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Ophthalmology & Optometry/Sudden brief blurring of vision

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Question
Dear Doctor,

I was taking a nap today and when I got up, I realized that my right eye is blurry. I washed my eye several times but it persisted. When I wore my glasses I still could see only blurred with my right eye. When I blinked, it seemed like there was a thin film on my eye blocking my vision. I was really scared and I rushed to the ER, where I could immediately meet an Eye surgeon fortunately. He checked my eyes and took a vision test making me read alphabets on the board etc. He concluded that there has been a very small change in my right eye vision. By then the blurriness had reduced significantly but it was still there. He also used some instrument to look inside the eye that shone bright light in the eye. He said there was nothing wrong that he can see, probably an infection and gave me Xinep and Lotepred eye drops. I used them once and vision seems to be much better than before.

What I wish to know is how did this happen within a gap of 1 hour and what can I do to avoid it. Additionally, I am taking muscle relaxants for a TMJ issue since yesterday so is it related? Finally, I have started taking Cod Liver oil supplement since 2 days (1 capsule in a day) as I was diagnosed with VIT D deficiency. Is it possible that its overdose of VIT A which is also present in the cod liver oil capsules.

I am basically very very panicked with the whole episode and would appreciate an answer.

Answer
Lily,
It is difficult to say exactly where the blur came from, but what you're describing isn't terribly unusual.  The most common source of this temporary blurred vision, especially after sleep, is ocular surface issues.  While we're asleep we don't blink our eyes, so no oil is released into the tear film.  If the eye get's too dry/irritated/etc (from too low oil), the surface of the cornea can have some slight swelling on it.  Many people get this frequently in the morning.  A few hours, and putting some drops in lubricate the surface and the swelling normally goes away.
There are other things it can be, so if it returns please make an appointment with your eye doctor.
Good Luck!
Dr.D

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John M. Dovie, OD, FAAO

Expertise

As a residency-trained Fellow of the American Academy of Optometry I am able to answer most questions regarding eye and vision health. Anything is welcome, ranging from dry or allergy eyes, bifocal contact lenses, or thoughts on LASIK surgery. As I am not a surgeon, detail-oriented surgical-related questions may be better answered by an ophthalmologist.

Experience

Selected to participate in the PCO residency program in Philadelphia at The Eye Institute, where I worked OD and MD specialists gaining invaluable experience in various clinics including glaucoma, cornea and cataract, oculo-plastics, retinal disease, neuro-ophthalmic disease, primary care, emergency medicine, and special populations. Have practiced and trained in numerous settings including hospital, academic, retail and private practice. I earned my Fellowship in the American Academy of Optometry (FAAO). There are currently only about 3000 active fellows worldwide, and there are only about 70 Fellows in the state of Virginia. I currently own and operate my own optometric practice/clinic.

Organizations
American Academy of Optometry, American Optometric Association (Contact Lens/Cornea Section member since 2001), Southwest Virginia Optometric Association, Virginia Tech Alumni Association

Publications
Seminars/Presentations:
“Nyctalopia as the Presenting Sign of Vitamin A Deficiency: A Late Complication of Gastric Bypass Surgery.” Clinical Case Study Poster presented at The American Academy of Optometry Denver, Colorado, December 2006, co-authored with Bradley Lane, OD.
“The Importance of Considering Paranasal Sinus Mucocele as a Differential Diagnosis in Diplopia.” Clinical Case Study Poster presented at The American Academy of Optometry San Diego, California, December 2005, co-authored with Kelly Malloy, OD, FAAO and Cherie Farkash, OD.
“Acute Onset of Halos and Glare: Bilateral Keratitis—An Atypical Presentation of Amiodarone Keratopathy.” Clinical Case Study Poster presented at The American Academy of Optometry Tampa, Florida December 2004. Also Presented to New Jersey Academy of Optometry, Neptune, New Jersey March 2005.
“The Opportunity for an Optometrist to Save a Life.” Clinical Case Study and Grand Rounds Presentation presented at The Pennsylvania College of Optometry, Philadelphia, Pennsylvania, September 2004.
Publications:
“Corneal whorls cause wonder.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 10/15/2006.
“Acute onset of halos and glare: bilateral corneal epithelial edema with cystic eruptions--atypical presentation of amiodarone keratopathy.” Co-authored with Andrew Gurwood, OD, FAAO. Published February, 2006, Optometry.
“Pondering the posterior polka-dots.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 5/15/2005.
Professional Involvement:
“AION: Amiodarone-Induced or Anterior Ischemic Optic Neuropathy?” Participated as a peer-review referee for Expert Review of Ophthalmology (London, UK); refereed 10/2006.

Education/Credentials
Bachelor of Science, Cum Laude, Virginia Tech. Bachelor of Science, Pennsylvania College of Optometry. Doctorate (OD), Pennsylvania College of Optometry Residency, Pennsylvania College of Optometry Fellow of the American Academy of Optometry

Awards and Honors
Winner, First Place, "Best Beside Manner" by Our Health Magazine: 2012, 2013, 2014 Winner, First Place, "Best Eye Doctor" by The Roanoke Times: 2013, 2014 Recognized as a Fellow of the American Academy of Optometry, December, 2006 Recipient of the Onofrey G. Rybachok Memorial Scholarship, 2000-2001 Member: The Golden Key International Honor Society Member: The National Biological Honor Society Member: The National Honor Society Eagle Scout awarded 1994

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