Dr. Souhad Abdulhalim Lawand
Ophthalmology (Eye Care)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
Five days ago, when I woke up, I felt dizzy, and my vision was off. I was sluggish all day and had a headache upon waking. I figured I was coming down with something and laid around all day on the couch. When I woke up the next, I had no headache and was no longer lethargic, but my vision was still off. I noticed that I was having double vision when I looked at objects both close and far away. I closed one eye, then the other, and my vision was perfect (binocular double vision). I also noticed that if I looked at something with my head and eyes straight, it was there and got worse if I looked down. But, when I look up with my eyes, it went away. Keeping my head pointed slightly down and looking up at something made it go away. I also noticed that it seems to be my right eye because if I gently pull the corner of my eye outward towards my ear, my vision goes back to normal. I went to the eye doctor, and she said it is because I am 44 and I need readers. I bought a pair from the local pharmacy, and it does help with my reading on the phone, computer, etc. Even though it is blurry looking at a distance, there is no double vision. Granted, maybe I do need them at my age, but that does not explain the double vision or how I can get it to go away by looking up or pulling the corner of my eye. My vision was tested along with all of the other standard tests, and it was all fine. I have 20/20 vision still after having Lasik to correct nearsightedness 13 years ago. I am not nauseous and no longer have a headache, but the problem persists. And, it is 15 days since starting the Keto diet, and I thought that maybe that could be causing this. So today I carb-loaded to replenish my glycogen stores, yet the problem persists. I flew back from a trip and read that maybe something could have happened with the pressure. I am not diabetic and do not have high blood pressure. I have no idea of what is going on and if it is severe or not. I do have an appointment with an Ophthalmologist coming week, but I am getting worried. Do you have any idea on what could it be? What should I do?
Hello,
Welcome to icliniq.com.
The fact that your vision becomes better upon changing the position of the head or pulling your eyelid towards your ear proves that this is only related to your newly acquired age-related refraction. By reducing the area of the eye slit (changing the position of the head leads to the being covered more by the upper eyelid and reducing it manually by pulling your eyelid to the side), you reduce the refractive changes in your eye. The fact that the specs provide you with better vision while reading and relieves you of your main symptom is enough to make you feel calm towards this newly acquired physiological (it always starts after 40) change in vision. However, please refrain from using that correction to see distant objects because it is not designated for that distance, taking into consideration that you do not need it for distant objects, and might lead to headaches if you do. Otherwise, you should be good to go and start adapting to this newly acquired condition because from now on, every five years it is going to change and you will need more correction to correct that age-related deficit. Some additional recommendations would be to increase the size of the fonts on your devices to evade the necessity of using the specs every time you need to visualize your devices at a near distance. Also, lubrication of the eyes with artificial tears can also help maintain an absolute clarity during visual activities.
Patient's Query
Hi doctor,
Thank you very much for your reply. The thing I cannot understand is how I woke up with in the morning, and it came out of the blue. Is that normal? Also, I have trouble walking the street and driving without pulling my eye or tilting my head or gaze and certainly cannot continue to function this way. Does that mean I may need some permanent corrective lenses? When I was at the eye doctor the other day, I tested 20/20 in both eyes. She recommended progressives with a small amount of distance correction to make things nice and clear and of course they have the built-in fix for when reading up close. I am on my phone or computer from 5 am to 11 pm on most days. Would that correct the blurred or double vision issue? It also happens up close to the point that I am having trouble while shaving and looking into the mirror. Again, I am concerned that this came on so quickly and without warning. I can accept that I need readers for my age but the double vision scares me and I am not able to live my life as usual. I really want two things to get clear. To know that it is nothing serious such as a brain tumor because I am a stage 4 testicular cancer survivor from when I was 18. Next is, what exactly can I do to get it corrected right away so that I can go on with my life? What do you suggest from here?
Hello,
Welcome back to icliniq.com.
Well, I would not hurry with the progressive lenses because as we already established your far vision is 20/20, and it is still early to dive into progressive lenses yet as I mentioned your vision would continue to worsen with age and so will your far vision. Try to use the recommended specs only when needed for reading and considering that you have intense visual activities during the whole day. Also, your eyes must be going super dry, which can also cause deterioration of vision and lack of clarity. So, using artificial tears in your case is a necessary thing. You can use it every hour if you need to, except for the last 30 minutes before sleep. You mentioned that the lethargy and weakness happened only once so you should not worry yourself so much. Taking the cancer issue into consideration, I would not refrain from having a brain MRI for the sake of excluding any lesions.
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Ophthalmology (Eye Care)
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