See spots when moving eye

[paravantis]

I am a 49 yo male without health problems. In April 2009 I suffered a concussion (grade ii) caused by a stupid fall and hit to my head while doing garden work. Over the next 2 weeks after the accidents, I got black circles around my eyes. The 4th cranial nerve (trochlear) of my left eye suffered a minor palsy due to which I have had double vision; this is getting better over time. In December 2009 double vision is 90% corrected.

In the fall, I visited an eye doctor to investigate a weird phenomenon in my right eye (the good one): I realized I saw a transient spot when I moved the eye quickly from left to right. Part of the spot is dark (like a floater, of which I have always had quite a few) and part whitish, sort of like an afterimage. The spot is small and disappears when I stop moving my right eye.

I was instructed to do an Optical Coherence Tomography (OCT) which was normal in both eyes with the exception of a tiny (non serous) pigment epithelial detachment near (but not in) the fundus of the right eye. The retina specialist told me that no treatment was required due to its size and location. He said that the detachment was caused by stress and I should stop worrying about it. He characteristically told me "come back only if you see any changes in your vision - I bet the small detachment will be absorbed and go away."

Re the detachment, I have looked into the literature and found a link with cortisone. I did use some cortisone (5 mg daily for 6 weeks) to cure a right inner ear concussion that appeared a few days after the hit. Could the cortisone have caused this?

Since that time I have visited another retina specialist, reportedly the top one in Greece, who again carried out a dilated eye exam and found nothing wrong with the retina of both eye. He did see the small detachment spot near the fundus of my right eye and told me "Don't know what caused it and don't care - it's there now, forget about it and only come back if you see any changes." He suggested that I return for another retinal exam in the Spring of 2010 to see how the detachment spot is faring.

My vision has always been 160/100 (in other words, outstanding) in both eyes, with the exception of some age-related far sightedness that I correct with eyeglasses.

I still see this weird spot in my right eye, like a floater that only appears for a second when I move my eyes rapidly left/right and up/down. In fact, I now see another transient whitish circular spot in the middle of my right eye when I lift my head rapidly so that my eyes are fixated on the ceiling; this spot is larger and looks like it was caused by a bright light - only it is not. All these weird (endoptic?) phenomena only last for a second while I move my eyes rapidly. And only happen in my right eye.

This is my story folks. I would appreciate you feedback. What the heck are these phenomena? Why do they happen in my right eye only? Could they be related to the pigment epithelial detachment? Could they be remnants of blood infusions into the vitreous of the right eye, effected by the black eyes I got after the hit - if so why do not they affect the other eye? Might it be that I have some weird decease that has escaped detection so far? Should I carry on any addition tests?

Many thanks and best wishes for a happy new year from Athens, Greece.
John P.

[Ray T Oyakawa, MD]

A guess would be vitreous traction that tugs on the retina giving you the symptoms.

[paravantis]

Dr, O.,

Thanks for showing up. I have seen many a considerate responses of yours in the forum and was hoping I would hear from you.

The top retinal specialists IN GREECE saw a normal retina (fundoscopy, OCT) and opined that all is well.

Perhaps you could share with me YOUR TAKE on my symptoms Sir.

Although your opinion would not be based on an exam, since we are separated by half a planet, perhaps you could indicate to me possibilities my doctors may have missed.

John

[Ray T Oyakawa, MD]

You expect an answer after seeing the top retinal specialist without an exam?

Dr. O.

[paravantis]

Near the top of my message, I erroneously write "accidents" - it was just one accident.

Also I forgot to mention that all 3 doctors (my regular eye doctor, the retina specialist that carried out the OCT and the top retina specialist I saw last) could not explain the spots and attributed them to vitreous density inhomogeneity that is not important.