The eyes have it.

30 responses total.

I had an opthamological exam last week, both to get a revised prescription
and for general checkup. I suppose there is a recommended interval for
this, but I hadn't been for 11 years. My eyes are OK, and my prescription
has hardly changed, but the doctor observed small dot-like scars around
the periphery of the retina. He said that practically everyone that has
lived in the midwest for some time has these, and they are due to
*histoplasmosis* - a fungal disease usually of the lungs, but apparently
also occurring sytemically. 

See, that's why I hate going to the doctor's now.  Every time I go, they
actually find something disturbing.  

Sorry to hear that Rane.  I get my eyes checked by someone I think is good
at the U of M every two years and he never said I had histoplasmosis.  I have
only lived in the midwest for twenty years.  

Apparently it causes no problem if peripheral, but sometimes the infection
point occurs more centrally, when it can cause bleeding. If anyone has an
opthamological exam coming up, would they ask the doctor (if she/he
doesn't say) whether they have such retinal scars? There is another
connection by which I might have gotten a mild case of histoplasmosis,
which is that I am a caver. The virulent lung form is well known from
tropical caves, but in the US the usual cause of histoplamosis is from
fungi in bird droppings in the southern states. 

I have histoplasmosis, contracted in 1973 when I was cultimulching the fields
on the family farm.  I had 12 hours of an intensely high fever, followed by
almost immediately being well again (although one tends to be a little worn
out from that kind of fever).  When I got a TB test about three years
later, it was "inconclusive".  A chest x-ray was ordered, which showed a
large area of scarring on my left lung.  Further tests for TB ruled that
out.  They then tested for histoplasmosis, and *bingo*.  

But, I've had several eye exams since then and no one has said anything
about scars about the retina.  I'll have to ask about that next time.  And
yes, histo is systemic and with you for the rest of your life, although it
rarely flairs up after the first time.  I've even asked about giving blood
since I know I have it, but the blood was accepted.
 

I searched the web and came up with the term "ocular histoplasmosis". There
are citations to references on it, but I could not find a simple description
of symptoms and treatments. One page said that the lung infection conveys
immunity, but there is a form that invades white blood cells, which is
systemic and does not confer immunity. That must be the one. 

There is information about histoplasmosis from the American Lung Assoc. at
http://ovchin.uc.edu/cgi-bin/mfs/01/ala/HISTO.html?19#mfs
but this does not mention ocular histo (though it does mention "disseminated
histo", which can be very serious). Onward with eyes..

This item has been linked from Health 36 to Intro 111.
Type "join health" at the Ok: prompt for discussion of
eyes, ears, noses, throats, and other body parts.

Other than fever, what are the symptoms of histoplasmosis of the lungs?

You probably read response #4, John.  Other than that, I've had no problems
with it.  Every few years I get a chest x-ray to make sure the lesion hasn't
changed in any way, but other than that, it just sits in my bloodstream, I
guess.

My father had histoplasmosis, for which one lung was removed almost 40
years ago; I was seven years old & not very inquisitive so I don't know
much about it beyond that.  He spent 6 weeks in the TB sanitarium and we
all had to have chest X-rays.

Re #8: you can find a good description by searching for histoplasmosis on
the web, but presuming you are webless (and lynxless), here is a brief
description of symptoms from the Merck Manual:

"Of the 3 recognized forms of disease, the 1st is _primary acute_ with
symptoms (fever, cough, malaise) not distinguishable in endemic areas (except
by culture) from otherwise undifferentiated URI or grippe-like disease. In
a relatively small number of infections, disease disseminates hematogenously
fromthe lungs, and the _progressive disseminated_ form results, characterized
by hepatomegaly, lymphadenopathy, splenomegaly, and less frequently oral or
GI ulceration. A still less frequent by extremely serious manifestation is
Addison's disease. The _3rd form_ is _chronic cavitary_ with pumonary lesions,
indistinguishable (without culture) from cavitary tuberculous disease. The
principal manifestations of this form are cough, increasing dypsnea, and
eventually disabling respitory embarrassment."

"respitory embarrassment" indeed. That's a description of drowning too, isn't
it?

Probably.  I have asthma now, and that *feels* like drowning soemtimes.

Last Wednesday evening I had the sudden appearance of "spots" (known
as "floaters") in my left eye, along with white flashes. This resolved
by Friday into a speckly circular ring just in from the periphery of
vision. I went to the opthamologist on Friday. I asked him what caused
this, and he said "age". Apparently it is caused by the vitreous humour
in the eye contracting and pulling away from its attachment lines just
behind the iris and around the point at which the optic nerve enters. It
happens usually between the ages of 40 and 80, and is very common. So,
how common is it? Anyone else here have this symptom appear? The doc said
the floaters and flashes will fade with time as the process completes,
and not otherwise affect vision, although there is some danger of the
process detaching the retina instead of separating from the retina. This
symptom is described in the Merck Manual, but not in their "Home" edition.

I have been under the care of an Opthomolgist for about a year for
deterioration in the vitreous humor in both eyes.  I became aware of it at
night seeing flashin lights if I turned my head suddenly.  The physician I
see said the only concern would be if my retina suddenly detached along with
the tugging from the vitreous masses.  Then, he said, I would have a sudden
dark spot in the periphery of my vision. Immediate surgery to reattach the
retina would be necessary to preserve my vision.  Actually, if I recall
correctly, its probably more like two years now.  I still have the flashing
lights at night, but I am less concerned about them.  The floaters are still
there but I only become aware of them when I am reading.  Now that I know what
it is caused by, I don't pay much mind to the symptoms.  I am checked every
six months at the U of M to make sure nothing else is going wrong.

Do you have any idea of how frequently that the process leads to retina
detachment? I would think if it were epidemic it would be more commonly
described and discussed. They want me back in six weeks this time, but
it might settle down to six month checkups - like the dentist. Too bad
the exam can't be combined with the dental prophylaxis, while you are lying
in a dental-optical chair...

Sorry, I didn't ask the statistical question.  But I am on six month call back
with the admonition and confidence that I would rush right in if I had
symptoms.  I dont think the problem is anywhere near epidemic proportions
since I had never heard of it before.  You are the only other person I know
who has it.  Ain't getting older wonderful???  At least I have most of my own
teeth, speaking of dental checkups.  I do those three times a year so my teeth
get professionally cleaned that often.  I wish I could do all my physicals
at the same time.  I could even have my yearly gynecological exam at the same
time.  What an image.

Do you mean to say you want to have your teeth cleaned during your yearly
gynecological exam?  Would it be interesting to have an item on getting older,
or are there too few of us?  I can think of at least one advantage, I never
seem to get the common cold any more, must be immune to all the common
variants of it.  Ripped tendons are more common as you age, I ripped one last
year and it has not healed yet, over 12 months.

The speckly circle has mostly disappeared, but in the right illumination
I can see a slightly muddy puddle in the center of my vision. These seems
to slosh around if I move the eyeball suddenly. However a new phenomena
has appeared - very small sharp black dots near the periphery of vision.
Rather hard to keep them in view. 

A gerontological cf? I don't know if many would want to *dwell* upon
the phenomena. I find particular medical phenomena intersting, whether
they are age related or of other origin (like my optical histoplasmosis
spots). 

I also very seldom get colds, except for very severe one's that someone
else in the family brings home. Ripped tendons? I did that when I was
ca. 41 - Highland Dancing. Ended my dancing career. 

An item here in Health about aging would be appropriate.

My mother's retinas detached, when she was 53.  She was legally blind in 
one eye for a while, in consequence.
I must not be old enough, I catch entirely too many colds.  Too little sleep,
and school-age children in close association, I expect.  (Though my
husband seems to bring home more germs than they do, judging by symptoms)

I have started a new item on health and age.

rane, if you look closely at graph paper, do the lines appear to be uniformly
spaced?  I had a similar problem and the graph paper appeared to have a
3-dimensional wave in it.  (Sort of a bowl, actually).  It turned out that
I had a phenomona which translated meant "vail over the retina".  I can not
remember the medical term.  The eye Dr. said I had two choices.  (1) operate
- this is an in-the office & walk out procedure, but not recommended, and (2)
wait it out.  the way he explained it, the problem would always be there, but
your brain would figure out new pathways to see around the problem.  

I opted for #2 and have no perception of the problem now.  My left eye was
affected and I don't think it is as sharp as the right, and it appears to see
colors somewhat less bright.

The doctor showed me a piece of graph-like paper - a square perhaps six
inches square ruled both ways with parallel lines about 1/8 inch apart.
I said it looked like what I just said... 

My symptoms have changed. The speckly ring has disappeared except for
a blotch that had been within it at about 10 oclock. I have now for the
first time noticed a similar blotch in my other eye (which never developed
the ring). There is also a very small, very sharp, black dot, which seems
to wander slowly over the field of vision. I recall once hearing that that
is a single blood corpuscle. The funny thing about the remaining blotch is
that it disappears when I hold my eye still. I wonder if it is directly over
the "blind spot" where the optic nerve enters the retina, but moves off
that location when I move my eye. 

Could the dissapearance/reappearance be due to parallax effects within the
eye?

How would that work? This is just with one eye. I can see the pattern
of what I am looking toward all around the patch that disappears. That
area just takes on the background pattern. It is a little vague as I
am not looking directly at it, but the disappearance is quite noticeable.
I shall have to bring a card with me with a dot on it to see if it
disappears at the same location.

I think everyone has that happen.  If you have a clean white card and put a
small x and a dot about 3" apart, stare at the x and bring the card slowly
toward you. If the dot does not disappear, repeat, looking at the dot and the
x will disappear somewhere around a foot from your eye.  

I just tried it.  With the spots 2" apart, I stared at the right dot with my
left eye.  The x (on the left) disappears at about 8" from my eye.

Yes, the speckly smudge I see is coincident with the blind spot when my
eye is still, but moves away from it when I move my eye. I think the
speckly smudge may be on the back of the vitreous humour, which is now
loose(r), and can shift.

Hmm...  I would be worried that the speckly smudge is associated with the
gathering of nerve fibers where the optic nerve meets the retina.  I have not
read carefully all the prior notes, but I assume you have been checked by a
medical retina specialist, such as at the Eye clinic at Reichert (St. Joe's)?

I also think that if you move your eye, it would give the perception of both
the blind spot and the specly smudge moving, because the back of your eye
shifts. 

But they don't move together! The blind spot has not rods or cones so
is truly blind (the rods and cones in the eye point *outward*, and the
optic nerves run across the retina and then turn into it - hence there
can be no rods or cones where the optic nerve enters the retina). The
blind spot moves too with respect to the view, but is fixed with respect
to the eye. [Yes, I am seeing an opthamologist - except of course when
he moves into my blind spot ;)]

Good one!

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