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Medical Forum / General / Vision / July 2009

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Question: vertical 'drift' in one eye.

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BD - 15 Jul 2009 23:34 GMT
Hey, all.

So... I'm 40, I have a +4.5-ish prescription that hasn't changed
appreciably in about 20 years. Pretty static.

Possibly of note as well - I have slightly elevated blood pressure
(managed with medications), and I experience ocular migraines once
every couple of months. going through one right now, in fact - which
was what reminded me to post this question. ;-)

On two separate occasions in the past year or so, I've experienced a
rather odd symptom. I have mentioned this symptom to my GP, and he
indicated he would like to set me up to see an opthalmologist. That
appointment has not happened as yet.

The symptom is as follows:

With no other noticeable symptoms, the orientation of one of my eyes
gently drifts downward by maybe 2 degrees. The effect is similar to
that experienced when you go cross-eyed, except this is not voluntary,
and it's vertical. It's impossible for me to be clear on which eye is
drifting, nor which direction, as it's all relative to the orientation
of the other eye. I could say that one eye is suddenly oriented lower
than the other, were I to have paid enough attention at the time. I
did not. It *felt* like my right eye was drifting downward.

In both cases, the effect ceased within a couple of minutes, and my
eyes drifted back into normal orientation.

I believe that in both cases, I was lying on my site watching TV at
the time, so my head may have been at an odd angle. Not sure if that's
a possible factor. But that said, I've watched TV in that posture for
decades, and this hadn't happened in all that time. ;)

This is very much a one-off, I grant - but I'm curious if this kind of
'vertical drift' is necessarily indicative of some issue or other.

Comments welcome, as always - with the exception of comments from one
or two specific people, which will be answered with raspberries
regardless of what they say. ;)

Cheers,

BD
Neil Brooks - 16 Jul 2009 00:26 GMT
> Hey, all.
>
[quoted text clipped - 32 lines]
> This is very much a one-off, I grant - but I'm curious if this kind of
> 'vertical drift' is necessarily indicative of some issue or other.

Does it sound like it's explained by Dissociated Vertical Deviation:

http://en.wikipedia.org/wiki/Dissociated_Vertical_Deviation

??

> Comments welcome, as always - with the exception of comments from one
> or two specific people, which will be answered with raspberries
> regardless of what they say. ;)

The (brother of) the inventor of ferret bowling has lost none of his
sage wisdom ;-)
BD - 18 Jul 2009 00:15 GMT
> > Hey, all.
>
[quoted text clipped - 47 lines]
>
> - Show quoted text -

Geez, that must have really cracked you up for you to remember it
after all this time. ;)

I recently pet-sitted (sat?) for my brother for a week - no ferret
this time (that one's deader'n dead at this point), just a border
collie and a guinea pig. The dog's smarter than me, but all the rodent
can do is eat, sh*t and squeal. Far less entertaining than a ferret
would have been, I expect. I guess I could have tried bowling with it,
but I'm sure the little brat would have bit me. I'd probably have
scarred the dog emotionally in the process too. I know a couple of
times when the dog was typing at my computer he had this oddly
scrutinizing look in his eye. Figured he was cutting an email to my
brother, so I thought if I abused the rodent I'd probably get ratted
out for it. Not likely worth it, so I behaved. ;)
BD - 18 Jul 2009 00:19 GMT
Oops. forgot to address your on-topic comment. ;-)

If DVD is associated with squinting, then I'd have to say no. When I
was experiencing the symptom, I tried squinting, blinking, opening my
eyes very wide, going cross-eyed, shaking my head... everything shy of
slamming my skull into a wall. Nothing I could voluntarily do had any
effect. And then it went away on its own.

If/when I get in to see the eye guy, I may mention that condition in
passing, and see if it would make sense to quickly test for it.

Thanks!

> Does it sound like it's explained by Dissociated Vertical Deviation:
>
[quoted text clipped - 10 lines]
>
> - Show quoted text -
Mike Tyner - 16 Jul 2009 01:08 GMT
You never said whether you actually saw double.  "Feels like it drifted"
isn't very specific, and it's an important distinction.

If you have a neurologic deficit like fourth-nerve palsy, you can usually
elicit double vision anytime, by looking in a certain direction, eg down and
to the side. You can check this with the "alternate cover test" while
looking in different directions.

If your symptoms cleared within a couple of minutes, it's likely just the
way your glasses were sitting, or a posture that stretched or rearrangeed
the muscles and padding around your eye temporarily.

Your glasses (+4.50) are strong enough that lifting one lens just a few mm
will make you see double via induced prism. If your posture moves the frame
only half that much, you'll still see single but you'll have to exert a new
effort to maintain single vision. If you get used to that for a half-hour or
more, it would be normal to feel "drift" when you straighten back up.

When reading, I often lean my head against the arm of the couch, enough to
pull my cheek back slightly toward my ear. It relieves my deviated septum,
but it also pulls my eyelids in a fashion that disturbs my vision until it
"gets settled." Then when I do get up, I'll see double for a half-minute or
so.

If you weren't seeing double, it makes the symptom less significant.

You need an eye exam to see if there are any neurological issues surfacing,
but it may just be the result of normal physiology.

-MT

> Hey, all.
>
[quoted text clipped - 40 lines]
>
> BD
BD - 18 Jul 2009 00:04 GMT
A few clarifications, Mike:

I did see double. The effect on my perception was identical to that of
going cross-eyed, just in a vertical orientation.

This doesn't appear to be something I can make happen by looking in
any specific direction (just tried).

I don't generally wear my glasses. I wear contacts, and only pop the
glasses on when I pull my lenses out, a couple of evenings/nights a
week. There is typically a brief adjustment phase in my vision when I
go from one to the other, but this kind of symptom has never occurred
when I change from one to the other.

Yeah, if I wiggle my glasses around, all sorts of wacky stuff will
happen. I have the rather flexible titanium frameless jobbies, so it
doesn't take much pressure to move the lenses out of place.

That said, when these symptoms occurred, I was wearing my contacts.

I'll pursue the appointment with the opthalmologist, as I'd like to
try to get some kind of coherent reason for what happened.

> You never said whether you actually saw double.  "Feels like it drifted"
> isn't very specific, and it's an important distinction.
[quoted text clipped - 73 lines]
>
> - Show quoted text -
 
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