Vision problems, elimination diets and a social dilemma

I have a friend who had (or used to have) bizarre vision problems. The doctor has assessed him as having perfectly acceptable sight, i.e. he doesn’t need glasses, surgery or anything of the sort. However, although the friend’s vision is ‘technically’ perfect, he is still miserable. As he describes it, his sight may be sometimes grainy or cloudy - imagine a tv with a reception problem. He sees things shrouded in darkness when they should be light. Has trouble with screens and brightness, like snow or bright sun, for instance.

This friend can be a somewhat depressive and private person. I’ve asked him if there is a name for his condition and he implied that there was, but it was an ‘ugly’ name and he didn’t want to tell me. I think he’s sporadically seen doctors, but they’ve done little to help.

A while ago he saw a naturopath, who advised some sort of elimination diet. At first he barely ate ANYTHING - small portions of boiled rice and some meat with no marinade was the only thing he would eat all day. When he ‘felt faint’ he would eat a small piece of cheese. I should say, this friend, while not overweight in the slightest, had often expressed his body image issues (of the ‘I wish I had the willpower to be anorexic’ dark jokes) and I think saw this as an excuse to crash diet.

One of my concerns was that this diet seemed to be infinite. There was no timeframe, no ‘I’m going back to the naturopath next week and will begin adding fruit into my diet’, just this mysterious eye problem, a secretive diet and reclusive friend. He rarely went to social events anymore, partly because he couldn’t eat out at cafes or restaurants, drink alcohol or even coffee, partly because his vision problems restricted things like movies. We’re university students, but he’s now deferring until the beginning of next year (for reasons unrelated to his problems) and doesn’t even have a part-time job or anything, so he’s essentially sitting at home ‘wasting away’ much of the time.

After seeing him recently, it seems he has at least a somewhat more sensible approach to the diet - is eating at least nuts, some berries, vegetables etc. Still in ridiculously small and controlled portions, but I think that’s his personal preference rather than what has been imposed by the naturopath. He claims his vision is getting better, which is definitely good. Still, he’s rather vague and blase about what he can’t eat, and for how long. Eg. he can’t have wheat, and one of my other friends (a coeliac) asked whether he could have the gluten-free bread that she does. He said he probably could, but dismissed the idea because he worried he would ‘go crazy’ with it.

Another slightly unrelated problem is that we’re trying to incorporate him back into the social group (partly after my coeliac friend ''H" ran into his mother who was at her wits ends over what to do with him moping at home all the time, and basically begged her to rekindle their old friendship) but he can be a rather difficult person to be friends with sometimes, for a variety of social and logistical reasons (eg he rarely initiates contact, even when he’s glad to do something.) Plus him and “H” used to have a weirdly intimate relationship which she doesn’t particularly want to re-create (he’s gay and she was in love with him, but it got to a point where she would let him walk all over her and he would take advantage of her unconditional support, etc.) So stepping back into his life has to be done with caution.

Wow, sorry for the rambling backstory. I guess my main questions/concerns are:

  • What could this vision problem be? I admit its partially nosiness, but I would feel better about his well-being if I could at least know what we were dealing with. Some googling suggests pre-diabetes (glucose-related vision problems) but I have a feeling that if it were something ‘normal’ sounding like this he would have told us, plus it would have been diagnosed by a doctor.

  • What experiences do people have with naturopaths? Good/bad/kooky?

  • And experiences with elimination diets? Am I wrong in thinking they should be more controlled than “I just won’t eat anything any more, ever?”

  • Also, any advice on how to maintain a balance between supporting someone but ultimately letting them take responsibility for themselves, and completely losing yourself in their life? (More for “H”) than myself.

I know this is a messy first post, but if anyone had some relevant experiences or insight I would be grateful to hear it!

Floaters? My vision is fine (with prescription glasses), as long as floaters are not in the way. The problem is, is that floaters accumulate over time as you age, and you get a bunch of floaters in your way of seeing things clearly and makes certain vision spots blurry until you shift your eyes away to move them. It makes certain activities unpleasant, more so when you enjoy a specific activity such as reading.

Just a guess, but possibly his doctors told him the condition was a somatoform disorder. In other words, that his problem has a psychological, not a physical, basis. This would explain why he thinks the diagnosis sounds “ugly” and why he is unwilling to share it.

Persistent visual snow is a well-known migraine aura. It sounds very likely that this could be what your friend is experiencing, and would explain why his eye doctor did not find any problems. He should go see a neurologist if he hasn’t already.

Here is a reference for more information:

I have migraine too, mostly just the aura and almost never the headaches. I have visual disturbances too, and my eye doctor was not able to find any problems. In my case I have partial to complete visual loss when experiencing aura but it tends to go away after several hours. It’s a very frustrating thing, and a lot of doctors are not aware of all the manifestations of migraine aura. Tell your friend to find a doctor that specializes in migraine to really check him out and either rule this in or out.

An elimination diet is meant to be temporary, not long term. The idea is that you go back to one or two highly non-allergenic foods and eat just those for about two weeks while your body heals from what was ailin’ ya, then you add in another food and then another. When your symptoms return, well, you’ve found what you’re likely reacting to. You cut that food back out, and then go on trying other foods again. Most docs say you can add one more food every 3-4 days, but I’ve known some pretty conservative ones who like to give it a week between new additions.

Food sensitivities can be tricky things to diagnose, though. Back in the seventies, my dad had migraines, which are sometimes triggered by diet. He started keeping a food diary, and they couldn’t find any correlations going back 24 hours or even two or three days. Finally, he got one of these new-fangled home computers so he could log his diet on something called a “spreadsheet”, and he took some programming courses so that he could program the computer to look for patterns he and his doctors couldn’t see. Turns out that, like clockwork, 12 days after he has alcohol, he gets a migraine. WTF? Something in the alcohol reacts with something and then something else, and it takes 12 days for the metabolites of the metabolites to turn into whatever it is that gives him a migraine. (When I say “whatever”, it’s because I don’t know. He’s a Pharm D, and I believe he did finally track it down to a specific chemical or three, but I don’t know the whole pathway of alcohol digestion well enough to remember specifics.)

So I’m willing to believe that if your friend’s sensitive to something, it might take a while for it to show up, and if his vision is getting better (whether of physical or psychological origins), then that’s a good thing. People don’t really need a whole lot of food, or a great variety of it, to live, and he may be getting enough nutrients on what looks like a very Spartan diet. The foods you mention - nuts, fruits, rice, cheese - are very calorie dense and provide a good variety of nutrients, so I’d lay off him on that count.

OTOH, I’d be worried about the severing of school and friend ties. I can understand not wanting to go out for dinner or a movie, but how bout a classical concert, or a walk in the park, or a trip to the beach or a pottery class? If you get more creative, does he find reasons to shoot those down, too? If so, and if it’s not just you but all his friends, I’d suspect clinical depression or an anxiety disorder. Of course, if that’s it, there’s really very little you can do about it, except recommend he see someone qualified to diagnose and treat that.

Speaking as someone with a background in alternative medicine, I’ll say that some naturopaths are great and knowledgeable, if (by definition) unconventional, and some are total snake oil frauds who should burn in hell. I have no way of knowing which this one is. If you could find out where she earned her degree, that would help.

Based on these parts of your story, I definitely agree with QN Jones that this sounds like a psychological issue more than anything else.
Even if a physical cause for his vision issues can be found, I’d still be worried about his depression and it sounds like he may even be developing an eating disorder.
If you can find a way to get him to see a psychiatrist, I suspect that would probably be more helpful to him than anything the naturopath can do.

On the other hand, I’ve known enough people who suffered problems that were dismissed by their doctors and later turned out to be real. Hepatitis C in the early 1980’s is a good example. These folks were treated as if they were somaticizing, when a better answer might have been “I don’t know what’s wrong, but we’re going to keep an eye on you, since it would be incredible hubris to think that we know everything that ever was and ever will be.”

That said, to me the crux of the story is that the friend has received a diagnosis or diagnostic impression but refuses to share it. In other words, the friend is concealing at least this piece of information, and perhaps others. I don’t know if you have enough data to play “guess the diagnosis.” You might ask your friend if he wants your help in this matter. If he says yes, explain your dilemma. If he says no, you may want to express your concern, which appears to be more related to his behavior than to his vision problem.