Is this just how vision deteriorates with age?

February 22, 2023 5:51 AM

Unsurprisingly, my vision has been getting worse with age. But is the particular way that it’s getting worse unsurprising too? Or worth a follow-up or a second opinion?

I’m a woman in my 50s. A little over a year ago, I started being unable to see well out of my right eye when I woke up in the morning. I’d feel like wiping/rubbing it, as though that would clear my vision of goop or crustiness or eyelashes stuck together or whatever, but there wasn’t actually anything there. It started out lasting maybe 10 minutes or so, and then about an hour, after which it would clear on its own. Now, it sometimes lasts all day, or maybe recurs during parts of the day – I’m not sure. (When it’s bleary, I feel like I stop processing the input from that eye – I have to close the left eye to check what the right one is seeing.) I’ve also noticed that when I first wake up, it’s sometimes hard to open that eye unless I cup it with my hand, I guess because it’s light sensitive(?), while the left eye is fine.

Shortly after this started, I saw my ophthalmologist about it. But, while I described it all to his intake technician, I forgot to ask him specifically about the morning onset and intermittent nature of the problem, which is what I most wanted to know. I don’t know what the technician wrote down or what he read. He did a thorough exam and didn’t find any new problems, but I also didn’t have the symptoms while I was there.

A few details that led up to that point…

- More than two years ago, I had two styes lanced, in the upper and lower eyelid of my right eye. I can still see a scar inside if I pull down the lower lid.

- About two years ago, I was seeing sparkles and my ophthalmologist diagnosed me with PVD in my right eye. The sparkles have since gone away.

- Somewhere in there, I got a mild glasses prescription, and they do help. (Specifics: Right: SPH -0.25 CYL -1.25 AXIS 135; Left: SPH -0.50 CYL -1.00 AXIS 50)

I asked my PCP about my symptoms, and he suggested going about two hours away (to Mass Eye & Ear in Boston) if I want a second opinion. I made an appointment there, with a doctor who seems like a top expert, for a couple of weeks from now. But now I’m second-guessing that plan. Maybe I should call back the ophthalmologist here instead and clarify whether he took into account what I’m describing – except it was over a year ago so I imagine he’d have to see me all over again. Or, if this just sounds like how aging vision and/or PVD and/or stye scars present, I could just wait another ten months or so until my next routine exam with him.

So, go through with the second opinion in Boston, follow up with the local ophthalmologist, or figure this isn’t unusual and wait about ten months for my next routine exam?

posted by daisyace to Health & Fitness (18 answers total)

Personally, I'd follow up and get a second opinion.
posted by kokaku at 5:59 AM on February 22, 2023 [14 favorites]

Get seen. It might just be from dry eyes - lots of us make far less tears as we age and that can make one's vision blurry. Do you use lubricating eye drops? Worth trying but I'd also make an appointment.
posted by leslies at 6:19 AM on February 22, 2023

Best answer: I would go to Mass Eye & Ear for that second opinion: they're very, very good. My wife got good care there for an ear problem, and it was worth an hour's drive each way, each time. (Turning into that parking lot from Storrow Drive was a heart-stopper in morning traffic, though.)

Make a list of symptoms and questions so you don't forget anything, and also make a short, bulleted list of the symptoms as you described them above that you can hand to the doctor.
posted by wenestvedt at 6:20 AM on February 22, 2023 [5 favorites]

I had a similarly goopy eye for like two years (when I was much younger) and various eye doctors told me I needed to be shampooing my eyelashes and stuff like that, but eventually a short course of antibiotic eye ointment cleared it up. It might be something really easy like that!
posted by mskyle at 6:21 AM on February 22, 2023

Probably a long shot, but is there any chance you sleep on that side? I had a problem with blurry vision from one eye upon waking and realized it's because I was mashing it into the corner of a hard foam side sleeping pillow all night. I don't have advice on what type of medical professional you should see, however.
posted by whistle pig at 6:28 AM on February 22, 2023 [2 favorites]

Best answer: I have seen a lot of ophthalmologists in my life and would say that after so long, the local one would certainly want you to come back in before they'd make any comment beyond it clearly not being an emergency, whatever it is. As such, you're unlikely to get another appointment much sooner if any than the one you already have, so unless the Mass Eye & Ear person is a hardship, I'd stick with that. Nothing against your local person, obviously, but I've always received excellent attention to all aspects of my concerns at teaching hospitals and if they do say it's fine, then you've got two places agreeing, versus being in this same position of uncertainty about whether something might have been missed.

I agree with others that your symptom pattern may follow dryness, but it also sounds a lot like corneal swelling I have (humidity and physical exertion are triggers for the intermittent problems, and if the scar is raised that could be another factor), and there are also very simple drops for that if so. Ten months is a long time to wait in any case, especially with all of the seasons there are to get through between now and then (pollen, more sun, higher temps, mold, swimming, etc etc), so if nothing else I'd bump up that routine exam to the next convenient opening they have locally.
posted by teremala at 6:28 AM on February 22, 2023

I think it's worth getting a second opinion in case it's *not* dry eye. (I had a similar problem and it turned out to be severe dry eye combined with blepharitis that I have to use an eyelid scrub to manage as part of my daily skin care routine. When I start getting the blurry morning vision I just start using a night time TheraTears liquid nighttime gel formula until it goes away again. I think mine might be related to allergies but I'm not disciplined enough to manage a trigger diary to nail down the source. But it was annoyingly difficult to nail down--I had to see three different people before someone gave me the scrub and the gel formula recommendation.)
posted by MagnificentVacuum at 6:32 AM on February 22, 2023 [1 favorite]

I too am a woman in my 50s with similar symptoms and was diagnosed with PVD in December of last year. The dr gave me lubricating drops and told me that using an overhead fan at night while I sleep could be contributing to dry eyes. I'm watching this thread—blurrily—with interest!
posted by fiery.hogue at 6:34 AM on February 22, 2023

I'm also a woman in my later 50s and although I am increasingly nearsighted and farsighted (thank goodness for varifocal contact lenses), and noticeably need much brighter light to read fine print, I am not experiencing anything like what you describe. I would definitely go straight to the expert in a couple of weeks since you have the appointment already. From other comments in this thread it sounds like there are plenty of non-serious possible causes, but it also does not sound like fun to be dealing with, so I would want to get the right diagnosis and treatment and get it sorted out.
posted by Rhedyn at 6:52 AM on February 22, 2023 [2 favorites]

I was also going to suggest that it might be dry eyes. You certainly won't go wrong by trying some lubricating drops in the morning while you're waiting for your appointment. Personally I'd probably keep the appointment anyway -- can't be too careful with your eyes.
posted by number9dream at 7:07 AM on February 22, 2023

Best answer: I had a similar problem a couple of months ago. It was common for me to wake up a little blurry and feel like rubbing my eyes, and then it would clear up. Then one day, I woke up and it actually hurt and stayed blurry all day, so I asked Metafilter. Everyone told me to see an ophthalmologist, so I did. Turns out it's recurrent corneal erosion. My eyes get dry during the night, and they stick to my eyelids, so that when I open my eyes, the eyelids pull a little on my eyeball. (Or, as I get a kick out of telling my co-workers, I rip pieces of my eyeball off. SO METAL!) Apparently it's pretty common. They suggested I buy a specific kind of OTC eye drop (Refresh Optive Gel), and to use them before going to bed and again in the morning. I'd still probably keep your appointment, but since it's a ways away, it wouldn't hurt to buy some drops and see if that helps.
posted by kevinbelt at 7:31 AM on February 22, 2023 [3 favorites]

See the specialist—
You’re entitled to a second opinion and it’s even been over a year since the first opinion!
posted by calgirl at 7:57 AM on February 22, 2023 [3 favorites]

Mid forties - I definitely notice that I need my glasses and need better light to read small print. My prescription is fairly mild but does change enough between eye tests (I manage one ever 2-4 years) that I get new glasses at that point. And I don't regret getting them.

But I have no stars and no blurriness that takes a long time to resolve. Just blurriness because it's too dark to read the small print I am trying to decipher, especially without my glasses...so nthing the chorus of get seen.
posted by koahiatamadl at 8:13 AM on February 22, 2023

Ok I guess I need to ask my doctor about this too (57 and I get something like this on and off for the last few years).
posted by matildaben at 10:40 AM on February 22, 2023

This sounds like dry eye, so I would start using lubricating drops regardless of what else you do. I don't see how it can hurt and, even if it doesn't work, it's another piece of information you can give when you get your second opinion, which you should definitely do in case it's not something that simple.
posted by dg at 6:36 PM on February 22, 2023 [1 favorite]

Response by poster: Thank you, everyone! I feel reassured that I should keep my appointment in Boston. I'll try lubricating eye drops before then, and I'll have written details in hand. I'll report back in case anyone wants to know. I appreciate it!
posted by daisyace at 11:07 AM on February 23, 2023 [1 favorite]

Response by poster: I tried the drops and then had my appointment, and in case anyone's wondering, here's the update...
- I have macular pucker, but it's very mild so it's not anything they'd treat. It could resolve or it could worsen, and if it worsens, there's surgery for it.
- The right eye is drier than the left, that lower lid is a little inflamed, and there's more of the beginning of a cataract on that side than on the other.

None of that is a great fit for AM light sensitivity and bleariness that clears. So it's unclear what's causing those symptoms, but there's not anything worrisome that they suggest other than what they checked for.

The testing felt very thorough, and the doctor's expertise and attentiveness were reassuring. She says I should continue the drops I tried on all of your advice, despite my not perceiving any impact yet, and that I should add warm compresses. I'm glad I went so I can stop worrying about what it might be. Thanks again, all!
posted by daisyace at 8:22 AM on March 9, 2023 [3 favorites]

Just chiming in to add that, since (I understand) it'd been a year since you had last seen your regular doc, last month would have been a normal time to be going back to them. One year eye checkups are standard in my world. That would have obviated the "second-opinion, big-hospital" issue in this thread.

That said, glad you had a good experience and please do consider getting more frequent checkups in the future.
posted by JimN2TAW at 2:27 PM on March 16, 2023