My Vision of the Future Remains Unchanged…

Wednesday, February 22nd, 2012 | Health

…in which I talk about my recent discoveries behind my double vision.

So,  a while back, I spoke at length about how of late I’ve been suffering from double vision. I mentioned how I would be going to a new doctor to see if they had any better ideas on how to correct this vision impairment. I did some research and ended up discarding all the suggestions and referrals that were offered to me and instead went with a Ophthalmologist here in town. The office actually has two Ophthalmologists and an Optometrist, so I thought it sounded like a professional decision. It’s been a little over two months since my initial visit and a lot of exciting and bittersweet facts have been revealed to me.

As usual, I was initially interrogated and tested by a technician who detected something that years of complaining and testing had never revealed at my previous Optometry clinic. She detected a slight deviation in my left eye. According to Wikipedia, it is called Divergence Insufficiency  or Strabismus, “in which the eyes are not properly aligned with each other.” My more assoteric friends call it “cock eyed.” At any rate, she determined that a prism in my left lens should compensate and correct the problem. The Ophthalmologist concurred and they gave me an adjusted prescription for my new pair of glasses. He instructed me to return in six weeks if I was still suffering from double vision.

Best glasses ever.
Slightly tinted, but not so much that I think I look like a tool.

It took a little nerve to go back to my old eye-care clinic to order new glasses, but they’ve always been good to me so I put aside my feelings of defection and headed in. My first order of business whenever I go to buy new glasses is to locate the section of the store that has magnetic clip-on sunglasses. Unfortunately, to my disappointment, I could find only one pair – and it was obviously left over from an era when glasses the size of your face were still of a fashion. After talking with the clerk, I learned that they had fallen out of fashion in favor of either vision correction surgery or transition lenses. Frustrated, I left the store and sat in my car for a little while. I called Heather, annoyed and unsure of what to do, and then finally settled my nerves and returned to the store.

I asked a few more questions about the transition lenses and finally decided to give them a shot. Just to be safe, however, I ordered two pairs of glasses – one with transition lenses, the other as dedicated sunglasses. Sure, it was probably overkill, but lately the wind has been bothering my eyes when cycling, so a pair of wider, more curved glasses could help with that. Besides, they were having a year-end sale. They were even nice enough to rush the order since I was leaving town in less than 5 days.

The glasses came in a day earlier than expected even, and my initial experience was fantastic! Like most new prescriptions, there’s a period of adjustment where everything just looks “different,” and then slowly everything seems to settle in and you realize that they really are helping. These felt that way for two weeks, maybe even a month, but then things kind of went downhill. Unfortunately, that timing coincided with my return to work, so I started suspecting that it was either massive eyestrain or a problem with my work environment.

Well, over the next month or so, through the close of January and start of February, I noticed that it took less and less time for me to notice the development of my double vision. Where, in the past, it had taken hours to really become intolerable, it was now happening almost instantly upon sitting down in my chair. I began to wonder if this was some psychosomatic issue telling me that I was really unhappy with my job, which didn’t make sense because I’ve really been happy as of late. I also thought that maybe my disappointment at the fact that the glasses weren’t working was actually making me think it was even worse than it was. Finally, I had to come to the conclusion that it was the glasses and the situation was truly worse with the prism. I made a new appointment and went to get checked out again.

The one thing about this new optical clinic is that they have several stages of waiting rooms, which I’ve never seen before, but after running the gauntlet of two waiting rooms and two exam rooms, I finally got to meet with a technician. This was a different technician than my first visit, but he definitely seemed more thorough, at least as far as the double vision was concerned. He spent a good ten minutes or longer measuring the divergence between my eyes and I starting noticing something that I had never noticed before. The double vision was different depending on how I tilted or turned my head. The technician recorded several different measurements and then escorted me back to waiting room #2.

In time, I was led back into yet a third exam room and waited patiently while I could hear the doctor and technician talking about his measurements outside the door. I couldn’t make out what they were saying, but it didn’t sound very positive. Of course, if there’s anything TV has taught me, the more the doctor has to deliberate, the worse the situation. So the doctor comes in and he mentions the inconsistent deviation and explains that the pattern is perfectly consistent with a Fourth Nerve Palsy. Basically, my eyes are not only not aligned incorrectly, but that they don’t move at the same rate, so the alignment is off by a different degree, depending on what direction I’m looking in relationship to where my head is pointed. The condition is typically the result of head trauma, degeneration from aging, or the patient has had it from birth. I have suffered no head trauma in recent years, so that was out. I’m not old enough to have developed it from aging. And lastly, I never suffered from double vision until, as I said, a few years ago – or at least not that I was aware of (more on that, later).

So, I asked him what our options were. Firstly, he wanted to rule out any other causes of the palsy, so he scheduled an MRI for the following day. Secondly, he told me the best that they can do is correct for my straight on vision, and then I’ll just have to learn to turn my head to deal with the variations around my field of vision. He drew up a new prescription and I immediately headed out to get new lenses.

The next day, I had my MRI, but before that, I had to get an X-Ray of my eyes due to an incident with some rust in my eye years and years ago. I would not be allowed in the MRI without first proving that I had no metal in my eye. The X-Ray came back clear, so it was into the thumping chamber. The MRI actually wasn’t so bad. I don’t have a problem with claustrophobia, so the small space didn’t bother me at all. I did find, however, that I was paranoid to move, so I didn’t scratch the itches that came up throughout the scan, and I didn’t change my body posture for fear that it would blur the image. After an hour in the worst bass-thumping dance club ever, and several very short naps, I was sent on my way.

I heard back from the doctor a couple of days later to say that all the scans came back clean and that there was no indication of abnormal. He encouraged me to try the new lenses and that we’d check it later to make sure that the double vision wasn’t getting worse over time. I should be getting the new lenses today, so we’ll see how that works out.

The bittersweet fact of this, is that I don’t have cancer or tumors, or anything of that sort, but conversely, there’s no way to repair the fourth nerve, so I’ll always have to wear some kind of glasses. The deviation cannot be corrected by laser vision surgery, which I was hoping to get done sooner or later. There are so many reason why I hate wearing glasses, most of all, the simple inconvenience of it, and yet now it seems that I am destined to wear them forever. I guess at this point, though, I’d be happy just to see straight, again.

FedEx Arrow
Once seen, it cannot be unseen.

So about that whole congenital fourth nerve palsy thing… Heather and I were musing over that at one point, thinking about the fact that it couldn’t be congenital since I never had double vision as a child. But then we started thinking that maybe I have had it since birth but my brain has been compensating for it, forcing the images together without my realizing it, and having had the wrong glasses for a year somehow made me aware of it. Like the arrow in the FedEx logo, I never noticed it before, but once I did, I could no longer ignore it. And then, I remembered something from my childhood. When I was younger, and even all the way through high school, I dreamed of having double vision. The dreams changed, and were never really what I would consider nightmares, but frequently I would have double vision in the dream and be forced to close one eye to see straight. I can remember having these dreams as far back as second grade, and repeating ever few years through, as I said, high school. I wonder, have I really been dealing with this my entire life and I just never noticed? Has my subconscious mind been screaming at me in my dreams and I just never took it seriously? It makes me want to go back through some childhood photos and see if I frequently tilted my head to compensate.

I may never be able to determine how long I’ve been suffering from this trochlear nerve palsy, and there may be no way to repair it, but at least now I’m more aware of what’s going on and why I’ve been having so much eye strain lately. I’ve got new information about what it is and what’s going on inside my head and an array of tools to deal with it. I’m getting the new prism in my glasses today, I’ve moved items around on my desktop and am prepared to get a different monitor setup to better deal with the issue. I may never be able to get Lasik and I’m likely doomed to wear glasses for the rest of my life. I guess it’s a good thing I look good in glasses. So what do you think of the mustache?

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  • Tingsteph

    At the very least, I’m glad you finally have answers.

  • http://kclose3.com/blog kacey3

    Answers, yes.

    Solutions, not so many. It’s going to take time to get used tot he fact that double vision is somehting I’ll always have to deal with. That and I was really getting excited about LASIK.

  • JoshRose

    This was really interesting, Kacey!  I’m glad the MRI came back clean, and although the palsy cannot be completely done away with, do you think over time you’ll learn to compensate for it in a way that is second-nature?

  • http://kclose3.com/blog kacey3

     Well, I was supposed to get the new lenses yesterday that offer the best correction for my straight ahead vision, but apparently they were cut wrong so I have to wait a little longer. The doctor tole me that I’ll just have to learn to look with my face, rather than with my eyes.

    I was telling a friend that and she immediately took it a step further and said I’d be looking with my shoulders like Michael Keaton’s Batman.

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