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Dr. Diana, both a doctor (therapeutic optometrist), and a recovered POTS and ME/CFS patient, offers help and hope for POTS, Dysautonomia, Ehlers-Danlos syndrome, Chronic Fatigue, Chronic Lyme, vascular abnormalities, Fibromyalgia, and Multiple Sclerosis. Dr. Diana is now working full time at POTS Care.

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Reply To: Divergence Insufficiency

NEW STUDY! Parasym Plus™ for Multiple Sclerosis › Forums › PrettyIll.com Discussion › Vision › Divergence Insufficiency › Reply To: Divergence Insufficiency

June 20, 2013 at 11:19 am #3792
Dr. Diana
Keymaster

Wondering if anyone else has been dx with this… I have had double vision on and off over the last 5 years or so especially after reading for prolonged periods or when tired. But since January everyday as my eyes fatigue my vision becomes double for distance vision. If I do any reading it will come on faster I guess as my eyes tire quicker. Usually by 1:00 or 2:00pm I can no longer drive. This is problematic as I am a single parent.

After many docs saying there was nothing to be done (I’m only 41)I have finally found an opthamologist that states he can cure this with in-office vision therapy + homework over the next 20 weeks. This is not covered by my benefits so will be very pricey hence my questions if anyone else has experienced this or had treatment work.

My history is complex. I have syringomyelia with a very long syrinx, tethered cord (detherered 4 years ago) POTS, Chiari zero, ?EDS (borderline on Beighton scale) and Cervicocranial instability. I have symptoms of increased ICP regularly. When researching this condition I was not surprised to see that blockage of flow of CSF thru the posterior cranial fossa is one of the possible mechanisms.
An eye question! I know this one! 😉 Assuming your doctor has ruled out other causes of double vision (trauma, tumors, etc), AND hearing that you have symptoms of high intracranial pressure, this sounds like a straight-forward case of lateral rectus palsy secondary to high intracranial pressure. Did you see The Driscoll Theory? Do you know that many of us tend to develop high intracranial pressure? If you have no contraindications to Diamox, that may take care of both conditions simultaneously (and at about 8 cents a pill, it is much less expensive!). I’m surprised that your doctor wants to try eye exercises for this, as such exercises CAN be beneficial for exotropia (an eye swings OUT), they are much less useful for esotropia (an eye wants to swing in). Lateral rectus palsy is fairly common with us, actually. One patient I consulted with had a reversal of 17 prism diopters of esotropia (that’s a LOT). More importantly, as a symptom of high intracranial pressure, your doctor shouldn’t ignore the potential dangers of allowing your high pressure to continue. While you are working this out, you can drive with an eye patch on (you’ll want to get used to the lack of depth perception, however) or just close one eye as needed. Did you have fundus photos taken? An MRI of your head/neck performed? An MRV of your head and neck perhaps? Likely, signs of the pressure can be found in any of those images, but it can be subtle. Much like the exaggerated pictures of stretchy skin in EDS (which throws off doctors when ours is only slightly stretchy), the changes in the vasculature of the fundus (and in the optic nerve head) can be very subtle. An OCT can help, or looking for abnormalities in an MRV can provide the “evidence” needed. Your symptoms of hydrocephalus are also indicative of the problem, and your response to an overnight trial of the pressure reducing medication can also be diagnostic. Will you let us know? 😉

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