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VisualDude

Ghosting - Question about Medications

14 posts in this topic

The double-vision / ghosting which I get is by far my most annoying symptom. It is vertical ghosting. If I go close enough to the object/light source it will disappear, but I have to go really close for this to happen, and so when I am reading text of a computer screen I constantly see double. I can manipulate it by squinting - the more I squint the more prominent it becomes. Under certain conditions / if I squint enough I will see triple.

I am new to all this so I haven't tried any medications, as of yet. Someone over at the VS forum reported an improvement with diazepam: http://thosewithvisualsnow.yuku.com/topic/7123/diazepam-and-other-benzo-s#.TzlSRbRA1UM - however, I think the I don't think this is a viable long-term solution.

I have attached a couple of examples of what I see.

post-904-0-64162800-1329156560_thumb.jpg

post-904-0-65095200-1329156589_thumb.jpg

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Thanks for the pictures. For me, there are multiple overlapping images in one eye. The other is not so bad as to notice unless looking for the problem.

The 'blur' version is illustrated in this picture from a member on DPSelfHelp.com.

dpmoon.jpg

The effects I get with the good eye are about as severe as the 2nd moon. The bad eye is more like the third moon. When initially looking at the moon, I see the first (normal) moon. But in the course of a few seconds these blurs develop - each pattern unique to each eye. The patterns match the 'multiple overlaping images' as well - so obviously related.

A few times this has cleared up briefly - along with derealization. The first time was trying Keppra. The second was extreme heat with hydrocodone.

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I can't say I can notice any difference in either eye - seems to be about the same. The moon looks normal to me first as well, before this ghosting develops. Only for a split second, though. At times I have also seen a rainbow contained within a halo when looking at the moon, similar, but not quite as prominent, to this:

PA192767m.jpg

Not relevant I know, but I have added it in case it is of interest.

Is your derealisation linked to your ghosting? I.e. do they only clear up together, and not seperately? I do not suffer from DR/DP.

What was the experience with Keppra? Did the ghosting return whilst you were still taking Keppra, or did it return once you stopped?

As it happens, I took some codeine (Wiki tells me it is what hydrocodone can be derived from) this evening which was contained in a migraine pill (16mg) - didn't do anything for the migraine or visuals. Since this was an over-the-counter med I'm guessing that is an insignificant dose.

This user over at the VS forum reported an improvement on double-vision based upon Coq10: http://thosewithvisu....com/topic/6319 - I don't know what type of double-vision he experienced and whether it was similar to our ghosting. Irrespective, upon further research, I also discovered that he had been taking statins which reduce CoQ10 and can have the side effect of double-vision, and that when he stopped taking statins his double vision resolved.

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Ghosting was the last visual symptom i developed before DP...I only have floaters out of my left eye...sometimes i feel like my brain has a hard time assimilating what both my eyes are seeing and connecting them into one image, but i only notice it rarely, such as scrolling through my ipod at night, the little musical note begins to form into two, almost as if i were going cross eyed (dont know if i am) and one eye was starting to shift right and the other one stayed...

My ghosting isnt too bad, if i squint it becomes more prominent, better with glasses than without.

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I have also seen a rainbow contained within a halo when looking at the moon

I found that the rainbow and the halo (as shown above) were due to an 'oily' film on the surface of the eye. The only things I've found helpful are a topical antihistamine called Patinol (which works for a few days) and dopamine agonists.

Is your derealisation linked to your ghosting? I.e. do they only clear up together, and not seperately?

They may be linked. My DR is mild compared to many who suffer it.

What was the experience with Keppra? Did the ghosting return whilst you were still taking Keppra, or did it return once you stopped?

Keppra improved DR for a while about an hour after taking it. My work with Keppra has been difficult. It seems only to work when combined with Gabapentin - but it is still being evaluated.

This user over at the VS forum reported an improvement on double-vision based upon Coq10...

Interesting info. People with Parkinson's are big about taking a lot of CoQ10, based on some research. In general it is great stuff. Hadn't heard of it helping vision though.

almost as if i were going cross eyed (dont know if i am) and one eye was starting to shift right and the other one stayed...

You might actually have some mild 'binocular conversion' problems.

I notice that if I gently touch the side of the eyeball in the right spot, the amount of ghosting greatly reduces. Currently am trying to confirm if this particular symptom is caused by a dysregulation of eye tremor. Basically, eyes vibrate about 130 Hz very slightly (about the diameter of a photoreceptor). This vibration is either to help photoreceptor chemicals to regenerate or because signal from receptors to the brain (through the optic nerve) are mainly "phasic" (trigger by change).

If this vibration is of much greater amplitude than it should be, then ghosting would be a probable symptom. Since touching the eyeball can still/quite this vibration (and other involuntary eye movements such as drifting), then perhaps this is the reason it reduces multiple images for me. Of course, it is impractical to walk around with one's finger poked in their eye.

Again, this kind of stuff reinforces that for some, there is a link between HPPD and reduced dopamine function (which is necessary for cognition and motor control)

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Finally found what the eye tremor is called -- Ocular microtremor (OMT)

And they have instruments to measure it. Mainly to determine if a person is really brain dead. Also, in theory, to monitor anesthesia. And it changes with Multiple Sclerosis and (you guessed it) Parkinson's disease.

http://en.wikipedia....i/Ocular_tremor

http://arrow.dit.ie/cieocon2/7/

http://www.ncbi.nlm....pubmed/19256709

http://jnnp.bmj.com/.../66/4/528.short

I doubt I'll find someone who is able to measure it and see it is causing ghosting - but will try.

It could theoretically improve with anti-seizure type meds and other calming meds (perhaps the experience with Keppra). It could theoretically improve with Sinemet but has not for me. The hunt goes on ...

So again, the focus (pun intended) of this thread - Anyone have experiences with meds affecting ghosting?

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Visual,

As I have probably mentioned before at some point. I can certainly relate to the double vision/ghosting vision. I guess i'm about 5 months in on Keppra and it hasn't really helped me with ghosting.

I can say that some of the ghosting is due to my astigmatism. It's much worse in my right eye- the moon in the third picture is what my right eye sees while the left eye sees the middle one. If i squint really hard then the ghosting goes away slightly. Glasses sometimes help and sometimes don't.

Also, can second the "oily film" over the eye worsening halos. In the morning my eyes are always more "moist" i guess and lights always have bigger halos and streaks.

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Lugwig, thanks for the info. Another question:

Since you know you have an astigmatism, the question is - did it get significantly worse with HPPD?

Since astigmatism is a physical charactoristic of the lens, then it should remain unchanged with HPPD. Another posibility is that the lens is not being pulled evenly by the muscles that control it (don't know if this is just a theory or an actual thing that can happen ... but, just as the back muscles (trapezius and latissimus dorsi) are controled fibre by fibre (not as a whole) this could happen with the len)

back-muscle-exercises.jpgThe%20ciliary%20muscle%20and%20lens%20(posterior%20view).jpg

It seems significant that in my case that the bad eye (with most ghosting) is also the one with sluggish dialation. This dilation problem resolves by increasing Gabapentin. When dilation is particularly notable (as in the picture below), so is an abstract anxiety that is bad enough to curl one in a ball (which also resolves by increasing Gabapentin). However, the ghosting is not affected by Gabapentin. If I see dilation in the mirror, then I increase Gabapentin (if not then suffering will follow) - so this is my 'canary'.

800px-Anizokoria.JPG

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You have some interesting theories Visual.

One thing I thought of is that maybe everyone has a slight astigmatism, but the brain usually filters it out. In our case, it is not. So maybe it's not actually the astigmatism which is changing with HPPD, but rather our ability to filter it out.

I had an eye doctor dilate my pupils a couple of months back - and during this time the ghosting certainly changed - but it was hard to establish how because I could hardly see when trying to focus on something, and it was also during the day when I don't notice the ghosting as much. But it seemed as though the ghost image became more prominent in that it looked less ghosty and more solid, but at the same time less prominent in that it seemed much closer to the original image, pretty much right on top of it. Maybe the ghosting disappeared, and it was just general blurriness that anyone would see when their pupils were dilated. It's hard to say really. At the same time, my halos increased significantly.

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I've always noticed that as soon as they put numbing drops in my eyes, vision improves.

Ghoasting is least outdoors in bright light (small pupils) and worse in dim light - especially strong contrast such as looking at a LED clock across the room.

It is so hard to know for sure what is going on. Certainly, touching my eyeball could be shifting the shape (even though gently) or encouraging subtle peripheral signals. Given that non-HPPD people can create mild CEVs by touching their eyes, it is possible that HPPDers who have psychedelic symptoms (like CEVs) have overactive or dysregulated neuronal systems [ overly 'creative' as it were ].

At any rate, questions like these can best be analysed by lots of user feedback...

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I have been searching for some lesser-known causes of ghosting.

Someone reported similar visual disturbances for 15 years before they discovered they cause of their problem - a sinus infection.

http://www.healthboa...n-ghosting.html

Other less common causes of similar symptoms include keratoconus and sixth nerve palsy.

I'm not saying we have any of these things - they seem unlikely for a number of reasons - but it's good to keep an open mind.

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Opiates are the only thing i've found that totally alleviate ghosting for me and it's because of their effect on pupil size. The constriction really reduces the amount of light entering your eyes.

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