Re: Jumping flickering fluttering vision

"JayLene" <jaylene17@xxxxxxxxxxx> wrote in news:1155823817.382603.273770

( Does he feel a flutter in his lid? NO does the vision go dim? NO
does he see
double? NO does it blur?

By definition, this is an "intermittent oscillopsia" or a jumping around of
vision that only happens sometimes. The most common causes would probably
be a lid twitch, that he may or may not feel, which is harmless, to other
harmless things like too much caffiene or fatigue. There are other causes
though. Could even be a strange migraine. His regular doctor should, at
the very least, do as thorough a neurological office screening as a general
practitioner does. An optometrist likely will not be helpful, unless an
episode happens in the office. An ophthalmologist might, but still
wouldn't be the right type of doctor. The GP might want to consider a
referral to a neurologist.

The bit where you say that there's a wobble type of movement on rising
might mean his blood pressure isn't adjusting when he stands up. This
doesn't have the feel an inner ear problem to me, but it might be an inner
ear problem known as Benign Postural Positional Vertigo (which is harmless,
but very disturbing), and he's just not describing it as most patients with
this disorder do, or he may have an uncommon variant. The more sure he can
be that the symptoms are related to sudden changes in head position, the
more likely this is, but a lack of "dizziness" pushes this away as a
possible cause.

Is the effect in one eye, or both eyes? If he closes one eye or the other,
does it go away?? Can he describe the direction things seem to be moving
in when they jump? Is it left/right, up/down, or does it sort of twist
around the line of sight? Would he describe the movements as "pendular",
or swinging back and forth, or is it more of a sudden jerk.

If someone is around when its happening, do they see a small twitch in the
lid that he might not feel?? This would point to a very common and benign
lid myokymia.

If the eye movements that cause the visual motion are only in one eye, and
the motion is the twisting sort, or somewhere between twisting and
vertical, do a search for "superior oblique myokymia", which can have many
different causes, or an undetermined cause. I'm not a doctor, but I read
plenty about SOM when I coauthored a paper on it, and your original
description had this type of feel. Try to read about the symptoms of this
disorder, and see if they match up. If it is this, treatment with
Gabapentin might help, but might not even be worth doing if the condition
doesn't bother him that much. If I had superior oblique myokymia, I'd
probably want a thorough exam from a neurologist, but I wouldn't be very

Have him do a search for the term "oscillopsia", and see if the
descriptions he'll find match the symptoms he sees. "Acquired Nystagmus"
might also be a good search term.

Last but not least, you seem to be describing two different types of
motion: a "jump" and a "wobble". To be a tad technical for the docs in
the group, the "jump" description has the feel of a saccadic intrusion or a
muscle twitch (myokymia), and the "wobble" description seems to suggest an
intermittent acquired nystagmus. If there really are two types of motions,
he should make absolutely certain his doctor is aware of this.

Scott (not a doctor)
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