Small spot or smudge in vision when moving eyes left or right

[xltjim]

Hello all, let me start with a little background.  I had vitrectomy to repair RD in my LEFT eye last september and have a cataract in that eye which formed shortly afterwards.  I have been getting along fine with my right eye compensating for the left.  Its amazing to me that the good eye has compensated so well.  Sometimes if I have been tired I do get blurred vision, but blink a couple of times and its fine.  The cataract in the left eye has gotten worse the last couple of months.  I saw the retina MD in April and he examined both eyes (did OCT on both) and approved the left eye (vitrectomy) eye for cataract removal.  I just saw the cataract surgeon last week and she did a dilated exam of both eyes as part of new patient exam, then took eye measurements.  I felt she did a very thorough dilated exam, the slit lamp was very bright and the brightest that I have ever experienced - so much as that it was very uncomfortable.

Now being scheduled for the cataract surgery on the left eye, I have recently (since last exam by cat surgeon) noticed in my GOOD (right) eye a spot in the central area that is almost like a collection of dots, or a smudge, and sometimes a short line.  This occurs only when rapidly moving my eyes horizontally, and immediately goes away.  I get no flashes at night and seems to be only noticeable in lighted areas.  Vision is good out of the eye.  I do have floaters but nothing new and have had them for years.  Having experienced a detachment of the left eye last september, I am not experiencing any of the shadows, peripheral flashes, nor the tons of wisps/smokey floaters that I had then.  ** Now I am not sure if I am apprehensive of upcoming surgery and just fixating on my eyes more and seeing what has always been there, but I don't think so.  Amsler grid test seems fine.  I am scheduled for the cataract surgery on the left eye (vitrectomy eye) in two weeks, been cleared medically by general md, but can't help but be concerned.  Most likely will be calling the eye md and getting it checked but does this sound concerning to you?

[xltjim]

The saga continues.......Yesterday while driving home from work, I noticed some new floater in right periphery of my up until now good eye.  Also noticed that the flashes that I have had only on eye movement in certain lighting were more apparent and easy to recreate (if that makes sense).  Immediately called my retina surgeon who scheduled me to come in the next day and to call if certain symptoms manifested (shadow, vision loss, etc).  

When I awoke this morning I had millions of tiny dot floaters, wispy cobweb floater.  I felt this warranted an urgent call via the office answering service.  Dr. had me meet him in the office within an hour.  Dilated exam, OCT, Schleral depression were done.  The partial pvd appears to have finally, 6 months later, progressed to a near full one.  Dr did find a spot where he felt caused the blood but didn't see any holes, tears, or detachments.  Since this event the flashes seem to be much less than they have been since originally diagnosed.   Barring anything new, I see him back again in 3 weeks.   I believe this to be good news all in all so far (knock on wood).  My goal is to catch any issues with this eye much earlier than what happened in my other.  Take care..Jim

[JohnHaganMD]

A million tiny dots is how people describe blood in the eye. When blood in eye 98% of the time there is a retinal tear.   So you are so far one of the lucky few.

[xltjim]

Not so lucky Dr.  After 4 days being cleared by retina surgeon, I had a sudden recurrence of the millions of dots, along with streaks of black lines, shadow near nose when looking right.  Got in right away, surgery same day for vitrectomy.  Surgery seems to have gone well so far.  Dr. says the vitreous was very sticky.  So, I had hoped to catch this as early as possible to avoid the major surgery, but it sounds like I was destined for vitrectomy in this eye no matter what.  Hoping for a good outcome.  Doing the positioning and following all the dr orders.  Thanks,, Jim

[MrPresley]

Jim,

Thanks for the informative posts. Like you I'm  watching for any new symptoms in my right eye, which was diagnosed with macular pucker just like my left eye (which was that got me referred to a retinal specialist in the first place three years ago). Best of luck on your recovery, and you're doing everything right in my opinion.

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

Best of luck. Unfortunately its a common sad story.

[xltjim]

I hope I am not being overly obsessive on updating this with my status.  I just would like to post in the hopes that it may help others.   So, I am happy to report that I am now 5 weeks post op and my eye looks and feels great.  I have a 12 week gas bubble which is now at 50%.  On the plus side .....  I can see over it pretty well.  So far I seem to have a full field of vision although some debris/floaters which may go away as things progress.  Vision is a little blurry and cloudy which is partly attributed to the gas bubble and cataract starting already.  The left eye is compensating well and I am very functional and pleased.  I got through the 3 weeks of left side positioning and am now only required to sleep on my side.  I am on 30 day followup pending anything going south.  I am able to drive, but being cautious.  Tapered off of the eye drops with one week left.

On the negative, I have slight tingling in my hand which dr feels may be related to laying on my side for such a long time.  I followed his instructions to the letter.  May be Ulnar compression.  Seems to be getting better with time, although I do have a referral for a neurologist if it doesn't get better in the next few weeks.  Most likely related in part to age and 30 years of IT computer - keyboard work = and laying still on side still for 3 weeks sure didn't help it.

From having the same surgery (a year to the day lol) in my left eye, I am pretty aware of what to expect.  This eye seems to be healing (so far and knock on wood) much better than the other.   Monitoring for any new changes but all good so far though.  Baby steps for sure.

My regards to all, until the next update..Jim

[JohnHaganMD]

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[melinda68]

Jim, could you see through the shadow near your nose or was it opaque? I have a large shadow near my nose but ophthalmologist told me no retinal problems and to see a neuro (which doesn't make sense to me, as it's only in one eye)

[JohnHaganMD]

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[xltjim]

Hello, the shadow I had is kind of hard to describe.  After the PVD, where the retina the doctor cleared me,  flashes that I had for months went away.   A few days later I noticed flashes in my right eye = toward nose.  It was a area like the size of a nickle if you held it in front of your eye.   I noticed a dark shadow in that area only when looking to the far right.  Not noticed unless I moved my eye quickly.  Couldn't see through it when it was there.  I went right to my retina surgeon who found five tears and I was in surgery that day.  Not saying anything negative about your MD, but did you see a retina doctor?  Anything abnormal now that's who I call.  In any case perhaps get another opinion while awaiting a neuro ophthalmologist appointment as well?    Of course if things change or go south get in somewhere asap.  Good luck.  Jim

[JohnHaganMD]

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[melinda68]

Thanks, Jim. I was checked first by an optometrist, then by my glaucoma specialist. The optometrist was way more thorough that the GS. There is no retina specialist in the county where I live, but I am considering travelling to see one.

[JohnHaganMD]

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[xltjim]

Hope I am not jinxing myself but .....  Had the cataract surgery yesterday and patch was removed from eye today.   The dr. made my right eye just a little near sighted to be able to work with my left (had cataract removed last year).  I am one day out from the surgery and am comfortable typing this without wearing glasses.   My glasses are too strong for my right eye now so I am getting by with not wearing anything.  They seem to be working together fine - the left eye appears to be accommodating for reading, the right can see distance (little fuzzy close up).  Together vision is fine.  Dr. says we will see where things settle in a month for new prescription and I fully expect, and had intended to be wearing glasses.   I cannot be more pleased this soon since the surgery.   Modern medicine is a miracle, and Dr Hagan my hats off to you and those in your profession.    Now....time to take the eye drops...lol.

[JohnHaganMD]

Best of luck.  Very happy for you.

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

Short answer is "yes" when you have RD in one the risk of RD in the other is as high as 5-20% depending on a number of factors. You should report the new smudge to your retina surgeon and see if you need to come in for dilated exam "just to be sure".   Also read this information about cataract surgery:  
http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You

[xltjim]

You would think that with all that I have been through I would know by now that if I notice anything new to not even pause and call the eye md.  You are right, and I have already called and going in to see him today.  Thanks for this and for the info on the cataract surgery.  I found that awhile ago as well.  Will post the outcome for others reference as well.  Take care, Jim

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

Thanks best of luck

[xltjim]

Welp....It is a PVD.  Glad I had it checked.  Going in for followup in 3 weeks or sooner if I get the RD symptoms.  Said to go forward with cataract surgery as planned since my left eye is pretty useless right now.  Boy....if I knew retirement was going to be like this I would have kept working.  (little humor).

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

When it rains it pours. Sometime the sun will come out.

[Alitheia]

Found this post you referenced replying to mine xltjim. Sounds like you and I are in the same boat. I am a watch and see, so I get regular exams quarterly. I’ve never had a RD, nor a macular tear. So as annoying the smudge (mine was a smudge, now its more of a clear or blackish blob with white circular lining for a split second after moving my eyes, especially looking at a light background) was/is, I just figured it would finally resolve once the PVD was complete. I am just hoping that I do not have a macular tear in the process.

And in the words of my best friends dad growing up *This getting old ain’t for sissies*.

[xltjim]

Hi Alitheia, I replied to your other post that mine seems to be mostly subsided.  Still on watch for any RD symptoms.  I have to say that with the procedures I have had thus far, I am  very impressed with the medical community and their ability to help those like us.  I like to think of this as a speed bump to life, little bump in the road, but all will be fine in the end.  I made the mistake of not taking urgent action on my left eye back in september.  Heck, I even rode my motorcycle 2k miles with a little blob in the corner my eye.  Was a retina detachment and I got lucky in that a vitrectomy (pending cataract repair) seems o have saved my vision.  Never again will I ignore the symptoms.  Shame on me.  Well I certainly hope for the best for you!!  Regards, Jim

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

Thanks for the post

[Alitheia]

Wow Jim, I'm glad all.was well despite you not realizing you needed to get yourself to a doc right away with that blob.

Did that blob come and go too? Or was it always present? What color was it?

I have a few blobs that come and go in the right upper corner of my right eye as I blink. They dissipate after blinking and dr doesnt see anything on eye exam. I've had them before in different parts of my vision. Eventually they have all gone away. The latest ones just bug me but I wasnt worried about them.

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

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[xltjim]

Hi again...lol.  Im not a doctor by any means, but what you may be seeing are floaters casting a shadow on your retina, or afterimages.  I get those as well.  There are many posts here about things like this.  The good thing is you are seeing regularly, and told your dr about them and he doesn't see anything wrong.  I have learned that I am super aware of things with my eyes now, so much that I am quiet sensitive to anomalies that I may have always had.   With my left eye useless with a cataract, my right eye is doing the work...so I tend to notice everything now.   The best that I have learned is to report anything new to the Eye MD.  

I was going to give you my ordeal about my left eye in detail, but after typing it up I thought "who would want to read all this?".  Anyhow, that blob I was referring to was like a translucent jelly looking like thing in the lower right quadrant - left eye the size of a pea.  Nothing like what we have been discussing.  It would flop around as I moved my eyes left to right.  Some times it would disappear entirely.  I had initially seen an optometrist (mistake) when the PVD symptoms started.  He said to expect floaters, some flashes, etc until PVD was finished.  I had told him about the blob when I saw him so figured it was ok, thought it may be a floater.  Long story short, I came back from motorcycle trip and went to Opthalmologist who immediately (like emergency referral) sent me to retina surgeon who treated me for retina detachment.  First attempt to freeze or laser failed after a week, then it was to the hospital for vitrectomy.  By then I was losing vision with a grey like curtain on the periphery.  Took 6 months for eye to feel like itself again, now just gotta get cataract taken care of and keep an "eye" on the other one.    Got to rambling ....sorry.  Take care, Jim

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

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[xltjim]

Well, thought I would post an update of where I am at, in case anyone is going through similar.  Cataract surgery was on 6/25.  Being that I don't want to touch my good (right) eye unless it needs intervention, my decision was to have the vitrectomy eye (left) IOL set to a little near sighted.  This will allow my eyes to work together with glasses.   Truthfully, having glasses over the years has actually prevented me from eye injuries.  So that was my decision, and I am very good with it.  Surgery seems to have gone well.  Eye feels great after a couple days of irritation right after surgery. Followups have been good and will be getting a new prescription in a couple weeks.  Can't believe how good I can see even now with old prescription which is a little strong.  I wear those sunglasses that fit over glasses whenever outside in bright sunlight.  Found a pair that don't look so obnoxiously large and will get a few more to leave in car and etc.

The right eye has a PVD in process.  The little smudge I was seeing in lighted areas against a bright colored wall has been replaced with a faint circular ring that I can still see, but I have to really search for that when moving my eyes rapidly (again in lighted room with bright wall).  No flashes that I can detect at night.  I see the retina eye MD tomorrow for followup.  Some floaters in both eyes are a nuisance but seem to only bother me when I look for them lol.

All in all I am very pleased, but still keeping a watch on the right eye to try to catch any issues early.  Will post later as to how the PVD settles in right eye, and anything else.  Regards and good fortune to all.  Jim

[JohnHaganMD]

Thanks for the follow up and we are pleased with your good results thus far

[xltjim]

Just thought I would post an update to my saga in the hopes it would benefit anyone going through similar issues.  I have had some correspondence with folks where we compared our notes.  

Right eye status - Have been to my retina surgeon 3 times since I noticed what started as a smudge evolve into a circular flash on eye movement - only noticed in certain dim lit conditions.   My last visit was some weeks ago.  Dr. had diagnosed a partial pvd and said all looks good.   He said consider this as a baseline and call right away if flashes/floaters increase in intensity as well as any shadows in field of vision.  Barring anything happening (knock on wood) I don't need to see him until my next annual checkup.

Left eye status - Got my new eyeglass prescription a month ago.   Vision is "OK" for the most part although I do notice some blur/waviness when using this eye alone.  It's funny in that sometimes the vision seems excellent, other times not so much.  It's been almost a year since the vitrectomy (macula on rd repair) on this eye and my understanding is that this may be the best its going to get.   The good news is that when using both eyes together I can see perfectly.  I do find that I tend to drive myself crazy by testing the vision in this eye several times a day.  My plan is to let things continue to settle and hope for further improvement.   I also will contact the Dr. if this doesn't improve before my next checkup.  Don't get me wrong -- All in all I am very thankful for what I have -- just a little disappointed that it wasn't like it was before all this started.   I hope all goes well with other folks with a situation like mine.   All the best....take care (and thanks to Dr. Hagan for all he does for us).

Regards,  Jim

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

Thanks for the follow up. It will be helpful for other walking that road. Best of luck.