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What Causes Blurred Vision?

Posted on Sat, 31 May 2014

Question: 2 months ago i got up one morning and it is like i am looking at everything through water. everything appeared glary/blurry. so it makes it difficult to read. if i close one eye the vision sharpens but when both eyes are open the vision distorts. the lights from the computer and the tv affects my vision also and it is difficult to read, so my eyes gets tired and hurt after a while. i visited the eye doc and he did ct scan of eye visual field test and all test were normal, all blood test normal, no high blood pressure no diabetes, did mri, all normal. went to 3 neurologist, one diagnosed status/prolonged migraine aura. he started me on valproate 200mgs for a week after 2 weeks no change. he then added to that 25 mgs of topamax morning and 25 mgs eve to increase dosage by 25 mgs each week plus 5 mgs of stemil. this has been for 4 weeks now. a week after i started taking 40 mgs of lasix. still no change. i have adjusted by diet aggressively now for abt 4 weeks and still no improvement in my vision. i do not have visual snow or anything like that. no zig zag nothing like i hear about in the other prolonged persons, just this constant state of blurry, i am not wondering if i was misdiagnosed, also if the treatment is correct. whereas i do suffer from migraine i never had aura before migraines before. never had vision issues before. i do am not able to work as i need to be able to work with the computer and i am not able to do so comfortably. please help

Answered by Dr. Sudhir Kumar (4 hours later)

Brief Answer:
History is suggestive of diplopia.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your history. It is unfortunate that a proper diagnosis has not been made and treatment has not worked.

Your symptoms are suggestive of diplopia or double vision. What I mean is that there is weakness of eye muscles, more on one side. That explains improvement in vision after closing one eye.

We need to exclude conditions that cause weakness of extra ocular muscles such as myasthenia gravis, cranial neuropathy affecting ocular motor nerves.

There is no need to worry as MRI and other investigations are normal.

I hope it helps. Please get back if you have any follow up queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (20 hours later)

what i need to clarify is whether i close the left or the right eye is the vision sharpens it does not matter which eye is closed the vision sharpens, would your diagnosis then remains the same?also what the major conditions that causes weaknesses of the ocular muscles and what are the likely tests to be conducted to exclude the conditions,

not sure if i also mentioned that i had extreme photosensitivity to the lights from the computer and the tv too not sure if that would have been a factor of the weak eye nerve. hope you can help. which is not as bad these these

Answered by Dr. Sudhir Kumar (3 hours later)

Brief Answer:
Diagnosis would be same.

Detailed Answer:
Thank you for getting back and providing more information.

The diagnosis would be same, that is, weakness of ocular motor nerves, even when the sharpness increases with closing one eye.

Investigations would include a detailed examination by a neuro-ophthalmologist, repetitive nerve stimulation (to exclude myasthenia gravis), and a re-look at the midbrain region of brain on the MRI by a neuro-radiologist.

I hope it helps.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar