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Are OCT results related with light sensitivity?

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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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Published At May 10, 2018
Reviewed AtJune 16, 2023

Patient's Query

Hi doctor,

Since 5 years, I have significant floater 3 to 4 numbers in both eyes. I have mild light sensitivity photophobia. I was on stress medicine Escitalopram (Cipralex) 10 mg, an SSRI, for the past 5 years and presently not taking any medicine. Perimetry and eye pressure done regularly every year for the past 5 years. Got an MRI brain and CT scan done two years back and the results were normal. My eye pressure was between 18-20 and the normal vision with floaters is 6/6. Present scenario is recently I have got OCT done for eyes. Please refer the OCT results and let me know, is there any threat for loss of vision? Are OCT results related with light sensitivity? Kindly explain in detail or describe about borderline results of OCT? What does it mean? Does Novoret - Lutein, Zeaxanthin, Omega-3 will help to improve borderline thickness region? How to improve borderline thickness area? Please help.

Hi,

Welcome to icliniq.com.

At the outset I want to assure you that, after going through your history and the OCT results (attachment removed to protect patient identity) there is no possibility of any threat to your vision. Photophobia is caused by some inflammation in the front part of the eye. OCT stands for ocular coherence tomography, is basically a scan of the eye, specially the back portion of the eye. It gives us valuable information about the status of the retina, optic nerve etc. If the photophobia is due to an inflammatory process, then there will be other accompanying signs in the eye, like redness, mild pain, etc. In absence of these signs, mild photophobia could be attributed to increased sensitivity. Wearing As explained earlier, OCT is an eye scan, especially of the back portion of the eye. It is very valuable in detecting very early cases of glaucoma, which is a condition, in which the eye pressure increases. OCT also helps in detecting changes in the retina and optic nerve. It also measures the thickness of the retina, the nerve fiber layer NFL, which normally should be above 80 microns. A borderline case would be retinal thickness of 75 to 85 microns. This could be a sign of early glaucoma. Novoret containing Lutein, Zeaxanthin, Omega-3 will not really help to improve borderline thickness region. If the thickness is borderline, then you cannot actually increase it. But, you can prevent further reduction in the thickness by using eye pressure reducing medications after establishing the diagnosis of glaucoma. I would suggest you to; continue monitoring your eye pressure with periodic OCT and perimetry, preferably automated perimetry. Nowadays there is something called as low pressure glaucoma, the possibility of which should be kept in mind. Lastly, regarding the floaters, fortunately 90% of the time eye floaters are innocent and outcome of the usual wear and tear process. The only time when there can be an indication of something serious is, when there is a sudden sharp increase in their numbers especially accompanied by flashes of light. I have studied your history and your OCT results. You do have some risk factors of glaucoma evident in your OCT. Though your overall RNFL (retinal nerve fiber layer) thickness is fine, you do have low thickness in one sector in each eye. You also have deep cupping of the optic nerve head. Your eye pressure is also in the range of 18 to 20 mmHg. Though this is within the normal range, I would ideally want it somewhere between 12 to 14 mmHg. You have not mentioned anything about family history of glaucoma, which is another risk factor, if positive. I hope I have addressed your concerns. Feel free to reach out if you have any further questions.

Patient's Query

Hi doctor,

Thanks for your reply.

Being in nonmedical professional it is very important to know and accept the condition what I have. My whole family does not have glaucoma now or in the past. I was wondering about light sensitivity and floaters and by the tests something else came out, which is different than I was worried about. You mean to say, I do not have immediate threat of vision. But, based on OCT result, should I regularly do checkup to eliminate doubt of developing glaucoma? As my family does not have glaucoma there is 50% less chances for me to get it. My mom and dad aged 60 years also have 16-18 eye pressure without any symptoms. Am I thinking right? Do use of mobile, computer and television cause retinal problems? My light sensitivity may be optic neurological issue? Lutein, Zeaxanthin have highest concentration in eye retina, then why they cannot rejuvenate thickness of retina cells? Is there any way to increase retinal thickness? Do you see any abnormality with optic nerve head?

Hi,

Welcome back to icliniq.com.

You do not have any immediate threat, but regular checkup is advised. Over use of anything is not advised. For example, using smart mobile phones in the dark for long time can cause retinal problems such as macular degeneration. You should always have adequate amount of light and it should fall on the object, not on your eyes. I do not think of any optic nerve issues, because your vision never 6/6. Retinal tissue cannot be rejuvenated by any means, they can only be preserved. Your optic nerve looks healthy, except for the deep cupping mentioned earlier. Cupping can also be a normal variation. But, it is advised to get it checked regularly.

Patient's Query

Hi doctor,

Now further to this my present problem is mild light sensitivity which is difficult to explain what I am suffering from? So to explain this I found out from various resources about after image effect (Palinopsia) is that exactly I am suffering about and worrying all the time. Positive after image effect when I see bright objects and negative image if I see dark and light objects. For me it is very difficult to understand and express myself to describe problem. Most of the ophthalmologists test everything like OCT, retina, fundus, eye pressure and perimetry and conclude that my eye do not have present optical abnormalities. One neurologist told it can be persistant stress symptoms. But with treatment of SSRI drugs like Cipralex - Escitalopram had suppressed the symptom but after withdrawal it again persisting. Two years back brain angio was done. Kindly advice what should I do now? Please let me know, how much I need to worry in relation to the after image effect of optical illusion in my vision? Kindly help.

Hi,

Welcome back to icliniq.com.

It is normal to see the after image for a few seconds after it has been withdrawn. Palinopsia is the persistent of an after image, after that image has gone. If it is established you really do have palinopsia then you should be investigated for its probable cause, which commonly is caused by some old head injury, drug abuse, and also stress.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sheikh Zubair Abdul Razzak
Dr. Sheikh Zubair Abdul Razzak

Ophthalmology (Eye Care)

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