Opthamologist identifies gray curtain/floaters

[Marguerite53]

Hello to all of you with annoying little visual disturbances. I had my eye exam today and asked my ophthalmologist about the floaters. He called it the grey curtain and said it is a condition which is fairly common and not dangerous or a precursur to anything awful. It is called Posterior Vitreous Detachment. I googled it and the following link came up first. He showed me a great diagram and talked about melting jello (don't you love these doctors' metaphors!). Anyway, what I discerned was that a person with floaters should definitley see an ophthalmologist and be looked over carefully. Sometimes, rarely, the retina can detach and that is a medical emergency (and I believe one which is visually and possibly painfully obvious). Detached retinas occur for a variety of reasons, and this truly is not usually one of them. Nor is someone with Posterior Vitreous Detachment more likely to get a retinal detachement, but for some reason he thought it would be prudent, while they are looking you over, to check for signs of weakening there. I also asked him about guidelines for BAV, AVR and general valve replacement patients, and his feeling was that there was nothing special about getting eye checkups -- always check in if there is a problem, or oddity. Otherwise once every 2 years is fine. All this from one of Portland's best, and most experienced ophthalmologists.

Nice to finally have an answer!

Marguerite

http://www.rnib.org.uk/xpedio/groups/public/documents/PublicWebsite/public_rnib003660.hcsp#P2_29

 

[Buzz Lanning]

"Gray Curtain & Floaters"

"Gray Curtain & Floaters"

Marguerite,

I'm about 8 weeks post-op to replace a bicuspid aortic valve. In the first few weeks following surgery, I had a few eposides of the "gray curtain", where half of my vision would disappear as a "curtain" descended in front of my vision. I also had some intense "floaters". They have slowly subsided since surgery. I've had none of these epsoides in the last couple of weeks. Being on the bypass machine, major drugs, etc. really messes with your system!

Buzz

 

[tobagotwo]

Glad you received a good answer to your visual disturbances from the ophthalmologist. (< Spelling corrected thanks to AL, 8/28.)

I'm relieved you went there, first. I have read from some who went to other specialists first, fearing the vague possibility of a TIA. Some have undergone many interesting radiological and other tests, and are still being diagnosed to this day. Some are taking unnecessary "just in case/just to be sure" medications prescribed by uncertain physicians.

Some medical specialties are fraught with so many possibilities for these things that pursuing it through those routes can become a morass, and worse, an endangerment through misdirected aggressive testing and treatment.

The ophthalmologist's result, while prosaic, is relatively quick, it's accurate, and much more livable. This is about eyes and vision, so it makes sense to go there first.

Best wishes,

 

[MelissaM]

Sometimes, though, it seems like there is no way around the 'interesting radiological and other tests'. I went to the opthamologist first, and upon finding nothing of note w/r/t the retina, promptly passed the buck back to my PCP with the note that it could be "vascular in nature."

My poor PCP shrugged her shoulders and did the only thing a cautious physician could do - immediately ordered an MRI and MRA.

I had hoped to go in and get some correlation between my visual events and my recent high BP (it was 160/90 at the Dr's office), but she wasn't buying that line. And, unfortunately, posterior vitreous detachment doesn't seem to adequately define my visual experience - I could hardly call the double vision or the gray curtain effect a "floater".

 

[Bryan B]

Melissa,

I used to have visual disturbances for years before my surgery. They seemed to happen most often when I was stressed or nervous (but not always). I have not had one since my surgery (knock on wood), so I think mine WERE due to the fact that I had a higher than normal systolic pressure. There have been plenty of times where I've had 160+ readings at the doctor's office with normal diastolic pressures because I used to get so nervouos when seeing the doctor. I've been pretty much desensitised to that in the last year.

So I guess what I'm saying is that I personally believe that my visual disturbances in the past were caused due to my heart condition, although I never had that confirmed by a cardiologist or opthalmologist.

 

[tobagotwo]

Melissa, of course you're right. Sometimes there is nothing clear cut, and I didn't mean in any way to impugn the actions you have taken for yourself. I am espousing an opinion of medical practices in general terms, and certainly not of your own approach to your symptoms.

I tend to be wary regarding unnecessary medical attention, and the problems it can present to people. And there is always someone who had a similar symptom and it turned out to be a life-threatening issue.

As a group, we tend to be easy pickings for over-doctoring, as the line of what is important is often badly blurred, and we are easily roused to concern over items that others would ignore. This tendency is apparent in many posts, as people set off on uncertain quests to find out the causes of a wide variety of seemingly minor symptoms, in order to determine if they really are minor. Not infrequently, they post later saying that the doctors aren't sure, but they're receiving medication or treatment "just to be sure" (the four saddest words in the English language - they never go along with anything good).

One notes that someone has had an MRI and an MRA, with no apparent conclusion. Then it is reasonable devil's advocacy to ask if it was really an MRA or actually just the doctor's CYA.

I do believe the ophthalmologist is the best first stop (which you did make), as it is frequently enough to find an answer, and presents the least likelihood of complicating whatever other health issues we already have. Failing that, we must each decide for ourselves what value to place on the issue.

Best wishes,

 

[MelissaM]

There is a great book that explores this issue called "Complications: A Surgeon's Notes on an Imperfect Science" by Atul Gawande. (I picked up at Border for $3.99 the other day - might still be on sale there).

He explores the one time he didn't treat someone for something he thought "minor" only to have it turn out to be major and the time the he had no reason to believe someone had a grave illness - she displayed very few symptoms - but he trusted his gut and saved the woman's life. He talks about "bad" doctors and how they continue to practice, well after they should have been suspended, and says that many of the warnings re: bad docs come from the nurses and receptionists who steer patients away from them.

Medicine is as much an art as it is a science. Amazingly, there have been studies that deterrmined doctor's error rates with diagnoses DIDN"T IMPROVE with the advent of MRIs and CT scans. This book states that "I don't know" are some of the most often words used in medicine.

The book is fascinating reading for anyone who wants to see the world through the eyes of a physician. http://www.amazon.com/exec/obidos/A...68894/sr=ka-1/ref=pd_ka_1/002-1254104-9049662

As for chasing minor symptoms, it is just as hard to be a patient as it is to be a physician, huh? I dismissed minor symptoms and almost died of bacterial endocarditis. The doctor dismissed it as "stress." Makes it hard to know where to draw the line.

 

[tobagotwo]

By the flip of the coin, the doctor could have discussed the myriad unnecessary tests and prescriptions that he may have inflicted upon his patients, and any of the upshots of that in their later lives. There are equal stories of people who have been "treated" to death...

We agree, Melissa, that the line for action is a badly drawn one at best. I don't have a better answer than you to this.

I just think that sometimes we can spend our lives lunging at phantoms, and that somehow, we have to make decisions that allow a space for us to live the other part of our lives, without the focus on our health being the constant, driving force. If not, what have we really gained by extending our time?

Best wishes,

 

[Sherry]

I know I've posted on this several times, but I figured I'd chime in again this time. (Melissa, I think we're kindred spirits on this issue, aren't we?) I have had these gray curtain episodes up to three times per year for the last seven years. My first episode occured two days after surgery while I was still in the hospital. Both cardiologist and ophthamologist coined these episodes as "amaurosis fugax". The times when I've followed up after these episodes, I've either had high blood pressure or a low INR. According to the literature, they can be signs of numerous conditions, some rather benign and others rather serious (stroke). I've included a Medline Plus link that generally explains this phenomenon: the bottom line is that it's best to check INR and blood pressure (at the very least) when an epidode occurs, just to be safe. I never take them lightly. http://search.netscape.com/ns/boomf...m.nih.gov/medlineplus/ency/article/000784.htm

 

[Marguerite53]

Most spellings corrected

Most spellings corrected

Thank you Al, for correcting my spelling of ophthalmologist! I corrected everything, but the thread title which comes up on the forum page won't seem to correct. ROSS!! Can you correct that for us? No biggie, but I do hate being wrong!

I seem to be reading different accounts of this visual disturbance so I just wanted to repeat what I'd said in a long ago thread about what I was experiencing and why I asked my ophthalmologist about it yesterday.

" I am now noticing that I am experiencing grey floaties, like tendrils. These are very different from a migraine. They are always there. Most noticeable when looking at a white wall or reading a bright page. They move as I blink my eyes and then sort of right themselves back to their floaty position. They are more prounounced when I wear my barely tinted contact lenses. "

Apparently there can be much larger chunks which break loose from the gel sack and interfere with vision. That would be incredilby bothersome. Mine are really small, and the doctor said he'd had them for years and you just kind of get used to them. Easy enough for me to do now especially since I know that they are nothing serious.

I think if you have a large chunk of blacked out vision, that is a different story. That has happened to me, too, but it goes away. I've always presumed it was migraine related. When it doesn't go away, I believe that can be a sign of a detached retina (or perhaps a host of other nasty things) and should definitely be checked.

Marguerite

 

[KimC]

I just think that sometimes we can spend our lives lunging at phantoms, and that somehow, we have to make decisions that allow a space for us to live the other part of our lives, without the focus on our health being the constant, driving force. If not, what have we really gained by extending our time? QUOTE]

Couldn't agree with you more, Bob. This was lesson numero uno for me, (I'm a slooooooooooow learner though).

 

[bobbie416]

I woke one morning with these cobweb like things in my eye. Really weird. The night before while I was driving I had some flashes of light from that eye.
I have no heart problems- just wanted to tell that I needed immediate retinal exam(which was very unpleasant) and then had the holes in my retina put back with laser surgery that same day.

Anyone who sees flashes of light along with the cobwebs- run to the Doc. He said if left unatteneded I could have lost my sight in that eye.

Blesssings,
bobbie