hurt from optometry exam--question

[wendyoh]

darn it--I have been able to avoid an optometrist or opthamologist the last 18 mo.s but had to go now because of concussion and PVD from eye exercises.thankfully no retinal detachment for now and the flash lights and floaters have pretty much gone away.

so there is the thing---they had to do regular eye exam today to make sure no detachment---the last 8 years I discovered that various aspects of the exam hurt me and flare me up--I am not sure which thing is the worst but these three things seem to each hurt me--curious if any of you have had reaction to any of these and if you understand why, the mechanism, and best way to handle after the damage
it was a "necessary evil "today
and like most irritants with me I get a delayed reaction--had the exam about 4 hours ago and now I am starting to really feel messed up (eyes and neck hurt, more off balance etc)

1) shining the light in my eyes--shining the optometrist light in my eyes deeply like that makes my eyes hurt later and I suspect can cause flare up of general pain/fatigue/fog
I am more like the lupus type of sjogrens--can't handle much sun or heat and I like low lights

does anyone else have trouble with the eye doc lights in the eyes?

2) eye drop chemicals --today they did dilation, I don't know what chem it was, it wasnt fluroscein but we know flooscein a chem used at eye doc is a no go for me---I am pretty sure it contributes to increased eye and general pain and fibro type flare

3) then my neck---the little chin cup they have you put your head in--that position really hurts my cervical stenosis and makes my neck feel weaker and more out, no matter how careful I am---this makes sense to me structurally with my neck issues

but the part that baffles me more is the light in the eyes--why that is such an  irritant

I do have corneal erosion and just had another concussion--but I had this sensitivity before this last concussion

any thoughts appreciated! c
crossing fingers this will pass quickly

[Joe S.]

Tell them! Bring an advocate to your visit. This is very important. After several bad experiences, my wife comes with me to ALL medical visits. Because of my complaint and those of others to the clinic, one eye doctor was put on probation and a nurse was required at all of his patient interactions. Be brave. Tell the doctor, tell the clinic. If this does not help find a different doctor, a different clinic.

[wendyoh]

hey thanks Joe---I appreciate your advocacy

yes this whole process of going into treatment for concussion which involves seeing specialist doctor, OTs, PTs and eye doctors has been eye opening, no pun intended and getting on deeper level, again, about self care in system.

here is the dilemma--I am pretty assertive these days--learning I can be even more effective sometimes that I thought I was---but for this exam she didn't do anything wrong I don't think--I had seen a neuroptometrist before her who found alternative ways to do eye exams but when she sent me to her she said unfortunately I was probably going to have comply with the bright light and eye dilation as only way to rule out retinal detachment. As far as the putting chin in cup thing that sets off my neck--I am not sure if there is another way for them to do exam for the light test. I could try insisting and see what happens next time--hopefully won't have to be in that situation for another year or 2.

so I wasn't so much indicting the eye doctor as the bummer circumstance that I figured was unavoidable for certain medical tests when they need to rule out a serious problem.

but you got me thinking....if I absolutely refused could practitioners sometimes find another way or would they say sorry we cannot do the diagnostic test. I don't know sometimes, if its beyond my expertise and research. I have decided not to do the colonoscopy for this reason---there is no doubt that would hurt me, perhaps for a long time, and I don't plan to treat serious cancer if I get it so I do not see the benefit of putting myself thru medical torture of diagnostic exam for that---the anesthesia and the physical process would really be risky for me given my chemical sensitivity and intolerance to invasive procedures.

but hey the good news in all this so far, knock on wood, as the after effect of this eye exam yesterday will more fully unfold over a couple days--but the good news is that I think the frequency specific microcurrent treatment I have been doing was somewhat protective as I did not flare up last night nearly as bad as I did the last few times I went to eye doctors in last 8 years. I also think the lions mane mushroom has been really neuro protective for me since I started taking it in last month or so after concussion (research on it for brain health led me to it)

[Joe S.]

The last exam I had like that, the doctor held a thick lens with the lights on and had me look at the ceiling light. It took a minute or two longer but good results.

[Skylar]

wendyoh, I'm so sorry you have such problems after having your eyes examined. Did you discuss your problems with the optometrist or opthamologist before the exam? When I have problems I try to remember to let the Dr. know ahead of time so we can discuss alternatives or make a decision whether or not to have certain testing performed. For example my DH always refuses to have his eyes dilated.

I don't know about you, but when I fear something ahead of time, it does set my body up to react more strongly - I suspect most of us have that response. If you could have a few visits where you have positive experiences it could help diminish this effect. It may not be the light flashed into your eyes, but just the overall stress you feel from the visit that causes a flare.

Chin on the chin rest - OMG I hate it too, I'm in such an uncomfortable position. I've never complained and it only causes momentary discomfort for me - but if I were you, I would request that you be in a position that is comfortable - you can't be the only one, there are plenty of patients with cervical issues, there must be a way to accommodate your needs.

[wendyoh]

thanks you guys

Joe--I am curious what makes you opt out of the light in the eyes? besides it being unpleasant have you found that it has some detrimental effects that last beyond the exam? (I feel that I have but wish I understood better what the mechanism was)

and Skylar, why does your husband opt of dilation? I did work hard to get me neck into less compromised position and it did help make it less bad (yea its sort of delayed thing--doesnt necessarily hurt neck when they do it but its hypermobile so it puts it "out" more of alignment which can continue for a while)  . Re the dilation, looking at how puffy my eyelids are etc today and the bad mood etc I'm  in today I am thinking its not a chemical that is good for my body

[Skylar]

My DH is healthy - no reason not to get his eyes dilated - but he hates the after effect where sun light is irritating because the pupil can't react normally to it. It means that his Dr. doesn't see the retina quite as well as they would if the pupil is completely dilated. DH is happy driving home after his appointment, where as I'm wearing those stupid plastic tinted inserts they give you to wear when you leave the office - and I have to wait for the drugs to wear off. I had to have the Plaquenil checks for years and years so I hesitated to ask if I can' have the exam without dilation - now that I'm not taking Plaquenil, I'm going to ask if it's okay.

I also have to wonder if you're stressing your neck trying to hold it a particular way to fit into that neck rest - if you could somehow relax your neck it might not be so sore afterwards? Maybe if you had something warm and soothing like a heat pack around your neck to help it relax at the Dr's office. Maybe massage it during or afterwards?

[wendyoh]

Skylar--yes I guess I learned that I am going to take my chances in the future and not do any of the invasive procedures and if they can't do as good of an exam so be it. But they did motivate me by saying they needed to rule out retinal detachment which could mean serious complications and surgery so I compromised my well being for the short run.....I just don't think its healthy though.....we need to be living in star trek times where they can examine and assist you without causing other problems to do it imho

Yea....it has been 28 years of cervical neck issues....I have pretty much tried everything.....and have learned when avoidance the only safe option. Ie I cannot ever go to get my hair washed at salon.....I can actually rarely wash it myself because the motion can stretch neck out too far even if I am careful as a ninja (plus warm water also seems to be trigger for AI but that is another story)
But i have pretty significant cervical stenosis with bulging discs but then also was significantly injured by chiropractic years ago and it stretched it out to much so given the narrow constriction that i can only move neck within without irritating the way the structure is in there coupled with it even getting stretched a tad too much in an extension or flexion position seems to tweak it in a way to set off neurological kickback of pain, numbness sometimes in neck or extremities, brain fog, instability in neck etc I usually just have to wait it out....one time after getting a tooth pulled and the surgeon bent head back too far caused me to have about 6 months of worse symptoms.  So I have gotten pretty hypervigilant about what I will expose self to....and just reconfirmed eye doctor chin thingey is no go.

the first optometrist I saw who is a neuro one who does vision therapy she was able to do refraction test and determine if I need glasses and she did do it in a way that didndt hurt me, she did the light sort of like Joe described from more of  a distance and she didnt make me use the chin rest, she said it just takes longer---I am always going to go to her for checkups. And will probably do vision therapy with her for concussion once my eyes recover from the new pain the dilation and light caused this week. She sent me to the other opto this week though for more thorough exam to rule out retinal detachment and said they would probably want to do those invasive procedures. I am realizing given that I am in early recovery still from last concussion it probably set me back 3 weeks ......I guess I just didnt know what to say when they said they "had" to do it that way.....maybe they did. Maybe in future I will just wait and see what happens, if you have retinal detachment you will probably know sooner than later although I guess they can see signs before it is obvious. In 5 weeks I will be in the clear if it doesnt get worse, I guess there is a risk phase.

[irish]

I am looking at your complaints from a different aspect. It is very possible that your central nervous system is hyperactive and causes you to react more to these particular stimuli. It would be good to talk with your eye doctor and ask if there is a sedative that you could take prior to eye exam. This would make your CNS less hyper and these symptoms would most likely be less.
These responses might be included in a neuropathy.

I am one of those people who does little if any reaction to the dilating drug. I have to remind myself to put on sun glasses to protect my eyes. The other end of the spectrum I guess. Good luck. Irish

[wendyoh]

Irish--thanks--I wish I had your constitution!