Unexplained Blurry Vision: Seeking Answers for Left Eye Issues - Ophthalmology

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Blurred vision with an unknown cause?


Dear Dr.
Wang,
I noticed blurred vision in my left eye around the end of last year, feeling as if there was a layer of oil floating on the surface of my eye.
I initially thought it was due to wearing contact lenses, which caused eye fatigue, so I switched to regular glasses.
However, two months ago, I realized there was still no improvement, so I sought consultation at an ophthalmology clinic.
The doctor arranged for me to undergo Fluorescein Angiography (FFA), Optical Coherence Tomography (OCT), Computed Tomography (CT), 3T MRI, and a routine eye examination.
Aside from the Visual Field test showing some peripheral vision loss in my left eye, no other causes for my blurred vision were identified.
Currently, my left eye has not improved but has also not worsened.
I am unsure if I should undergo any additional specialized tests or if it would be better to be referred to another clinic for further evaluation.
Thank you for your response.
P.S.
No contrast agents were used for the FFA, CT, or MRI.
Marian

Marian, 20~29 year old female. Ask Date: 2010/04/08

Dr. Wang Yuwei reply Ophthalmology


Hello Marian: I'm not sure how severe the blurriness in your left eye is, but it's important to note that the diagnosis of any condition does not necessarily improve with more tests.
A detailed in-person consultation is more effective in identifying the underlying cause.

Reply Date: 2010/04/08

More Info


Hello Marian,
Thank you for reaching out with your concerns regarding the blurry vision in your left eye. It sounds like you've been through a comprehensive evaluation with various imaging studies, including Fluorescein Angiography (FFA), Optical Coherence Tomography (OCT), CT, and MRI, which have not revealed any significant abnormalities. This can be frustrating, especially when you're experiencing persistent symptoms.

Based on your description, the sensation of having a "layer of oil" over your vision could suggest a few possibilities. One common cause of such symptoms is the presence of a condition known as "visual snow," which can cause persistent visual disturbances, including blurry vision. However, this is often accompanied by other symptoms, such as seeing static or flickering lights. Another possibility could be related to the vitreous gel in your eye, which can become more liquid and lead to visual disturbances, especially if there are floaters or other changes in the vitreous.

The fact that you have experienced some degree of visual field loss in your left eye is concerning and warrants further investigation. Visual field defects can be indicative of various underlying conditions, including retinal issues, optic nerve problems, or even neurological conditions. Given that your imaging studies did not reveal any significant findings, it might be worthwhile to consider a few additional steps:
1. Consult a Neuro-Ophthalmologist: Since you have visual field loss and your current evaluations have not provided answers, a neuro-ophthalmologist could be beneficial. They specialize in vision problems related to the nervous system and can provide a more targeted assessment of your symptoms.

2. Consider Functional Testing: Sometimes, conditions affecting vision may not be easily visible on standard imaging. Functional tests, such as visual evoked potentials (VEP), can help assess the integrity of the visual pathways and may provide additional insights.

3. Re-evaluate Your Current Prescription: If you have recently switched from contact lenses to glasses, ensure that your glasses prescription is accurate and up-to-date. Sometimes, an incorrect prescription can lead to visual discomfort and blurriness.

4. Look into Dry Eye Syndrome: If you have been experiencing discomfort, it might be worth investigating whether dry eye syndrome could be contributing to your symptoms. This condition can cause blurry vision and a sensation of something being in the eye. Artificial tears or other treatments may help alleviate these symptoms.

5. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur, their duration, and any associated factors (like lighting conditions or activities). This information can be valuable for your healthcare provider in determining the next steps.

6. Follow-Up Regularly: Since your condition has not worsened, regular follow-ups with your eye care provider are essential. They can monitor any changes in your vision and adjust your management plan accordingly.

In summary, while your initial tests have not shown any clear cause for your left eye's blurry vision, further evaluation by a specialist, consideration of functional testing, and monitoring your symptoms are prudent steps. It’s essential to remain proactive in seeking answers, especially given the visual field loss you've experienced. Please do not hesitate to reach out to your healthcare provider for further guidance and support.

Best wishes for your continued health, and I hope you find the answers you seek soon.

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