Ocular disturbance after decompression diving, that is now my norm even though I’ve had 15yrs of tech diving, interested to hear from Medics.

[Bigbella]

That visual issue could also be migrainous in origin -- what is commonly referred to as scotoma or "scintillating" scotoma, which affects the vision of one or both eyes with shimmering image or temporary dark spots, often in the periphery, the so-called "aura."

I have suffered from the headaches since I was a teenager -- frequently while diving, recreational or otherwise; but often that aura effect (which affects about a third of migraine patients) is, thankfully, separate from the headaches themselves, and just a brief nuisance . . .

 

[LI-er]

That visual issue could also be migrainous in origin -- what is commonly referred to as scotoma or "scintillating" scotoma,

Nope. The presented symptoms do not support that diagnosis.

 

[Alex Ouroboros]

Did you have to perform a valsalva during the pfo testing Alex and who did the testing?

I'm UK bases and had completed a lot of dives before mine showed up.

Even if you were at rest during and after deco a valsalva or similar could push through a small hole.

My worst symptoms were very mild, ocular disturbances but I was asymptomatic on arrival at the pot.

Have you had any skin bends.

The PFO test I did I’ve described in an earlier reply and I can’t really add to that, never had any kind of skin bend, the only thing that does keep strangely repeating itself in all my deco cases is that sometimes my right knee feels like it’s popping a little inside, usually the sort of feeling you’d get if you were in a trilam drysuit and very thin undersuit and hand a crease or fold in it, just slight and it is always gone before I leave the water.

 

[JonG1]

Alex have you ever been Dopplered post dive or tried an O Dive, can be informative of how good your deco was.

Also what is your current preferred GFs and what ascent rates do you use from bottom to 1st, between stops and last stop to surface?

 

[Alex Ouroboros]

Alex have you ever been Dopplered post dive or tried an O Dive, can be informative of how good your deco was.

Also what is your current preferred GFs and what ascent rates do you use from bottom to 1st, between stops and last stop to surface?

Never had a Doppler test, but I agree the findings would be very interesting. and GF’s just on 30/70, ascent rate 18m/min up to 12-15m and then I just do the ascent dead slow (where’s the rush?) I tried others (GF) but thought I’d have it on the tame setting after the Irish incident,
Bizarrely I used to do deep stops and used to feel brand new doing them,,, I may re introduce them on my next deco dive and see if it makes a difference.
“O dive” I’ve just had to Google to see what it is, that does look interesting I admit, so may do a bit of homework on that!

 

[Alex Ouroboros]

Never had a Doppler test, but I agree the findings would be very interesting. and GF’s just on 30/70, ascent rate 18m/min I tried others (GF) but thought I’d have it on the tame setting after the Irish incident,
Bizarrely I used to do deep stops and used to feel brand new doing them,,, I may re introduce them on my next deco dive and see if it makes a difference.

Don't know what caused the vision problems but I can tell you one thing for sure, there's no way a buddy can look at your eyes and "tell you they're fine". There's a lot of stuff that goes on inside the eyeball and an untrained professional without an ophthalmoscope isn't going to be able to discern much of anything.

The fact that you can focus either eye independently but the problem occurs with both eyes open leads to a strong possibility that you're having problems with your binocular vision, more specifically there is probably difficulty converging the eyes, in other words the effort that it takes to maintain clear, single binocular vision is so great that the eyes are probably over focusing and driving excess convergence which causes the blur.

Next time it happens try looking at something far away, alternating covering each eye and then with both open. Then do it looking at an object at about arm's length. I'm going to wager a guess that your vision problem is worse close up. You can also do a "pen to nose" test where you slowly move a pointy object to your nose and see how close you can get without it becoming 2 images. Do this test under normal conditions and see if there's a noticable difference.

If so that means something is effecting the innervation to the medial rectus extraocular eye muscles and it could be a sinus pressure sort of thing but that's just one possibility of several, another is a momentary period of low blood circulation to the muscle which is a very mild version of sort of what happens to stroke victims who suddenly see double and one eye is pointed in the wrong direction. These poor folks usually need prism in their glasses, at least short term, sometimes forever if the problem doesn't resolve within 6 months it's probably never going to.

Obviously there is no way to say for sure without more tests being done at that particular moment. You could also check for subtle damage to an extra ocular muscle by doing a "pen rotation" where you view a sharp pointed object and rotate it in a large circle and see if there is a particular field of gaze where it breaks into 2 images. This test, and those above would be done by a competent vision care professional when you get yourself checked.

Definitely taking all points on board and will try the “homework”

As for asking my buddy to look in my eyes that’s to do with my first bend the neurological, apparently when I was sat on the assessment bed for the original dive Dr he came strolling up, asked a couple of questions then immediately exclaimed get him in the pot, my eyes were doing a mixture of bouncing and rolling and were not in any form of synchronisation. And I think I sort of look back and think how did anyone not notice?.

 

[LI-er]

my eyes were doing a mixture of bouncing and rolling and were not in any form of synchronisation.

Ok well that's nystagmus or saccadic rapid eye movements secondary to a neurological issue, but another person would see it by looking AT your eyes not IN them.

They were most likely synchronized, it's extremely unlikely that each eyeball was moving in it's own random direction.

 

[Alex Ouroboros]

Ok well that's nystagmus or saccadic rapid eye movements secondary to a neurological issue, but another person would see it by looking AT your eyes not IN them.

They were most likely synchronized, it's extremely unlikely that each eyeball was moving in it's own random direction.

Well yes although you must understand that at that point I wasn’t really in the real world in any other way than my body sat there, my memory of that whole event is more or less non existent, so I go by witnesses that told me my state at the time,,, I dare say I wasn’t well…
I know I was rushed in to the pot, and immediately pressurised to 30m on an emergency comex table not your standard table 6, I then fell asleep until they took me out, I then slept until they put me back in and within minutes I was asleep again, this went on for a few days by which point I could walk with a stick, although very wobbly, I was hopelessly exhausted because of it for a few weeks afterwards.

Don’t try it that’s for sure, I’ve spent a few days in nicer places whilst taking time off work…

 

[JonG1]

Pretty sure 30/70 would be regarded as a deep stop profile these days, something like 50/75 or 50/70 us more in vogue now plus a very slow last 10m where you are halving the atmospheric pressure, mostly 1m a minute although painfully slow is again pretty popular.