Sudden loss of sight in one eye

[federete]

Dear all, let me re-start a thread compiling all the information in a more systematic way.

I am 46 years old.

-January 2020: go for my annual glaucoma test (glaucoma runs in my family: mum and grandma). All fine (a bit high pressure) but developing Presbyopia. I am told my long distance sight is exceptional.
Right eye: SPH=0.0, CYL=-0.50, Axis=0.95, Near-ADD=+1.25
Left eye: SPH=0.0, CYL=-0.50, Axis=85.0, Near-ADD=+1.25

-Day 0 (about 1 month ago): headaches start (haven't stopped since then)

-Day 3 and 7 (approx): I remember telling my son that my sight is not as good as it was

-Day 12: I am having difficulties working, my glasses for presbyopia seem to not be working. I close my right eye and notice that everything is super blurry with the left eye. Short and long distance, very poor sight with the left eye. The right eye has worsen too, but not by any means as much.

-Day 14: go to the GP, who refers me to the Opthalmologist

-Day 14: seen by the Ophtalmologist in the Eye Clinic. Wasn't able to see even the large letters with the left eye, but with a pinhole, magic, everything became super clear (able to see even the tiniest letters). The ophtalmologist looked inside my eyes and says everything looked fine (apart of a bit of high pressure in the left eye). Must be a refractive problem. Recommends me to go to the optician and see if glasses can correct this.

-Day 16: visit optician. Come out with the following prescription:
Right eye: SPH=0.00, CYL=-0.75, AXIS=100.0, Near-ADD=+1.25
Left eye: SPH=-1.00, CYL=-0.25, AXIS=80.0, Near-ADD=+1.25
Both eyes: BVD=10.00

-Day 23: I go to collect my new glasses. They don´t help my left eye at all. They measure again my sight and provide a new prescription. Headaches continue (there hasn't been a day without them)

-Day 29: blood test to check for diabetes (results not ready yet, but I've measured my glucose levels at home and they seem totally fine)

-Day 30 (Today, morning): I go to collect my new glasses again. They are better, but still don't work well for my left eye. There is only one specific distance I can use the glasses with (about an arm distance), like if I lost the ability to focus to other distances.

-Day 30 (afternoon): Seen by the optician again. My new prescription:
Right eye: SPH=0.00, CYL=-0.75, AXIS=100.0, Near-ADD=+1.25, Inter-ADD=+0.75
Left eye: SPH=-2.25,  Near-ADD=+1.25, Inter-ADD=+0.75

I feel like there's something quite odd here and am so tired of the headaches. Yesterday I had to take some codeine because ibuprophen/paracetamol weren't working.

Any help or guidance is much appreciated. I'll see my GP on Tuesday.

Sorry for the long post and thank you very much if you have read all this,
Federico

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

20 or less is norrmal.

[federete]

They don't seem very keen in the eye clinic to see me - they are still discussing whether they can help or not. They try to convince me to visit the optician again, or the GP for the headaches. They explained me on the phone that they carefully checked for angle&standard glaucoma in my first visit to the eye clinic, including gonioscopy, and that all seems fine. And they say 26 eye pressure is not concerning for optical nerve damage.

Investigating myself (always trying to understand things...), I was wondering if this could be a sinus infection. Although I generally don't have pain in my left sinus when I have the headaches, I've had such pain a couple times; and one of those was very painful - that's when I went for codeine instead of ibu/parac. I've read sinus infections can cause blurry vision and headaches. How does this sound?

[federete]

Another thing I am reading about is Vertical Heterophoria. Since some years ago I find my self losing balance when watching a movie and the camera suddenly shows some height shots or do some strange movement; it also happens when walking in a station/building and suddenly a deeper floor appears in my sight (I always complain about new architectural designs with all those open spaces between floors). And I can't use the swing seat anymore, it makes me so dizzy.

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

When people complain about pain around and behind the eye and the eye exam is normal,   sinus problems (infection, blockage, allergy-inflammation) is high on the list. You could ask your GP to order  sinus X ray or Head CT with sinus/orbit views.   a vertical heterophoria should show up on eye exam, and most people have verticle double vision when tired, ill or after a couple of alcoholic drinks.

[federete]

Thanks again for the feedback, it is much appreciated. I'll try to keep my questions to the minimum, but will let you know what they say tomorrow at the hospital - I just received a call asking me to go tomorrow for a couple extra tests :-)

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

Good luck, look forward to the results.

[federete]

Hi, doctor. Back from the clinic and pupils back to normal after a nap. They measured my cornea thickness but the ophthalmologist wasn't able to access the results because there was some problem with computers (they will let me know later if they find any problem); they also did a scan of the eye, and had a thorough look with lights, dyes...

My eye pressure today was 28 (left) and 24 (rigth). High, but they didn't seem to be too concerned about it.

They confirmed there is a small cataract, they also found some inflammation inside the eye, and also that both eyes, but especially the left one, are dry. And also some blepharitis.

The doctor thinks my sight problems / headache problems might be a mixture of all these "minor" things. She recommended warm compresses 5' a day to treat the blepharitis and regular use of some drops and gel for to  treat dry eyes.  She is of the opinion that although the cataract is small, it may be responsible for my blurry vision. If glasses, compresses, drops, etc don't help entirely she offered to remove the cataract.

Thank you for all your help!

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

A last few comments;
1. The failure of your earlier eye doctors to diagnose a significant cataract in LE is disconcerting and goes with my long standing believe about getting consultations and second opinions.
2. IOP  28/24 IS concerning and your are a glaucoma suspect. You need checked by an ophthalmologist every 6 months with special glaucoma tests done annually visual field and OCT of macula and nerve fiber layer (NFL) and careful exam of optic nerve (cup/dis ratio).  Cataract surgery LOWERS IOP so if the cataract is troublesome  generally do surgery earlier in glaucoma suspects.
3. Be sure you NEW ophthalmologist has done gonioscopy as cataract sometimes cause chronic angle closure glaucoma

Good luck.

[federete]

Sorry to keep asking things...  I am trying to get used to the glasses, today morning I worked with them and it was fine. However, I've noticed that I cannot work with the computer for more than a few hours, with or without glasses. After that time my eyes start having lots of problems reading. It is not that my sight is worse after that time (although it may be too), it's like my eyes cannot coordinate between them, and they feel very tired. Then, I rest for a couple hours and can go back to work, now for just one hour. I've tried doing exercises (20-20-20 rule), but that doesn't seem to be helping much. I've been using drops for dry eyes too.

This is a problem because I work with the computer all day. I am thinking that working from home since March has been very bad for my sight: small screen (until recently; since my problems started I went for a big 4K screen), 8-9 hours work + 1-2 hour online chess + 2 hours movie... way too much screen. I am trying to limit that now and take care of my eyes, but I am facing this problem that I cannot accomplish my work. I am doing way less than 8 hours. It is interesting that when I've been using the glasses and my eyes get tired, then I feel some relieve getting the glasses off, then I can work for another bit without glasses (thanks to my right eye), but then my eyes become completely exhausted and simply need to give them a good, long rest. Headaches are clearly linked to this. The more I force my eyes, the more likely I get a headache.

I am starting to assume that what I've lost is lost and learn to live with my poorer sight, but is there something I should do? Long screen holidays? Some therapy or exercises? Is this worth a partial sick leave to limit screen time?

(sorry for the long message)

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

In reviewing this discussion,  I believe this is your present glasses RX and that the conscensus is you have a cataract in your LE.

CONFIRM THIS IS YOUR LAST GLASSES RX AND THAT YOU HAVE NO LINE GLASSES.
-Day 30 (afternoon): Seen by the optician again. My new prescription:
Right eye: SPH=0.00, CYL=-0.75, AXIS=100.0, Near-ADD=+1.25, Inter-ADD=+0.75
Left eye: SPH=-2.25,  Near-ADD=+1.25, Inter-ADD=+0.75

Your glasses RX is unbalanced (eye doctors call aneisometrophia)    There is a 2.25 diopter difference between your RE and the LE which has the cataract which I believe is causing it to get myopic.   Most people cannot adjust to more than 1.5 diopter difference between the two lens of the glasses.    Your glasses are like trying to team up a Shetland pony and a Clydesdale horse.   I suspect you will need cataract surgery on your LE sooner rather than later.

Basically you have tried the glasses and they aren't working, as the last surgeon said then its time to consider cataract surgery.

[federete]

Thank you very much, doctor. Yes, that's the latest prescription. I have glasses for long distance and glasses "to work" (arm distance). For some reason, the long distance ones are a bit more comfortable to work (arm distance).

I didn't know cataract may be causing this, I thought they were just another extra issue adding some extra blurriness to my sudden myopia... But what you say makes a lot of sense in terms of parsimony and simple explanations (can't judge in ophthalmologic terms).

Just to be as clear as possible, the last surgeon said "we can get that cataract removed *if you want*", but it didn't sound as she was recommending it, just like "we don't know what's wrong with your eye, this is the best we can offer and, who knows, it may work"

Happy Thanksgiving!

[federete]

Just called the Eye Clinic, they'll call me back. I was just thinking that the cataract may also be increasing the eye pressure, that' would also simplify the explanation (1  single thing causing all the symptoms: headaches, myopia, eye pressure...; as a researcher can't avoid trying to understand things). Do you think I should keep using the glasses (even if they bring discomfort) to prevent my left eye from becoming more and more myopic (if that's happening)?

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

Glasses do not prevent people from become more myopic, this is true for all ages.  At age 46 a person does not suddenly start getting more nearsighted after the glasses being stable for years.  True myopia in the young occurs because the eye is growing longer (axial length). In adults the eyeball (sclera) is no longer stretchy and in all cases except extreme pathological high myopia, the distance vision stops.   However cataracts often cause pseudo- (false) myopia because the lens gets hard and opaque and bends light more than normal which is what myopia does.   A long time ago before successful cataract surgery people called this 'second sight"  so a person say in their 60's or 60's that needed reading glasses started getting cataracts that caused pseudo myopia and the person could read without glasses hense the name.  If the glasses are uncomfortable, generally I tell patients to stop wearing them.   The surgeon told you, as I understand, they may/may not work. They didn't.  Your options at this point seem to be live with it till its worse or proceed with cataract surgery. The amount of pseudomyopia you have generally indicates this is not a tiny-small-early cataract but a clinically significant cataract in most people I can't obviously see you lens so this is a generalization.

[federete]

Thank you so much, doctor. I am so happy that there is possible solution and a simple explanation. My cataract is quite small. The first ophthalmologist didn't see it. The optician spotted the cataract and said glasses won't give me perfect sight because of the small cataract, but he didn't think my myopia was due to the cataract. The second ophthalmologist wasn't sure. She said the cataract is small but "what you see is different from what we see" in your eyes. That's why she offered to operate them.

Now I'll have to fight a bit. Although the ophthalmologist offered to operate, when I called yesterday the nurse said my cataracts are small, that she also has cataracts, that I have no big problems in my sight... The nurse said I have to talk to the optician so he makes a referral. I have to convince the optician now. Because my English is not good (especially spoken), or because I don't explain things well, I feel they don't really get what I try to explain, and make me feel as I am over-worrying. Sometimes I think that's true, and I've tried to accept my new situation, but it doesn't work, mainly because I cannot do my work properly.

I really appreciate all your help, doctor. I've been thinking on making a donation for all this help :-) If there's a charity of your like I'd be happy to make such a  donation.

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

Best of luck. If you are inclined to made a donation please consider "Research to Prevent Blindness"  https://www.rpbusa.org/rpb/?  

[federete]

Done :-)

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

Thank you.  As this plays out and you get a definitive answer please come back and post as a learning experience for others reading about your problem.

[federete]

Planning my visit to the optician tomorrow, I was reading a bit on cataracts and myopia and found pseudomyopia, which seems to fit quite well (apart of the small cataract). I always tried to explain my sight problem as if my left eye lost the ability to focus, and there was just a narrow distance range in which things become clear. This pseudomyopia (spasm of the ciliary muscle) causes the symptoms I have (am not sure cataracts explain them all): eye strain, headaches, blurring of distance vision, some pain in the eye, quick change in prescriptions (variable over weeks)... My right eye distance vision has also worsened, although this is 100% corrected with glasses. If I understood the optician that's because of astigmatism, which I don't think I had before (it doesn't appear in my January's prescription). Also, I noticed that my right eye sometimes needs some time to focus, perhaps because the left eye is not helping. I am mentioning all this about my right eye in case this can help understand what's happening on the left eye. Could pseudomyopia be the  cause? Is this something that the ophthalmologist would have noticed? My left eye vision is blurry not only at distance though, it is blurry basically at all distances but ~20 cm (I could measure this distance and keep some record because am not sure is always the same). Glasses (cannot wear them for more than a couple hours) don't correct the left eye blurriness entirely, more like 80% I would say; the optician said some blurriness would always be there because of the cataract. Does pseudomyopia make any sense? Should I be banned from googleing ophthalmologic stuff?

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

Pseudo-myopia is anything that causes the light rays of images at distance (greater than 20 ft or 6 m) to be focused in front of the retina other than longer than normal axial length/excessive corneal curvature.  In your case the most likely cause is the cataract. there are some cataracts that look small but have an inordinate effect on the vision. that is what I think you have.  I did not discuss, and will not discuss, every cause of pseudomyopia.  Since you have been googling.    I'm pretty sure you don't have spasm of accommodation. that occurs in BOTH eyes, is associated with small pupils in both eyes and causes double vision at distance.  And in between spasms the vision is clear.

[federete]

Thank you again!! This is reassuring, I was starting to wonder whether I should or should not convince the optician about the cataract surgery.

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

That is something I can't tell you. I'm not sure where you live but in USA and "optician' makes/fits glasses; an 'optometrist' is a non-physician that prescribes glasses and contacts and treats minor eye problems, an 'ophthalmologist' is a MD eye physician that does complete medical and surgical eye care.  The decision for surgery should be between you and ophthalmologist.

[federete]

I live in UK. The ophthalmologist in the hospital offered to operate the cataract. I call the hospital and the nurse said that this has to be referred by my optician. It's a bit weird but it's how it works here. The National Health System has tight contacts with private opticians, and opticians carry out some tests cover by the NHS, like my anual glaucoma test or, as it seems, referrals for cataract surgery. Once the optician refers for cataract surgery, I believe a surgery will make the final decision. But opticians and GPs tend not to refer to specialists unless they are very sure that's needed (this is because the system is organised to try to minimise referrals - I think there are some incentives for not referring too much, at least with GPs, but I am not 100% sure).

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

I think it is easier to put an astronaut on Saturn than get cataract surgery in the UK.  One reason for a thriving 'outside the system' specialists.  If the ophthalmologist in the hospital offered to do surgery you can be assured it is not a small cataract.

[federete]

Public health systems have their issues but they are so great... And with your extra help I think everything will end happily :-)

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

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[federete]

Back from the optician. He wasn't able to refer me for cataract surgery because I am below the threshold needed but suggested to call the secretary of the doctor who offered to operate the cataracts (rather than calling the nurse). I was somehow expecting this.

This optician was amazing, listening and explaining everything. He did so many tests too (pupil dilatation, OCT scan, etc). He asked something I've been asked by you and others, if I had any impact in the eye. He explained my left eye's lens looks a bit rough (not sure that's the word he used), and that this is typical of eye impacts. There's the small cataract too. He agrees that changing the lens would solve the problem.

Meanwhile, he worked out a prescription that seems to put much less strain in my eyes (I could tell instantly). My left eye won't see 100% clear, but these glasses would help. They are preparing the glasses now (fourth pair in a month!). This is the new prescription:

Right eye: SPH=+0.50, CYL=-0.75, Axis=100.0, Near-ADD=+1.50
Left eye: SPH=-1.50, Near-ADD=+1.50

I may try the glasses before calling back to the Eye Clinic and trying the cataract surgery.

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

Best of luck

[federete]

Dear Doctor, I hope you are having a good start of the year.
I wanted to share a new observation in case it changes in any way the potential diagnosis. I realised the other day looking with my left eye at the moon (half moon) that I can see about 8 moons one on top of each other, not so blurry, forming a quite pretty pattern. Christmas lights look also very nice, the center, where the light should be, becomes dark, surrounded by beams of light forming star-shaped figures. Is this expected for cataracts?

More updates: The new glasses didn't work either. I think it's the vaping that causes me the headaches; because it didn't happen before, might be linked somehow to the eye. Vaping has left lots of residue on my car windows and on my laptop screen (hard to get rid of it), if something like that happens in the eye lens... possibly not possible, but can't avoid to think of that. When all this pandemic thing is over (the situation is very bad in UK), I'll try to get my eye fixed.

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

Your first paragraph is a classic observation for cataracts, however as i have said previously other things on the cornea and macula can cause same.  If you are serious about your health you need to stop vaping.

[federete]

This is reassuring, they checked my cornea and macula (I believe) and all was fine. Thank you!

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

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[federete]

Hi doctor, just wanted to post something new. I realised today my left eye is having problems with near-sight vision, thinks look blurry/cloudy, like if I hadn't wash my eyes - I can see better from certain angles, just moving my head. On the other hand, it seems my far-sight vision may have recovered a bit, but I cannot be 100% sure. I'll go to the optician again once the lockdown is relaxed a bit in UK. Is it normal that cataracts progress and change over time so quickly? I hope everything is well with you.

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

In older people (greater than 65) cataracts usually change slowly. In younger people since they are not do to age they can change quickly especially if due to things like diabetes, steroids, trauma, inflammation.   If the person is 40-50 and the distance vision stays the same but near vision worsens it can be normal aging changes called presbyopia.

[federete]

Thank you, doctor! In my case diabetes and steroids are ruled out, unless topic corticoids (little amounts) to treat psoriasis can be be considered. No trauma that I recall, but I've been asked that several times.

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

So at this point only an exam can tell.  I have a line I use daily to patients "Cataracts are like teenagers, you never know what they will do or how they will behave"

[federete]

hehe, I'll keep an eye on this teenager, thank you doctor!

[federete]

(now I have three teenagers at home!)

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

Oh, my.  Best of luck

[federete]

This is weird... my left's eye long sight is so much better now. I no longer see strange patterns around lights or stars. The sight is not as good as before but way better than a month ago. My short sight is worse though, from certain angles, as if there was something in the eye. This is great news of course, no complains here :-), but would love to understand what's going on...  curiosity. I hope things are well there.

Indeed... I just did the experiment of trying the glasses they prescribed a few months ago (never used them because they made me dizzy), and now I see much worse with them than without them

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

As I recall you have cataracts.  They seem to be changing fast and that could account for your observations.  Another thing is diabetes. Hopefully you are not diabetic and have a test called A1c to make certain you do not have diabetes.  Diabetes can cause cataracts at young age and frequent bizzare changes in glasses and vision.

[federete]

Not seeking feedback, just wanted to give an update.
I went last Saturday to the optician. He confirmed that my sight has improved (not for the RE though, but the RE is more or less ok). In less than a year my LE went from SPH=0 (when my sight was perfect) to -2.25 (very bad far sight and strange patterns with lights) and now to +0.25 (very poor short sight, blurry even with prescription to correct +0.25, no strange patterns with lights). I am reporting SPH because it's the thing that changes most. This optician (always someone new) also said it's a very small cataract. Because this keeps changing I opted not to get another pair of glasses (I have four and haven't barely used them). Regarding diabetes, I got tested and apparently I am fine.
So, the good news is that my far sight is better; unfortunately that came with a deterioration of short sight... funny, very teenager like :-) I'd like to understand how all this works but I should be happy about the far-sight improvement.  As always, thank you very much for your help, doctor. Take care.

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

Thanks for post

[federete]

Me again. These past two weeks my left eye worsened (not much unexpected, it keeps doing these things), but now the right eye has problems too. From how I see things with the right eye (blurry) and how fast it is worsening, I think the right eye has the same problems than the left eye. They keep saying the cataract in the right eye is very small, let's see what they say next Wednesday, I hope the optician accepts to refer me to the ophtalmologist... I am starting to have problems to do my work :-(

[federete]

Correction: "They keep saying the cataract in the **left** eye... "

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

I would demand that you be referred to ophthalmologist. Your problem is too complicated and above the training of an optometrist.

[federete]

Hi again. This week I went to the optician. She accepted to send a letter to my GP, so the GP can try to refer me to the ophthalmologist. My left eye now is blurry at all distances (I lost what I mysteriously recover at long distance) and the optician decided not to use a prescription for the left eye and just try to help the right eye, which sees much worse than 1-2 months ago. Hence, I am getting glasses for my right eye, both short and far distance. The weird thing with the right eye is that with very far objects, such as birds, I see them clearer but double, which makes me think that the blurriness I see is just because double shapes overlap one on top of another, and they only become distinguishable when they are very far. And this makes me think that the right eye may be going through the same thing than the left eye, though the optician had a look and didn't mention anything. I'll let you know if I finally can be seen by the ophthalmologist!

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

What an ordeal. Hang in there. Look forward to what a Eye MD says.

[federete]

Thank you doctor :-) I'll let you know what they say (if I am finally referred)

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

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[federete]

It wasn't easy, a couple more visits to opticians, but finally got a referral to an Eye MD and next Tuesday I'll have my left eye cataracts removed! So excited, I can't barely see with that eye now. Thank you doctor for all the help! I'll let you know how it went in a couple weeks.  If everything goes well they'll do my right eye later, it's more or less ok but seems to be following its left mate lead.

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

An optometrist or ophthalmologist will ALWAYS record vision with and without glasses. When you go in ask for yours.   You have a concerning problem that your team of  GPs, Optoms, and ophthalmologist don't seem to be able to handle. You need referral to a tertiary eye center with more sophisticated testing and higher level of training by physicians.  Push for referral higher up the referral system.

[federete]

Thank you very much, doctor. This gives me more confidence to try push this higher up

[federete]

I've been reading about angle closure glaucoma and sounds scaring. I haven't had pain in my eye, except for a couple of times, but it was bearable. Although my headaches affect the entire head, yesterday and today (today less) I've had pain in my left sinus (on top of the eye).

I haven't had other symptoms of angle closure glaucoma like eye redness, but at this moment I have more tears in my left eye. Sometimes I just want to wear an eye patch to protect my brain from what comes through this eye.

Among angle closure glaucoma predisposition factors: I take sertraline since 2012; until recently I was farsighted (at least my long distance sight was exceptional); there's some cataracts building up in my left eye; my left eye pressure was a bit high in my last visit; and my myopia seems to be increasing from week to week...

Should I try to move faster and visit the GP on Monday instead of Tuesday? Is this concerning enough to go to A&E?

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

1. How high was the pressure in your eye?  If you are reading there are two forms of angle closure.   Acute Angle closure is dramatic: lots of pain, redness, blurry vision, fixed mid size pupil, often nausea and vomiting. However there is chronic or intermittent angle closure glaucoma in which mild pain, not much redness, not much nausea/vomiting. I don't think you need to go to ER but I would see  your GP Monday and I would start working now, perhaps with the ophthalmologist you saw to arrange transfer to an tertiary eye referral center like a medical school or major medical center.  You can also ask the ophthalmologist for "your best corrected vision in each eye with the refraction/glasses test they did and of course what the IOP was in each eye.

[federete]

Thank you so much, doctor, I'll follow your advice. To clarify, the ophtalmologist who saw my case is from the hospital (big hospital, Addenbrookes in Cambridge).  

Is it normal that, two weeks ago, the optometrist measured my left eye SPH=-1.00 and yesterday as SPH=-2.25? Is this indicating that my sight keeps worsening or is this difference within the range of uncertainty in measurements?

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

Yes very unusual and not normal.  Besides bad testing by one of the doctors,  diabetes and high blood sugar can cause that,  variable swelling on the macula or cornea can cause it.  That was one of the things that lead me to believe you needed another opinion.  A  normal variability in glasses test,  good observer (you) and good testers  plus/minus 0.5 diopter at most.  

[federete]

In hands of the Eye Clinic now :-) They are reviewing my case (remotely) and will hopefully provide an appointment with the specialist.

(My blood test results came back today: no diabetes, just a bit of cholesterol)

Thanks again, doctor!

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

Hopefully that will be soon. Do let us know what they find and don't find. Best of luck.

[federete]

Thank you, I'll do :-)
I forgot to mention something. The person from the Eye Clinic had a look at my record and let me know that when I went to the ophthalmologist my eye pressure was 26 in the left eye and 22 in the right eye. (26 is a bit high from what I read)

[federete]

Forgot to add something sorry. In the second visit to the optician he found I have a small cataract in my left eye (am surprised the ophtalmologist didn't see this... but who knows, all this is so strange to me...)

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

You are omitting important information. Visual acuity with and without glasses in each eye.  If your eye exam was normal with your glasses your distance vision should be 20/20  or 6/6 (metric) and the vision should seem the same to you. Since it wasn't the ophthalmologist would have been obliged to find a causes.  Cataracts at age 46 is very unusual unless you have risk factors like: diabetes, heavy smoker/heavy drinker/heavy person, on steroids, had trauma to eye.  However cataracts blur the vision but don't cause headaches.    I think it important you move to a higher level of care.  Perhaps a neuro-ophthalmologist, or a cornea/cataract/IOL specialist or even a retina surgeon.

PLEASE post you vision with and without glasses for each eye and begin efforts to work you way up the level of training and testing to something more than an optometrist or general ophthalmologist. I'm concerned about you and your symptoms.

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

ADDENDUM: WITH YOUR FAMILY HISTORY OF GLAUCOMA, AND ELEVATED PRESSURE IN THE LEFT EYE IT WOULD BE IMPORTANT TO DO A TEST CALLED GONIOSCOPY TO BE SURE YOU DO NOT HAVE ACUTE OR SUBACUTE ANGLE CLOSURE GLAUCOMA. That could cause blurred vision AND headache.    Is there a family history of sudden (acute) angle closure glaucoma? Very common in Asians and farsighted people

[federete]

Thank you very much for taking your time to see my case. I really appreciate it.

I thought I made it clear that glasses are not solving the problem in my left eye. I cannot provide accurate details, they haven't tested my sight with glasses. But this is how I perceive it:

Left eye: The latest long-distance glasses have improved significantly for long distance, but still things are blurred except for a very specific distance (less than an arm). At that distance I can see properly with the left eye. The short distance glasses didn't seem to improve at all. They are making a new pair now.

Right eye: It wasn't too bad, although I noticed some worsening in my long distance sight. This is completely solved with the glasses, everything is crispy clear. Very nice.

As far as I know there hasn't been angle closure glaucoma in my family. Just the standard glaucoma. They do every year tests, last year with a sophisticate scanner. But I haven't had a test since January. Only that I had a bit of high pressure when I visited the ophtalmologist. I am a smoker (~10 a day) and drink 1 or 2 or 3 beers a day. A bit of overweight. European ancestry. No trauma that I am aware of.

Isn't it strange that the first prescription had less dioptre (if that's the word, sorry am no native English speaker) than in the second prescription. Perhaps my left eye keeps worsening.

I'll bring all this next Tuesday at my GP appointment. This is very valuable! Thank you! I feel understood, which is very welcome