pulfrich? monocular diplopia in both eyes with failed pinhole test

[Chrystalheart]

I am 47.  Since 2005 I have had increasing diplopia in each eye (mono/vertical).  It is intermittant and has progressively gotten worse (more frequent and more impairing).  Typically I find it most crippling while working on the computer or reading.  Sometimes it gets so bad during the day that I can't read at all, even with the computer screen at 150%. It isn't all close work, though.  I was on a road trip once and found I was unable to read anything small.  So, it seems to be related to focusing my eyes at a relatively fixed distance for a period of time.  That is just usually close.

I have been followed by an opthalmologist and also just saw a neuro opthalmologist.  My ultrasound for thyroid disease was normal.  MRI was normal.  My dry eye problem was treated.  I have ptosis of the right brow, but it hasn't changed that I can tell.  I also have anasacoria.

My vision was fine until college.  It rapidly declined my first or second year of college to its current prescription.  That is also when the other problems started.

The right eye has 50% reduction in the optical nerve and obvious drusen.  The left eye has drusen per the ultrasound, but its not obvious via photography.  The right eye also has afferent pupillary defect.  The left has some barely visible flourescence.

My vision field tests vary.  One showed my left eye (20/200) ok, but my right eye (20/400) impaired on the upper right quadrant.  The next year, both eyes were fine on the VFT.  This year the VFT showed both eyes bad on the left third of the sphere.  This correlates with shadows I have been seeing out of the corner of my eye to the left for the last 6 months or so.

The pinhole test made my vision much sharper, but increased the number of lines from 2 to 3.  

I also have muscle fatiguing in all 4 limbs, my right lung, my jaw, and my lower back and pelvis.  I tested negative for Myasthenia Gravis.  I am going to be tested for Mitochondria Disease via the genetic blood test soon (or so I'm told).

The neuro opthalmologist suggested pulfrich stereo phenomenon, but mono version.  

Thoughts?

Jen


This discussion is related to Bilateral Monocular Diplopia Help!.

[JohnHaganMD]

I have no expertise in attributing any problem to the Pulfrich Effect. What is your best corrected visual acuity and your glasses RX with them?

I have many patients with optic nerve drusen (OND) but only about 2 with severe central and peripheral vision loss due to the OND.

JCH MD

[Chrystalheart]

For those who may be interested in these sort of symptoms, after a lot more diagnostics I discovered I have angioedema (immune related swelling) which is causing (among other things) my face, sinus area and eye area to swell.  It is thought this pressure on my eyes is pushing them enough for the light to refract incorrectly.  We are working on the swelling.  It does seem less of a vision problem when my swelling is gone.