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Doctors Lounge - Neurology Answers
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| jimbo1234
- Sun Aug 31, 2008 5:30 pm |
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Patient has a history of trigeminal neuralgia which was treated for 4 years with amytriptilin until about 3 weeks ago. Patient has COPD and been on oxygen for 2 years. Patient has been diagnosed with Psoriatic arthritis, which has gone untreated. Patient has been diagnosed with CHF for 1 year, and began treatment 2 weeks ago for this condition including lanoxin, potassium, ACE inhibitor and diuretic. Patient was taking oxycodone and prednisone for arthritis pain, but has stopped both medications. Prednisone was stopped 5 months ago and oxycodone within the last 2 weeks. Patient is taking asprin for pain and is in nursing home. Patient has recently developed pinwheel lights in eyes that are brown in color which is causing a loss of vision. Patient is also bedridden. Any suggestions as to the cause of the vision loss/pinwheels?
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| John Kenyon, CNA
- Sun Sep 07, 2008 12:05 am |
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 Hello -
The sort of lights in the field of vision as described usually are due to one of two problems: either optical migraine (scintilating scatoma) or, more serious, detached retina. Since optical migraine generally doesn't last for more than a day, and since retinal detachment usually would impair vision in one eye, I suspect a central neurological cause which could be benign or could signal some change in brain function. Opthamological exam, neurological consult and possible MRI of the brain would seem to be the appropriate next steps, in order of necessity.
Please keep us updated as to patient's progress.
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