Q. about personal experience c blurry vision

[HiddenTruth]

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Hi all,

I have a personal experience that occurred a couple weeks ago that's got me kinda' scared--I understand that this place is not for medical diagnosis, advice, etc. I am just interested in your guys' thoughts--esp. those who are residents/physicians.

So, I am a MS2 and couple weeks ago I took the comprehensive basic sci exam given by our school, and after about 30 mins into it, the same thing happened what I was afraid of. So, I would read for about 3-4 mins, like 3 -4 q's max, and after that everything on the paper was just kinda blurred out. I could see the paper and writing, but i couldn't make it out. So, I would have to look elsewhere (either the ceiling, or elsewhere for a couple of secs), or rub my eyes, and then re-"focus". And this was a repetetive cycle. I got pretty stressed out, because i was getting screwed on time. And, it became just very frustrating. I am not sure whether this is test anxiety or is there something more serious that I should get checked out.

The thing is that this has happened a few times before on previous class exams. Probably started late in first year, but wasn't consistent. And, it wasn't that big of a deal because those questions aren't that long and I was able to handle it. Additionally, those questions didn't require that much thought process and itnegration like boards typa' q's do. Initially, I attributed it to not getting enough sleep, but then I made sure i got 6-7 hrs prior to the exam nite, but it still occured. I don't have any medical conditions that I know of, don't wear glasses/contacts, I am relatively young (21) and have done fairly well in school overall (~3.7 gpa or so). But, anyways, the reason I am so concerned is that I have to take step 1 in a couple of months, there is absolutely no way i am going to take the exam if the same thing occurs--i will screw myself. The wierd thing is that i don't experience this while i study or am doing anything else. I think, maybe it occured once or twice before, but usually a day prior to exams while i was studying.

I am not sure what I should do. I did schedule an appt with my school counselor to see if this is anxiety related. I don't know/think how helpful this may be. (Moreover, I feel wierd, and i usually woudn't go, but the fact that this involves boards, and the fact that i didn't do so hot on the cbse--infact i ran out of time, i had to fill in 10 bubbles or so--i feel really concerned).

I'd appreciate any feedback. Thanks so much.

 

[SteelEyes]

Has this ever happened outside of an exam situation?

 

[JennyW]

Hi all,

I have a personal experience that occurred a couple weeks ago that's got me kinda' scared--I understand that this place is not for medical diagnosis, advice, etc. I am just interested in your guys' thoughts--esp. those who are residents/physicians.

So, I am a MS2 and couple weeks ago I took the comprehensive basic sci exam given by our school, and after about 30 mins into it, the same thing happened what I was afraid of. So, I would read for about 3-4 mins, like 3 -4 q's max, and after that everything on the paper was just kinda blurred out. I could see the paper and writing, but i couldn't make it out. So, I would have to look elsewhere (either the ceiling, or elsewhere for a couple of secs), or rub my eyes, and then re-"focus". And this was a repetetive cycle. I got pretty stressed out, because i was getting screwed on time. And, it became just very frustrating. I am not sure whether this is test anxiety or is there something more serious that I should get checked out.

The thing is that this has happened a few times before on previous class exams. Probably started late in first year, but wasn't consistent. And, it wasn't that big of a deal because those questions aren't that long and I was able to handle it. Additionally, those questions didn't require that much thought process and itnegration like boards typa' q's do. Initially, I attributed it to not getting enough sleep, but then I made sure i got 6-7 hrs prior to the exam nite, but it still occured. I don't have any medical conditions that I know of, don't wear glasses/contacts, I am relatively young (21) and have done fairly well in school overall (~3.7 gpa or so). But, anyways, the reason I am so concerned is that I have to take step 1 in a couple of months, there is absolutely no way i am going to take the exam if the same thing occurs--i will screw myself. The wierd thing is that i don't experience this while i study or am doing anything else. I think, maybe it occured once or twice before, but usually a day prior to exams while i was studying.

I am not sure what I should do. I did schedule an appt with my school counselor to see if this is anxiety related. I don't know/think how helpful this may be. (Moreover, I feel wierd, and i usually woudn't go, but the fact that this involves boards, and the fact that i didn't do so hot on the cbse--infact i ran out of time, i had to fill in 10 bubbles or so--i feel really concerned).

I'd appreciate any feedback. Thanks so much.

This is going to be a little bit controversial on a board dominated by surgeons, but I deal with this type of problem all the time in my optometric practice.

The problem is convergence localizing closer than accommodation. That is to say your eyes are not pointing where they are focused.

Demands for sustained concentration and immobilization during intense near work generate a stress response characterized by a pattern of visceral dominance in which accommodation is activated to a greater degree than convergence. The sympathetic nervous system which is activated under these conditions causes a shift in accommodation towards far, so that increased accommodative effort is required to sustain accurate accommodation at near. This hightened innervational effort for accommodation generates overconvergence.

In a famous study, researches demonstrated an increase in accommodation when a task demand was swtiched from reading numbers on a page to adding them. Accommodation increaed though there was no increase in accommodative demand.

The solution is the use of low powered plus lenses for near. These lenses allow the individual to localize objects as being farther away in space.

I have seen +0.50 OU work WONDERS on peoples ability to read, comprehend and perform on near vision tasks.

Jenny

 

[HiddenTruth]

Has this ever happened outside of an exam situation?

Fortunately, no. Well, I take that back; it has happened "outside" of exams, but like I stated in my OP, the timing was in the context of exams, like the night before, and it was while I was studying.

What do you guys think about Jenny's comments?

 

[PBEA]

This is going to be a little bit controversial on a board dominated by surgeons, but I deal with this type of problem all the time in my optometric practice.

The problem is convergence localizing closer than accommodation. That is to say your eyes are not pointing where they are focused.

Demands for sustained concentration and immobilization during intense near work generate a stress response characterized by a pattern of visceral dominance in which accommodation is activated to a greater degree than convergence. The sympathetic nervous system which is activated under these conditions causes a shift in accommodation towards far, so that increased accommodative effort is required to sustain accurate accommodation at near. This hightened innervational effort for accommodation generates overconvergence.

In a famous study, researches demonstrated an increase in accommodation when a task demand was swtiched from reading numbers on a page to adding them. Accommodation increaed though there was no increase in accommodative demand.

The solution is the use of low powered plus lenses for near. These lenses allow the individual to localize objects as being farther away in space.

I have seen +0.50 OU work WONDERS on peoples ability to read, comprehend and perform on near vision tasks.

Jenny

I could not have said it better myself Jenny, while not the only possible explanation for this persons symptoms, your telemedicine diagnosis is definetely plausible. I agree hiddentruth should seek an evaluation to rule out any ocular condition. Make it so hiddentruth, and tell us how you fair.

 

[HiddenTruth]

What about using a beta blocker, if the cause may be attributed to a hypersympathetic state?

 

[Andrew_Doan]

What about using a beta blocker, if the cause may be attributed to a hypersympathetic state?

Do not take beta blockers for this.

 

[samdo]

Do not take beta blockers for this.

You heard the optometric answer and here is the ophthalmic one.

In order to determine the cause of your problem, you age, gender, refraction, medical/surgical history, social history, review of systems, and ophthalmic exam need to be performed.

Accomodative spasm in stressful situations is plausible and common. I have seen low plus power lenses prescribed for similar symptoms in which an organic problem involving a medical condition was later identified.

Bottom line see someone in real life who will take the time to evaluate your problem completely.

Samdo