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Eye and Vision Care

Have 20/20 Vision but Still Problem Focusing

06/04/2009

Question:

At the beginning of March, I began to notice vision problems that would last all day, every day. It began to get worse and I went to see an optometrist. I could see and my vision was not blurry, but it was rather that I could not seem to fully focus on anything. Much like how your vision might be after a beer or two. The optometrist ran the full gambit of tests and found nothing wrong. I had blood work done that came back okay for everything. When I had a CT scan done, a bilateral sinus infection was found and I went to an ENT for specific care. Upon getting a 2nd CT, the infection was found to be gone (after antibiotics) but my vision had only slightly improved. I began to develop dark circles and bags under my eyes, and was instructed by my ENT to see an Opthalmologist this time. Upon seeing her, I again received the diagnosis of nothing wrong. However, I am still experiencing problems focusing even with my "20/20" vision. I also experience some pressure in my eyes even though the opthalmologist said my eye pressure was fine. I honestly don`t think she believed me. What else could be causing this that four doctors have all shrugged their shoulders at? Please help!! Thank you.

Answer:

Wow, this is a mystery to me too! It sounds like you have had excellent optometry, ophthalmology, and ENT care recently, so all of the really bad possibilities have been eliminated. But focusing problems in a 20/20 eye are usually due to either: 

(1) ocular surface diseases (keratitis, allergic conjunctivitis, dry eyes, viral infections, etc.) or 
(2) accommodative (i.e., variable focusing) problems inside your eye caused by aging, systemic medications, minor changes in refractive status, etc.). 

Since this is the allergy season in Ohio, and you have experienced a recent bilateral sinus infection (the sinus cavity is directly behind your eyes) as well as dark circles and bags under your eyes, perhaps a board-certified allergist could help you identify the underlying cause of your symptoms.     

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Response by:

Robert D Newcomb, OD, MPH, FAAO Robert D Newcomb, OD, MPH, FAAO
Professor Emeritus of Clinical Optometry
College of Optometry
The Ohio State University