sudden onset and persistent multiple bilateral para-central scotoma's; and left eye dominant bilateral nasal corectopia

[Jcrow28]

What conditions could cause my symptoms? Two years ago I experienced sudden onset and persistent multiple bilateral para-central scotoma's; and left eye dominant bilateral nasal corectopia. I have been to two ophthalmologist's who could find no injuries, defects or abnormal intraocular pressure, no signs of glaucoma or optic nerve damage. The nasal corectopia displacement is 1.5mm in the right eye and 3mm in the left, pupils are symmetrical and round with normal light response but pupillary athetosis occurs after five seconds with a contraction/dilation rhythm of 2x per second, scotomas are elongate and leaf shapped numbering between 10-13 with the same image seen in both eyes. I' am 28 year old male, At the onset of these symptoms I began to and still experience episodes of labile hypertension and migraine headaches; could these symptoms be connected?

[JohnHaganMD]

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[naruto94]

(Male, 18 years old - Type 1 Diabetic - 14 years) I have the same symptoms. One scotoma appeared about 6 months ago. And got slightly better over the months. Then 2 weeks ago (after being sick with a pretty bad virus - maybe or maybe not flu), I developed a 2nd spot, same eye. Went to Retina Specialist "control your blood sugar, you'll be fine". Days later a 3rd spot appeared. Went to Neuro Ophthalmologist ... lots of testing. Diagnosis "Acute Macular NeuroRetinopathy." Supposedly very rare. No known cause or cure. Uncle (49 years old - not Diabetic) probably has the same thing, for 2 years ... same symptoms. Slightly better now. Maybe not so rare! Very depressing.

[Emilia_A]

I have same condition, female 35 y. o. Do not recall the flu, but the sumptoms and the scan confirms the acute macular neuroretinopathy. I have got paracentral scotoma for 6 months now, does it get better with time? How doyou guys cope?

[JohnHaganMD]

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[Furi]

Hey there, I'm a 24 year old female with exactly the same symptoms as you, only I had flu-like symptoms before my scotomas appeared. My doctors think it's a typical case of Acute Macular Neuroretinopathy, except they can't find any sort of lesions in my eyes. I'm extremely worried and I'd very much appreciate if you could let me know about the progress you have made since you posted this.

[Jcrow28]

Yes Dr. Hagan I have asked this answer before; and you did provided what you thought was the answer. But early onset Glaucoma is not the right answer, So I thought I would re-write the question to include more detail. I don't have any true loss in the quality of my vision, in fact my vision is 20/10, I simply have multiple small black spots in my vision with no known cause. The scotomas as I experience them are very similar to that of people with Acute Macular Neuroretinopathy but with no visible lesions with-in the eye. The fact the the same image is seen in both eyes would indicate an affect on the visual cortex with-in the occipital lobe and 'Not' a bilateral degeneration of the optical nerves. Sudden onset corectopia is also not a normal event, gradual development in old age or shortly after birth is considered normal but sudden onset would indicate a neurological or chemical impairment of the smooth muscle with-in the iris. I have an appointment to be evaluated for testing by a neurologist but that's not for three weeks, so in the mean time I thought I would ask others if they have had a similar experience and if so what was the cause.

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

You've asked this question before and its been answered. JCH MD