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Saw a patient recently, 32 y/o WM w/ CC of "twisted ankle", possible sprain. His ankle was only a strain, but when I did a review of systems he mentioned he has been bothered by "starbursting" around intense point or focal light sources. He said it has been going on for about 5-6 years but just recently seems to be worse.
He has a history of 15+ years of amblyopia of the R eye, this eye also has significant astigmatism. His L eye is 20/20 w/o correction, no astigmatism. His uncorrected vision using both eyes is 20/40. His historical IOP has been consistently low-normal in both eyes, usually around 7 mmHg. History of functional myopia and migraines with extended (6+ hours) of up-close work either on the computer or reading. Evaluations by optometrists and ophthalmologists during the intervening years were uneventful.
He indicated corrective lenses do not influence the presence or severity of the starbursting, neither does the light level of his surroundings, nor the time of day or level. He indicated that it is significantly worse in the L eye than the R eye. He indicated that he believes it gets worse when he is tired. Examples of when he sees it are the LED on a TV or video game system or streetlights when viewed from street level.
I didn't have any idea what to tell him. Considering his previous examinations by optometrists and ophthalmologists were nominal, I didn't really have anything to suggest. What do you think?
He has a history of 15+ years of amblyopia of the R eye, this eye also has significant astigmatism. His L eye is 20/20 w/o correction, no astigmatism. His uncorrected vision using both eyes is 20/40. His historical IOP has been consistently low-normal in both eyes, usually around 7 mmHg. History of functional myopia and migraines with extended (6+ hours) of up-close work either on the computer or reading. Evaluations by optometrists and ophthalmologists during the intervening years were uneventful.
He indicated corrective lenses do not influence the presence or severity of the starbursting, neither does the light level of his surroundings, nor the time of day or level. He indicated that it is significantly worse in the L eye than the R eye. He indicated that he believes it gets worse when he is tired. Examples of when he sees it are the LED on a TV or video game system or streetlights when viewed from street level.
I didn't have any idea what to tell him. Considering his previous examinations by optometrists and ophthalmologists were nominal, I didn't really have anything to suggest. What do you think?
