Dark Pillars in My Vision

I had RK surgery in 1991 (12 slits in each eye) and bilateral cataract surgery in 2010. Prior to that surgery,I was seen by a retinal specialist who said I had myopic degeneration. (My optometrist sent me to him because he detected drusen and suspected macular degeneration.) A year after the cataract surgery (I still need glasses). I was seen by the surgeon for a follow-up visit, and he said I had macular degeneration. The above is background for my question. Recently when I awaken in the morning and before arising I see dark vertical pillars. Sometimes only one, but sometimes half a dozen. Sometimes only in my left eye, but sometimes in both. They do not extend all the way up my field as I can see above them, but very little below. I am wondering if this could be caused by the drusen?

I do not find your description of these “pillars” very clear, but I do not see how they could be caused by drusen, especially as (if I am understanding right) they seem to be temporary effects. Could they be Charles Bonnet hallucinations? Those are a common symptom of macular degeneration. A more detailed description might help, though.

Reported for forum change. Medical questions belong in IMHO.

Moderator Action

Moving thread from General Questions to In My Humble Opinion.

I think those are the symptoms of macular degeneration. This is something that affects almost every old person. As you get older the ability of your eyes to respond to changes in the environment decreases. A person affected with macular degeneration will lose central vision.
Macular degeneration is of two types and it can be treated. You can read more about macular degeneration in here. http://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-overview
f detected early your vision will have a longer life. So make sure that you have your yearly eye check up. You can read more about it’s treatment in here http://www.evergreeneye.com/macular-degeneration.php

I don’t think so. Yesterday morning, I first saw one pillar (the type that Samson brought down, only more nebulous) then immediately saw several of them, at different distances from my eye. I closed my right eye and saw them at the same locations, then I closed my left eye and saw them at the same locations I saw with the other eye. I moved my hand in front of one, and the pillar disappeared. As I moved my hand blocking each one, they disappeared. Since I saw the phenomenon with both eyes, I now believe that this is not an optical problem but a neurological problem. This is further buttressed by the following history.

I am now 76. When I was in my 30s. I would momentarily pass out on occasion, both at home and once when I was having dinner with two ladies. About 20 years ago on a 10-mile run on a cold day I almost fainted. About 15 years ago, when I began to run fast without warming up slowly I would see beautiful orange pac-men. These were beautiful, but interfered with my vision. They would last for only a few minutes. My ophthalmologist said they were visual aura of a migraine, but a fellow runner (who was studying neurology) said they were caused by insufficient oxygen to my occipital lobe because there is a narrow artery supplying blood to my brain in the back of my head and when I run too fast without warming up, not enough oxygen can get to my brain.

I now believe that I have some kind of neurological problem but have had it for many years. I could see a neurologist but I probably will die before the problem gets very severe. But I want to emphasize that since I saw the same phenomenon at the same location with either eye, the problem is not in my eyes but in my brain.

In the light of your more detailed description of the “pillars”, I am again going to say, with a bit more confidence than before, that these are probably Charles Bonnet Syndrome hallucinations. Check out the link in my previous post. Charles Bonnet hallucinations are produced in your brain, not your eyes. However, one of the possible causes of them can be macular degeneration. This leads to a part of your visual cortex not getting its normal stimulation, and the neurally more central parts of your visual system produce hallucinations to make up for this. Charles Bonnet hallucinations can also arise from lesions to primary visual cortex which (like macular degeneration) lead to blindness in part, but not all, of your visual field. However, I believe this a far less common cause.

So yes, it is possible that this is a result of part of your primary visual cortex (which is in the occipital lobe) having been damaged by lack of oxygen (in effect, some sort of mild stroke), but as you have macular degeneration anyway (and do not mention any recent symptoms of stroke), Occam’s razor suggests that the latter is the more likely cause.

In either case, I am afraid, there is not much to be done about it. The recommended treatment for Charles Bonnet syndrome is, basically, to reassure the patient that the fact that seeing things does not mean that they are going crazy or demented. The symptoms are not related to dementia, and sufferers rarely (more than momentarily) confuse the hallucinations with realities.

njtt, are you an ophthalmologist? I’m not sure I have macular degeneration. The cataract guy said so, but the retinal specialist said it was myopic degeneration. I have no vision loss due to that. My vision lost has been due to severe myopia, which has been largely corrected first by RK and then by cataract surgery. The cataract surgeon said I no longer have myopia, but severe astigmatism (3 diopters). (An ophthalmologist with whom I once played tennis said one diopter of astigmatism is equal to 1/2 diopter of myopia.)

It could be that this is due to CBS due to some other cause. As I said I once had Pac-Men in my field of vision as I would begin a run too fast, which could have been due to a temporary lack of oxygen, or a migraine aura. I’ve had damage to my eyes with surgical cuts for the RK, but that improved my vision. I recall now that those Pac-Men began shortly after the RK surgery.

In any event, as you say, there is nothing to be done about it.