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Medical Forum / General / Vision / March 2008

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Info From My Eye Doc 2

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Simon Dean - 14 Mar 2008 01:19 GMT
Just a quick nudge, and Zetsu, you are not welcome to reply. Please
respect my wishes and I will not reply to you.
=========================

Hi,

Thought I'd write to my eye doc regarding all the barrage of tests I had.

Skimming over, I remember he suggested I had a fourth nerve palsy,
perhaps of recent onset if I hadn't noticed anything previously. What he
 writes says that what they have actually seen is a tendency for my
left eye to be higher than my right eye. But he believes this to be
minimal and non worthy of management with prisms (depends how much
double vision Im getting, which in real life is none)

He says that with the Worth 4 Dots, I definitely see double vision but
that doesn't mean my visual system is being placed under stress.

With the Frisby Davis Distance test for steriopsis, he says that I don't
perceive fine depth on any of the stereopsis tests. He says that this
doesn't matter in the normal course of daily living as it's not
necessary for most tasks in life.

He has given me some information on my fusion with prisms etc.

He says that my horizontal prism fusion range for near is 10 prism
dioptres base out to 8 prism dioptres base in, and for distance is 4
prism dioptres base out to 2 prism dioptres base in.

He says my fusion range is not large and I have a tendency to breakdown
on my prism fusion range quite easily and this is all related to the
fact that I don't use my two eyes specificially together.

He also adds that he has done an electrical assesment of my eyes,
involving an ERG and VEP both of which were normal. He then did a
photosensitivity test which measrues the sensitivity to light for a
variety of frequences of flashing light which demonstrated that I was
hypersensitive and suggestive that I have migraine.

He concludes that he belives I am sensitive to light and have migraine.
I have a small problem with eye alignment which I should cope with but
if there was a problem, then I would consider prisms.

1) In what circumstances might you need to perceive fine depth? Is this
why despite being long sighted I perceive some signs as slightly blurry?

2) Any thoughts on those prism measurements?

3) Could migraine explain those intermittent eye issues I had?

4) Let me know any other thoughts you might have.

Cya
Simon
Dr. Leukoma - 14 Mar 2008 14:13 GMT
> Just a quick nudge, and Zetsu, you are not welcome to reply. Please
> respect my wishes and I will not reply to you.
[quoted text clipped - 50 lines]
> Cya
> Simon

I have found the red lens test to be very useful in isolating a nerve
palsy.  A red filter is placed over one eye, and in a dark room a
transilluminator is held in front of the patient.  The
transilluminator is moved to each position of gaze.  If no palsy is
present, the patient perceives a pink light in all positions.  If a
palsy is present, the patient perceives a red and a white light.  By
having the patient move the eyes in the various positions of gaze, the
experienced pracitioner can isolate the muscle involved.  A superior
oblique or CN IV palsy will manifest more diplopia when the patient
looks down and out, as the secondary action of the muscle is
depression in the adducted position (eye looking inward).

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