Hyperopic shift in one eye.

[Rincer]

I am 53yr old male. I have had mild myopia since childhood. My prescription has stabilized at round -1.5 in both eyes. I only ever wear monofocal glasses for distance vision as my near vision is still clear. I am assuming the myopia is compensation for the age related loss of lens flexibility.

6 years ago I suddenly noticed a distinct change in vision in my right eye. Distant objects were suddenly clear without correction while near vision became blurry. I went through extensive testing including corneal topography and the Ophthalmologist diagnosis was that the shift in vision was a combination of irregular astigmatism and beginning of a cataract (he could not see the cataract, but concluded it was there from the results of the corneal topography test).

Over the course of about a year, my right eye gradually went back to how it was before this sudden change. I once again had clear near vision without glasses and clear far vision with my prescription in both eyes. My annual eye exams were uneventful. And by the way none of the optometrists could see any signs of a cataract or anything else wrong with my eyes.

Now 6 years later the same thing is happening with my left eye....  Far vision is suddenly clear without glasses and near is blurry. I am hesitant to go to the same Ophthalmologist, since I don't have the confidence his diagnosis was correct.

If anybody has any suggestions or can recommend a course of action, please let me know.

[jimbo33615]

Thank you for your quick response. Only 3 days in since this issue occurred but it appears just the one significant shift from -2.75 to +2.50 and now stable at the +2.50 but not sure. I did end up having a chalazion 2 days after vision change but went away after one day and no correction of vision. I will let you know if I end up getting a diagnosis so that maybe it can help you as well. Thanks.

[Rincer]

Yes, my chalazion also went away, but seems like it takes a while for the eye to return to its natural shape. At least that is my experience. I am actually enjoying my condition now. I can watch TV without glasses and see everything clearly. And my near vision is not too bad since my other eye is unaffected. Please keep me informed if you get a diagnosis. Good luck!

[jimbo33615]

Thanks for the silver lining!!! Will do. Thanks.

[John C Hagan III, MD, FACS, FAAO]

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[Rincer]

Hi did you end up getting a diagnosis? I am still having this issue on my one eye. I was hoping it would resolve by now but it hasn't.

[John C Hagan III, MD, FACS, FAAO]

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[jimbo33615]

Hi Rincer, I am sorry to hear you are still having this issue. I was never able to get a diagnosis but fortunately my vision went back to normal after a couple of weeks. In addition to the vision shift I had a rotation of my stigmatism. Again no diagnosis but stigmatism kept changing. I stopped using glasses that adjusted for my stigmatism so not sure if still occurring or not. For the vision shift and the stigmatism changes, none of the doctors I went to could explain or had seen if before. --Jim

[John C Hagan III, MD, FACS, FAAO]

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[jimbo33615]

Hi Rincer,

My name is Jim and your description from Feb 26, 2020 describes my recent situation as well. Three days ago my left eye went from -2.75 to +250 overnight. I have been through numerous tests from two ophthalmologists including a neuro ophthalmologist with no identified reason for change in vision. Were you able to get a diagnosis for your condition?  I am searching for what my next steps should be. I recently had a full blood work done and all parameters were in normal range.

Thanks,

Jim

[Rincer]

Hi Jim,

No I wasn't able to get a diagnosis. My vision keeps changing pretty much on a daily basis, so getting a new prescription is kind of pointless. As I mentioned in my original post exactly same thing happened to my right eye six years ago and eventually it went back to normal all by itself.  One thing I did not mention is that both times I had a chalazion on my upper eyelid of the affected eye.  I read that sometimes a chalazion can affect your vision by pressing on the cornea and distorting it. So try and look for any eyelid swelling or bumps on your eyelid.  

[John C Hagan III, MD, FACS, FAAO]

I would suggest a test for diabetes called an A1c.  Elevated blood sugar can cause unusual changes in the glasses prescription.  Cataracts can also but they don't reverse and get better.  same way with irregular astigmatism it doesn't get better. Some drugs can cause variable changes in glasses RX  birth control pills, estrogens or being pregnant can.   Topamax, a migraine medication can cause not only changes i glasses Rx but acute angle closure glaucoma.

[Rincer]

Sorry I didn't mention this in my original question. I am not on any prescription. My annual blood test results show a1c of 4.9, from what I understand that is normal.

[Rincer]

It is worth mentioning that 6 years ago the Ophthalmologist that I went to also did a diabetes test and a1c was 5.3, fasting glucose was 108, which is higher than the 70-100 normal range, but not enough to cause changes in vision according to him. I have since bought a blood glucose monitor and have been measuring my fasting blood sugar and it has been in the normal range. I think I have some rare condition that I can not find any information about online. And local medical professionals have no experience in either.  

[John C Hagan III, MD, FACS, FAAO]

An  A1c of 4.9 is fabulous, wish mine were that good.  So it is not diabetes.  It is unlikely that this is something that is vision threatening.  I would just suggest an annual exam by an ophthalmologist and a cornea topography and macular OCT yearly. If new symptoms develop then go in sooner.