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Visual problems,large blind spots,abnormality in left nerve,silent migraine,pressure in eyes,sea waves and star-streaks

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General & Family Physician
Practicing since : 2008
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I am an 18 year old male 175 lbs and 5 ft. 10 in., and for the past four years in high school I have been expierenceing visual problems. The most troubleing by far is very large blind spots that are noticible even with both eyes open. I know where they should be and they are there but very large. I have trouble reading a paper because of a visual gap and I know that is not normal. It has slowly progressed the past 4 years until now I can cover one eye and block out a car. Although originally in my left eye, recently it has also spread to my left. I have seen many doctors besides my family doctor including a optomitrist, optithalimist, nuerologist, and an opto-neuraligist. I have been told by them that it does not fit anything and that it should not be happening. I have had my eyes examined front and back dialated with the optic nerves examined and they checked at normally despite a slight abnormality in my left nerve. Interoccular pressure checks out normal. I am slightly near sighted. I have had an MRI w/ contrast which returned normal without abnormality. My doctors are baffled and have told me that it must be a silent migraine (history of migraines) but it strikes me as odd a migraine could exist 24/7 for more than a year (impossible). I've even been told its a visual hallusination... yeah. At this point a need an answer or at the very least a direction to pursue one. My two theories are increased intercrainal pressure or glaucoma (pressure isnt always the same between readings so maybe) I sometimes feel pressure in the eye in question. Sometimes I will see waves and starstreaks. I would really appreciate your time looking at this question and a timely responce because no-one is telling me anything useful and I do not want to lose my vision.
Posted Thu, 12 Apr 2012 in Vision and Eye Disorders
Answered by Dr. Raju A.T 12 hours later

Thanks for your query,

I would not consider either the raised intracranial tension or glaucoma to be the cause here. There are two reasons: They can be easily determined on examination as they present with evident and the typical signs in the eyes like narrowed pupil and raised intra-ocular pressure measured using a tonometer. I do not think the whole set of team would have missed either of them.

I would ask you to get a perimetry test done which gives the exact details of the scotoma ( blind spot ) which can provide good insights into the knowing the cause for the same.Also a report on the left optic nerve examination will be useful which when clubbed with perimetry can help to spot out the cause easily.

Visual XXXXXXX is another diagnosis which could be a possible consideration here . Most of times it is episodic and not associated with pain or present with pain after the auro ends ,sometimes it can also coexist with active migraine symptoms and present all the time atypically.Such problems can be expected in patients suffering from migraine for long time.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.
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