Unilateral Peripheral vision loss

[alharris]

I have what I would describe as tunnel vision in my right eye, but have yet to be diagnosed with a cause to this problem. I first noticed this problem when I was 15 years old and trying to participate in marching band. I was constantly in trouble for not walking in line with people to my right, and it was then I realized I had a very limited field of vision in my right eye. I am now 20, and the problem is persistant. I also suffer from migraines, which increases the tunnel vision in my right eye. I feel that doctors cannot find an answer to my problem, and have dismissed the problem as migraine headaches. Even when I'm not having a migraine, I still have tunnel vision althought it does worsen when I am having a migraine. I have had two MRI's, where I never was able to view the results myself, and was told that my brain appeared normal. So, is there pressure on my optic nerve that is causing the limited field of vision? If the problem is pressure on the optic nerve, what is causing it?
I have never been diagnosed with a brain tumor, but lately I feel that I could be experiencing some symptoms of a brain tumor- I've been getting confused, for example getting lost on my college campus that I have been attending for nearly two years, I opened the freezer door instead of the microwave when the timer went off, and could not remember where my food was. I have had an almost constant headache, and been feeling sick and vomitting with no real cause. I am tired all the time, and have diffuculty getting my day started because I feel so unrested even when I have had plenty of sleep. I am getting ready to make another appointment with my neurologist, and I would like to have some idea of what questions to ask or a suggestion for something else to test for. I am feeling lost and I fear that there is a test or problem that is being overlooked that could be the cause of my vision loss and migraines. If you have any idea what could be causing these problems, I would appreciate any advice or ideas, no matter how much of a long shot that suggestion may be.

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

It is extremly unlikey that you have a brain tumor given two normal MRIs and that you've had the problem at least 5 years. A visual field exam should easily document if you in fact have loss of peripheral vision.

It's also very unlikely due to glaucoma at your age.

I suggest seeing a neuroophthalologist. Find one near you at www.aao.org


JCH MD

[alharris]

I have had yearly visual field tests since i discovered the problem. I have a consistant pattern of tunnel vision in my right eye. I'm not sure of the name of the test that I do to get a print out of my visual field, but the picture looks a bit like everything in my vision is blocked out except for a piece in the middle that is shaped like the number 8 at a 45 degree angle. It stays in that pattern consistantly, but sometimes is expanded or smaller, always in the same shape. It is worse on days when the sun is bright or in a bright room.

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

Still suggest you see a neuroophthalmologist.
JCH MD

[zyx007]

Hi! I hope you are feeling better, and was wondering if there was an improvement or a resolution to your problem, as my daughter (12.5 years old) is suffering from the same symptoms, and we have not had much luck with a diagnosis so far.  Thanks

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

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[zyx007]

Dr. Hagan,

I couldn't view your comment, but will appreciate your guidance.

We have already shown our daughter to a neuroophthalmologist, who could not provide us with a diagnosis of the proble. We are based in Mumbai India, and there are no neuroophthalmologists based here, just one who visits from a smaller city in Gujarat. She was earlier diagnosed and treated with steroids injected intravaneously with suspected optic neuritis, but this diagnosis seems to be incorrect and is not validated by MRI scans, VEP and Multi focus VEP, and 6/6 vision.

The latest line of thinking seems to be migraine, but that does not fully explain the almost complete loss of peripheral vision in the right eye, and poorer color contrast.

Thanks and regards,
Rohit