Symptoms of Retinal Thinning: What You Need to Know - Ophthalmology

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Will retinal thinning have the following symptoms?


Hello Doctor, I am a graduating student from junior high this year.
I usually have tutoring sessions until 9 PM, and I have a keen interest in drawing, which puts a lot of strain on my eyes.
Sometimes, I see a persistent light spot in my field of vision that starts to expand, causing the surrounding area to turn white, along with dizziness, pain, and nausea.
These episodes typically last for about ten minutes before disappearing.
The first occurrence was in fifth grade, but I have experienced this condition less than ten times in total.
After visiting an ophthalmologist, I was told that this is called "scotoma," which might be related to my heart.
The doctor also mentioned that my prescription differs from my retinal condition, indicating retinal thinning and a slightly elongated optic nerve, even though my prescription is only -3.50 diopters.
Sometimes, when I experience chest pain, I see a small dark shadow in the center of my vision.
However, after researching online, I found that my situation doesn't quite match what I read.
I consulted a cardiologist, who found no significant issues, but my eye problems continue to cause me anxiety.
I have a history of depression, so I later went to a large hospital for a check-up, where I underwent a fundus examination and visual field test.
The doctor said everything was normal and suggested I consider seeing a cardiologist or a neurologist.
My mother has scheduled an appointment with a neurology specialist next Thursday.
Here are some of my other symptoms, as I am unsure if they are related, so I will mention my other health conditions as well:
1.
Since childhood, my vision has had a grainy quality, similar to a low-resolution phone camera, but I can see things clearly.
2.
Since childhood, if I don't focus intently, objects appear double.
3.
Sometimes, I see blue and yellow halos on the sides of my vision, especially when looking at black objects or people's hair.
4.
I have floaters.
5.
I see light spots that are not floaters, both black and white, appearing frequently, and recently I have seen flashes resembling a broken light bulb.
6.
There are translucent black shadows covering the edges of my vision, distributed differently in each eye, but the doctor said this is normal and he experiences it too.
7.
Recently, I noticed that when I close one eye, certain small parts of my vision disappear, and when I pass my finger through the center, a small section also disappears.
This happens in both eyes, and I can't tell if it's becoming blurry or actually disappearing, as I don't experience this with larger objects.
8.
Sometimes, when walking down stairs or making jumping movements, if my body experiences significant vibrations and my vision is very bright, I see what looks like blood vessels, similar to what is seen during a fundus examination.
9.
When I close my eyes, I see colors, and sometimes I see two faint circular shapes resembling pupils.
10.
When I move my eyes, I see circular shadows as if I were gently pressing on my eyes.
11.
There was a period when I experienced afterimages.
12.
After staring at something for a while, it begins to shake.
13.
I have a strong aversion to heat, to the point where it feels pathological; sometimes I still feel hot even in an air-conditioned room.
14.
I have difficulty concentrating, my memory has worsened, I have depression, and I am easily irritated.
15.
I frequently experience migraines.
I sincerely apologize for asking so many questions at once.
My mother already works very hard and is quite exhausted from frequently taking me to the hospital, and she is reluctant to take me to see another doctor.
However, my symptoms are distressing, and the doctors have downplayed them as normal.
I also forgot to mention some issues during my visits, so I thought it would be better to detail them here online.
Thank you very much.

Wang Tongxue, 10~19 year old female. Ask Date: 2020/07/24

Dr. Liang Ce reply Ophthalmology


It is recommended that you discuss the above situation further with your attending physician to determine if any additional examinations are necessary.
Thank you, and wishing you good health!

Reply Date: 2020/07/24

More Info


It sounds like you're experiencing a range of concerning visual symptoms, and I can understand how distressing this must be for you. Let's break down your symptoms and provide some insights into what might be happening, as well as what steps you can take moving forward.


Understanding Your Symptoms
1. Visual Disturbances: The light spots, visual snow, and the sensation of seeing double or having auras around objects can be indicative of several conditions. The phenomenon of seeing light spots or auras, especially if they expand and are accompanied by headaches, could be related to migraine aura. This is a type of visual disturbance that can occur before or during a migraine headache.

2. Retinal Issues: You mentioned that your doctor noted retinal thinning. This condition can lead to various visual disturbances, including floaters (which you also mentioned), flashes of light, and even potential vision loss if not monitored. However, the fact that your recent eye exams did not show any significant issues is reassuring.

3. Neurological Symptoms: The symptoms of dizziness, nausea, and the sensation of seeing things disappear could also suggest a neurological component. Since you have already consulted with a neurologist, it’s good that you are following up on these symptoms. Conditions like visual snow syndrome or even more complex migraine-related disorders can cause persistent visual disturbances without any underlying retinal pathology.

4. Psychological Factors: Your mention of depression and anxiety is important. Mental health can significantly impact how we perceive physical symptoms. Stress and anxiety can exacerbate headaches and visual disturbances, creating a cycle that can be hard to break.


Recommendations
1. Follow-Up with Specialists: Since you have an appointment with a neurologist, it’s crucial to discuss all your symptoms in detail. Make a list of everything you experience, including the frequency and duration of each symptom. This will help the doctor understand your situation better.

2. Keep a Symptom Diary: Documenting when your symptoms occur, what you were doing at the time, and any potential triggers (like stress, lack of sleep, or specific activities) can provide valuable information for your healthcare providers.

3. Eye Care: Continue to have regular eye exams, especially since you have a history of visual disturbances. If your symptoms worsen or change, seek immediate medical attention.
4. Mental Health Support: Given your mention of depression and anxiety, consider seeking support from a mental health professional. Therapy can help you manage these feelings and may also alleviate some of the physical symptoms you are experiencing.

5. Lifestyle Adjustments: Ensure you are taking breaks during long periods of studying or screen time. The 20-20-20 rule can be helpful: every 20 minutes, look at something 20 feet away for at least 20 seconds. This can help reduce eye strain.

6. Hydration and Nutrition: Staying hydrated and maintaining a balanced diet can also impact your overall well-being and may help with some of the symptoms you are experiencing.


Conclusion
While your symptoms can be concerning, it’s essential to approach them systematically. Continue to work closely with your healthcare providers, and don’t hesitate to seek further opinions if you feel your concerns are not being addressed. Remember, you are not alone in this, and there are professionals who can help you navigate these challenges. Take care of your mental health as well, as it plays a significant role in your overall health and well-being.

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