Ocular DCS Symptoms

[chrpai]

DAN is closed for the day and I'm leaving for BlackBeard's on Friday. That said...

I've seen an eye doctor a couple times and am going again tomorrow for a OCT test to try to nail down a diagnosis of glaucoma in my right eye. I've read about glaucoma and diving (assuming I even have it) and from what I can tell there's no concern as I'm not on medicine, haven't had surgeries and gave seemingly good vision.

That said....

I'm coming back as borderline in glaucoma hemifield test for my right eye. Computerized photos of my retina were taking last month and this week and in this weeks photos I had about 1/2 dozen dot hemorrhages.

I started reading about Ocular DCS and it's probably a stretch but I'm wondering what exactly "blind spots in vision". Are they very pronounced or are they subtle as in what I'm seeing in visual field tests?

In other words, is it possible I have some minor or possibly subclinical ocular DCS that's just happening to be caught due to my other screening going on?

I think I'm fine for now but I'm starting to get worried about my future in diving.

 

[DocVikingo]

You might wish to contact board member gert7to3 ( http://www.scubaboard.com/forums/private.php?do=newpm&u=11143 ). He's quite knowledgeable about eye issues.

Best of luck.

DocVikingo

 

[chrpai]

Thanks Doc. Done. Hope he doesn't mind the PM.

One thing to add, the Dr said my eye pressure was acceptable. I heard values like 17 - 18 and 20 on previous visit.

 

[DocVikingo]

Hope he doesn't mind the PM. One thing to add, the Dr said my eye pressure was acceptable. I heard values like 17-18 and 20 on previous visit.

I've brought this thread to his attention--he'll be cool.

Good news on the improving intraocular pressure values. IOPs in the 17-20s range are very bad.

Best of luck.

DocVikingo

 

[chrpai]

I realize how difficult getting accurate and complete data from a guy like me is in this situation so even the highest level of things to think about and questions to ask would be appreciated.

For example it just occurred to me to mention that several years ago an opthamologist observed pigment dispersion syndrome and told me to always pass information on. (I've told my recent Dr this and she did not observe this in recent exams.)

 

[Dr Deco]

Hi charpi:

I am pleased to read that Doc Vikingo had the name and addresss of a physician acqainted with your dive situation. Best of luck with your future diving adventures.

 

[tracydr]

Best of luck,Chrpai. I've been noticing a change in my vision for the past 12 months and seems like its gotten much worse since my questionable dive where I may have been bent. I have avascular necrosis which probably started several years ago after a huge dose of steroids but became suddenly worse ( a lot LOT worse) after a dive in March,2013. This is why we suspect I got bent.
I'm pretty sure mine is small cataracts as I had some small ones several years ago, the last time I had my eyes examined. Also, my brother is 2 years younger than me and he needs cataract surgery. My dad had cataract surgery in his early thirties and got his when he was only 20 years old.
I do know that added stress, especially illness, can exaggerate eye problems. This is what I suspect is going on in my case.

 

[gert7to3]

Hmmm, ok, I'll try wading into to some of this, but DISCLAIMER, I am not a doctor. I am an ophthalmic photographer and most of my experience has had to do with retinal issues.


Your eyes are essentially formed with fluids and fluid saturated tissue. As such there is no more compression effect on them than there is on all the other fluid filled or fluid saturated tissues in your body. The only things which compress are air filled spaces. And we all know how troublesome those can be on occasion, but these do not include your eyes.


First, glaucoma. Here's a good website for glaucoma information:


http://www.glaucoma.org/glaucoma/pigment-dispersion-syndrome-and-pigmentary-glaucoma.php


And I picked out the pigment dispersion syndrome bit for your initial perusal. It is rare and you said your doctor has not observed this of late, so you probably don't have it. It is also a more of a young person's issue (I know, 40 isn't that old).


Glaucoma itself is hard to nail down initially. Elevated intra-ocular pressure is an initial clue. However, there are many people who go happily along with pressures from 17-21. Loss of visual field is another and more significant clue. It looks to me as though you have had a Goldman field test and there is some loss of peripheral vision in your right eye. The OCT exam you will undergo will provide your doctor with detailed measurements of your optic nerve head(s) (ONH). This initial scan may provide another clue if your ONH is seen to be significantly cupping. Otherwise it will provide a baseline dataset. When you undergo future eye exams they will repeat the OCT occasionally. The new scans can be compared with previous scans and increasing cupping of your ONH can be detected.


A brief explanation of your optic nerve heads (ONH). These are locations in your eyes, offset several millimeters towards your nose from the posterior pole of each eye, where the retinal nerves form into the optic nerves to carry visual information to the occipital lobes of your brain (sort of back behind your ears). Think of the ONH as like a soft spot on a tire. Pressure inside a tire causes a bulge at the soft spot. Excess pressure inside your eye can cause the ONH to bulge. The distortion caused by this bulging damages the nerve fibers in the optic nerve which in effect disconnects your vision. It can also affect your retinal artery and retinal vein. For the most part this occurs slowly and can be controlled with meds.

The

dot hemorrhages you mention are more likely the result of early background diabetic retinopathy or hypertension. You should have this checked out. This may entail a referral to a retinal specialist and possibly a fluorescein angiogram, where you will meet one of my cheery colleagues. Loosing weight oftentimes reverses diabetic and hypertensive issues.

tracydr,

Waiting 12 months before having noticeable changes in your vision diagnosed is a VERY BAD THING TO DO. Anyone noticing changes in their vision should seek an eye exam from an ophthalmologist or optometrist. Making selfdiaguesses (I just created a new word) is not good practice.

Good luck everyone and have everything I wrote about verified by your doctor. Thank you DocVikingo for pushing me quite a bit above my pay grade.
​

 

[TSandM]

Love "selfdiaguesses". I'm going to use that with my patients from now on!

 

[chrpai]

Thanks everyone. Here is my take away from what I've read here and what I read from DAN.

1) While I probably do have glaucoma and I know understand it can be hard to diagnosis so that restores a bit of confidence in my doctor. Shes very nice and open in discussing her thoughts and that was revealing her indecisiveness and making me start to wonder.

2) Per DAN, I shouldn't have any problems going on my trip next week. I've not had any surgeries other then LASIK 13 years ago and don't take any medications and while there is some field loss on my tests I think my vision is generally healthy.

3) I started to worry about the dot hemorrhages being caused by a dive on Sunday. It sounds like this isn't the case so I don't need to worry about silent DCS.

4) I'm starting to get old and my choices are catching up to me. I have lost 25lbs and I need to lose another 25lbs.

5) I'm going to be going to a lot of Dr appts as they nail all this down and monitor it.

Did I miss anything? Sorry if I freaked a little, my mother (God rest her soul) had big time eye issues starting in her 20's. Glaucoma, Cataracts in both eyes. I'm also told macular degeneration and perhaps detached retinas. It seems she had to go to the national institutes of health back in the 1970's (clinical trials I assume) to get injections in her eyes every three months.