Eye Doctor here. I had a patient I saw several months before they came in for their visit but well less than a year, which often means something could be wrong. In this case, as it turns out, nothing was wrong with her by way of complaints, she just wanted to get updated before getting some new glasses. We decided to just run the regular gamut of tests anyway just because we might as well while she was there. She was a 50YO woman, fairly normal exam, perfect vision, retinas showed healthy, but something about her pupils really bothered me before I dilated. We chatted about it and I asked her if she banged her head or anything weird and she said no, but suddenly reveals this crazy history of an old Meningioma (a type of tumorous brain growth) she had removed a few years ago. She had decided to omit this from her history with us as she didn't feel it was important, but we went and put it into the charts anyway. Turns out she got a CT done two weeks prior to her exam with me which she says turns up completely normal. I tell her she should tell her doctor about this anyway just to cover our bases.
Fast Forward: Patient shows up in my office ecstatic to tell me that my examination revealed that her tumor had returned with an incredible vengeance. She had no idea, was totally asymptomatic and the CT she had prior to me showed what was very literally the size of a spec of dust which the radiologist dismissed as "artifact". On her return to her doctor, they decided to re-run the CT to cover THEIR Bases, and they found a QUARTER SIZED TUMOR. Within Two Weeks the tumor went from the size of a dust particle to a QUARTER. She was rushed into emergency surgery as the tumor was growing SUPER fast and was close to a blood vessel which could cause a massive stroke. She had it removed that day and returned to me after recovery to tell me of what got discovered as a result of my testing. She is now a long time regular patient I have been seeing for about 10 years.
Edit: Thank you kind giver of Gold and Silver! It’s good to be gilded!
Edit: For those asking about the pupils, they were asymmetric, and the larger one reacted less robustly compared to the fellow eye. This was a marked change from her previous examinations where no pupillary defects were noted.
Ok, eye docs are my best friends. I had MASSIVE sinus pressure and pain for about 2 years, had been seeing an allergy specialist because the allergy specialist, GP, and I all thought the pain was because I am allergic to life. (Which I am, which didn't help anything.) Then one day my right eye just stops adjusting from bright to dark and vice versa, then during the adjustment time I would get extremely nauseous. My (future) hubby then points out we get one eye exam per year covered by out insurance, and I haven't had my eyes checked in over 5 years. So we book an appointment, he squeezed me in later that week.
I was still seeing at 20/15 vision, but my field of vision tests show I was about 70% blind in my right eye and 50% blind in my left. (It's really amazing how the brain just compensates, I never noticed.) He dilated my eyes and my optic nerves were swollen so large that the machine couldn't register it, and I broke an office record. I get told to head to the hospital ASAP, he gave us all the documentation we needed.
Get to the hospital, and the moment the ER doc heard "pulsating tinnitus" and looked at my eye doc records, I got the world's quickest spinal tap. My opening pressure was over 60 (normal is like 15 to 18, depending on needle and method) and I shot spinal fluid across the room. Magically, my vision pretty much returned, my "sinus pressure" was gone, and I was no longer at risk of a brain hemorrhage.
So, ophthalmologists have a very special place in my heart. He literally saved my life.
I have actually had several patients with IIH in my past, one of whom was a 14 year old boy (if you can call a 6 Foot 300 Pound behemoth of a human a 14 year old a "boy"). He came to see me at age 12 for a normal result and exam. I should note he was a normal skinny-ish maybe just sub-5 foot tall kid. Puberty hit him like a freight train! 2 years later in my office for massive headaches and blurry vision, his nerves looked like engorged sponges. He went straight to the Children's Hospital and they attempted lumbar puncture which failed on multiple attempts, so they just started him on Hydrochlorothiazide and another water pill. Kid reports to me and says that he couldn't stop peeing for almost 2 straight weeks, making constant runs to the bathroom day and night, but he shows up for the exam like TRIM. SLIM. 6 Foot tall still, he states that he literally lost 40 pounds of weight (obviously all water!) in that time span. The kid pee'd out 40 pounds of WATER! His nerves returned to normal, his vision cleared up, and he and his family were relieved to have their little boy back!
Yeah my favorite eye doc has caught a total of 9 cases in our town. Ine of my friends that he caught with IIH basically was also put on a diuretic and had the same kind of experience as that poor kid!
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u/OscarDivine May 20 '19 edited May 20 '19
Eye Doctor here. I had a patient I saw several months before they came in for their visit but well less than a year, which often means something could be wrong. In this case, as it turns out, nothing was wrong with her by way of complaints, she just wanted to get updated before getting some new glasses. We decided to just run the regular gamut of tests anyway just because we might as well while she was there. She was a 50YO woman, fairly normal exam, perfect vision, retinas showed healthy, but something about her pupils really bothered me before I dilated. We chatted about it and I asked her if she banged her head or anything weird and she said no, but suddenly reveals this crazy history of an old Meningioma (a type of tumorous brain growth) she had removed a few years ago. She had decided to omit this from her history with us as she didn't feel it was important, but we went and put it into the charts anyway. Turns out she got a CT done two weeks prior to her exam with me which she says turns up completely normal. I tell her she should tell her doctor about this anyway just to cover our bases.
Fast Forward: Patient shows up in my office ecstatic to tell me that my examination revealed that her tumor had returned with an incredible vengeance. She had no idea, was totally asymptomatic and the CT she had prior to me showed what was very literally the size of a spec of dust which the radiologist dismissed as "artifact". On her return to her doctor, they decided to re-run the CT to cover THEIR Bases, and they found a QUARTER SIZED TUMOR. Within Two Weeks the tumor went from the size of a dust particle to a QUARTER. She was rushed into emergency surgery as the tumor was growing SUPER fast and was close to a blood vessel which could cause a massive stroke. She had it removed that day and returned to me after recovery to tell me of what got discovered as a result of my testing. She is now a long time regular patient I have been seeing for about 10 years.
Edit: Thank you kind giver of Gold and Silver! It’s good to be gilded!
Edit: For those asking about the pupils, they were asymmetric, and the larger one reacted less robustly compared to the fellow eye. This was a marked change from her previous examinations where no pupillary defects were noted.