru the slice images. Good luck. Don W. > Ms. Brainy, > [quoted text clipped - 34 lines] > > Don W. Thanks Don, I think you are right in your interpretation. I don't know about the "age adjustment". The "u" in the "urr" is not really a U but rather "?" (the greek symbol for micron). I cannot identify any pucker in any of the images. However, the difference between the eyes is apparent. Until now I have presumed it was the pucker that produced some distortion in my vision --minor "waviness" and seemingly a tiny blind spot near my central focus, sufficient to reduce my VA. This distortion is not noticed in my combined vision. Anyway, the doc said that it's apparently the macula that never closed perfectly, although closed. If you recall, my ordeal began with a macular hole. The doc recommends nothing at this point, except perhaps eye drops to reduce the swelling and bring the eye to a normal state. My subjective feeling all along has been that the healing process was never completed. I don't exactly understand this "swelling" stuff and its effect. > > Ms. Brainy, > [quoted text clipped - 51 lines] > the healing process was never completed. I don't exactly understand > this "swelling" stuff and its effect. Mrs Brainy, Sorry, for my behavior > Mrs Brainy, > Sorry, for my behavior Drinking? The listed trolls seem to have a proclivity toward substance use, substance abuse, and medication errors (Hi, Uncle Otie!). Just curious.... > > Ms. Brainy, > [quoted text clipped - 37 lines] > Thanks Don, I think you are right in your interpretation. I don't > know about the "age adjustment". The age adjustment would be built into the statistics of the machine. The "u" in the "urr" is not really a > U but rather "?" (the greek symbol for micron). > [quoted text clipped - 4 lines] > sufficient to reduce my VA. This distortion is not noticed in my > combined vision. I would speculate it would not be noticed, the good eye's input would override the visual field. The pucker distorting the retina would distort the visual field, the amount of which would be detected by the Amsler Grid. Anyway, the doc said that it's apparently the macula > that never closed perfectly, although closed. If you recall, my > ordeal began with a macular hole. The doc recommends nothing at this > point, except perhaps eye drops to reduce the swelling and bring the > eye to a normal state. I don't believe there are any "eye drops' to reduce this type of "swelling" of the retina. It may be he is talking about Kenalog which is an intravitreal shot. If it is "eye drops" I would like to know which kind. My subjective feeling all along has been that > the healing process was never completed. I don't exactly understand > this "swelling" stuff and its effect. As mentioned before, I think this would not be apparent from the OCT views that you are looking at. The cross sectional views would be more definitive. Don W. - Hide quoted text - > - Show quoted text - > > Ms. Brainy, > [quoted text clipped - 53 lines] > > - Show quoted text - After further examination of the OCT, symptoms, other records and Internet research, I have self-diagnosed the problem as macular edema. I have an appointment with my ophthalmologist (not the retina specialist) in a couple of hours and am curious to hear what he has to say and what treatment (if any) he will propose. > > > Ms. Brainy, > [quoted text clipped - 61 lines] > > - Show quoted text - Bingo! It's a macular edema. Finally, after 9 months, I have a diagnosis and a name for the "swelling". This explains the various symptoms I have, not all of which I have listed here. My doc prescribed Prednisolone and Acular eye drops and refered me to ANOTHER retina specialist, whom I am going to see next week. I hope to be able to clear the condition, which wil probably result also in improved visual acuity.
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