Amlyopia

[jlw99]

I've had amlyopia since childhood.  Had surgery to straighten left eye and vision is 20/100 to 20/80.  Right eye is 20/20 with glasses.  I'm 60, and have recently found out I have a cataract on my good eye.  I also have some map-dot dystrophy in both eyes.  Does anyone have any experience with these conditions in people with amplyopia?  I'm so afraid of losing sight in my good eye.

I could us some hope right about now.

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

Good luck Lauren. JCH MD

[LMBarfield]

Thank you for your time.  It's such a comfort to have received your response.  We'll start with a trip to the pediatrician and take it from there.

Warm regards,
Lauren

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

Children are always hard to evaluate on these things because its very difficult to decide what is the product of an overactive imagination or conjuring up symptoms for secondary gains like attention or time off from school. Moreover the work up can be very expensive when you get into MRIs and neurological work ups.

I would start by seeing his pediatrician. He likely will need to see an ophthalmologist.

Bright spots that come and go, with or without headache, that cover up part of the field of vision and that can be seen with the eyes shut are often childhood migraine.

JCH MD

[LMBarfield]

Dear Dr.  Hagan,

I had been reading the post string regarding bright spots and wanted to reach out to you for guidance.  My 10 yr old son causually told me while reading at bed this evenign -- that he often has trouble reading and seeing hte board at school because of a bright spot in his vision that covers some of the words on the page while reading.  Additionally about 1 wk back he complained for a couple days that hecould not bent over -- head below waist level -- because of extreme eye pain  -- described that he thought his eyes were going to come out. If his head was upright no pain or issues at all.  

I'm worried and will make an appt with MD 1st thing in the AM -- Can you provide any insight or direction?

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

1. No dystrophies cannot be cured but many are not serious or assymptomatic.
2. Read the dry eye entry on my blog on MedHelp.org
3. Slow cataracts: don't smoke, eat a good diet, don't get fat, exercise, wear hat and sunglasses in bright sunlight, don't get diabetic.

JCH MD

[jlw99]

Can dystrophy be reversed and is there anything that should be avoided that may slow the progression of the cataracts?  I do have an appt with my opthalmologist next week.

[jlw99]

Thank you very much.  Neither my optometrist or opthalmologist have said to use eye drops continuously.  More like on an "as needed basis".  That surprises me after the research I've done because I've had dry eyes for decades, and neither ever voiced any concern with developing dystrophy.  I didn't even know what dystrophy was until they told me I had it.  Had I known it could develop with dry eyes certainly I would have started using drops years ago.

Again, thank you for your time and information.

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

Your personal Eye MD is in the best position to advise you. Generally continuing to use drops for dry eyes is  beneficial.

The BMD map dot can cause recurrent erosions and your TX of drops day and ointment at night will reduce the risk of this.

JCH MD

[jlw99]

Thank you so much!  So, I can quit worrying about the dystrophy?  Should I continue to use the drops for dry eyes?  I've been using Soothe and Refresh and ointment at night.

The cataract is on my good eye.

Again, thank you sooo much!

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

1. the map-dot dystrophy (basement membrane disorder) is not a major problem and should have no effect.
2. In the USA alone last year there were over 3 million cataract/IOL surgeries. It is the most common and most successful surgery done on US adults.
3. Your amblyopia only means that if the cataract is removed from that eye it will likely never see better than the 20/80-20/100 vision you have had before the cataract developed.

JCH MD