NANOSNET

Has the patient been dilated and examined by an ophthalmologist.  Sounds like bilateral, progressive, inferior vitreous detachments.

------------------------------
August L. Reader III, MD, FACS
Ophthalmic Legal Consulting
Tiburon, California 94920-1056
------------------------------

Original Message:
Sent: 11-04-2025 16:51
From: anthony fok
Subject: visual disturbance in superior field od and os

Anyone seen this? 

Superior visual snow? 

I have a 21yo male farmer with 2 years of constant superior visual disturbance initially intermittent now constant. Describes it as a waviness in both eyes. The waviness moves and drifts. 

Came on after waking. 

No headaches at the time. Not a headache sufferer. 

Has had a hx of migraine but not significant. 

Formal visual fields and OCT RNFL , macula and GCL are normal.

MRI brain and orbits normal

EEG normal

Had VEP, mfERG and all normal

Tried pizotifen, endep, sumitriptan, topirimate, magnesium, riboflavin, 

Then tried ajovy one injection and had numbness on left side and mgiraines but made no difference to superior field disturbance. 

 This is a schematic of what he sees in his vision binocularly. 

Regards

Dr Anthony Fok

Neurologist/Neuro-ophthalmologist

Original Message:
Sent: 11/4/2025 4:57:00 PM
From: August Reader
Subject: RE: visual disturbance in superior field od and os

Has the patient been dilated and examined by an ophthalmologist.  Sounds like bilateral, progressive, inferior vitreous detachments.

------------------------------
August L. Reader III, MD, FACS
Ophthalmic Legal Consulting
Tiburon, California 94920-1056
------------------------------

Original Message:
Sent: 11-04-2025 16:51
From: anthony fok
Subject: visual disturbance in superior field od and os

Anyone seen this? 

Superior visual snow? 

I have a 21yo male farmer with 2 years of constant superior visual disturbance initially intermittent now constant. Describes it as a waviness in both eyes. The waviness moves and drifts. 

Came on after waking. 

No headaches at the time. Not a headache sufferer. 

Has had a hx of migraine but not significant. 

Formal visual fields and OCT RNFL , macula and GCL are normal.

MRI brain and orbits normal

EEG normal

Had VEP, mfERG and all normal

Tried pizotifen, endep, sumitriptan, topirimate, magnesium, riboflavin, 

Then tried ajovy one injection and had numbness on left side and mgiraines but made no difference to superior field disturbance. 

 This is a schematic of what he sees in his vision binocularly. 

Regards

Dr Anthony Fok

Neurologist/Neuro-ophthalmologist

deleted (wrong thread)

Original Message:
Sent: 11/4/2025 4:52:00 PM
From: anthony fok
Subject: visual disturbance in superior field od and os

Anyone seen this? 

Superior visual snow? 

I have a 21yo male farmer with 2 years of constant superior visual disturbance initially intermittent now constant. Describes it as a waviness in both eyes. The waviness moves and drifts. 

Came on after waking. 

No headaches at the time. Not a headache sufferer. 

Has had a hx of migraine but not significant. 

Formal visual fields and OCT RNFL , macula and GCL are normal.

MRI brain and orbits normal

EEG normal

Had VEP, mfERG and all normal

Tried pizotifen, endep, sumitriptan, topirimate, magnesium, riboflavin, 

Then tried ajovy one injection and had numbness on left side and mgiraines but made no difference to superior field disturbance. 

 This is a schematic of what he sees in his vision binocularly. 

Regards

Dr Anthony Fok

Neurologist/Neuro-ophthalmologist

Thanks for this. Will look into this ?

-------------------------------------------

Original Message:
Sent: 11-04-2025 17:26
From: Christine Greer
Subject: visual disturbance in superior field od and os



Hi,

I understand it's bilateral, but has anyone done optos imaging with autofluorescence? Seems retinal or vitreous related. Agree. 

Christine 

Original Message:
Sent: 11/4/2025 4:52:00 PM
From: anthony fok
Subject: visual disturbance in superior field od and os

Anyone seen this? 

Superior visual snow? 

I have a 21yo male farmer with 2 years of constant superior visual disturbance initially intermittent now constant. Describes it as a waviness in both eyes. The waviness moves and drifts. 

Came on after waking. 

No headaches at the time. Not a headache sufferer. 

Has had a hx of migraine but not significant. 

Formal visual fields and OCT RNFL , macula and GCL are normal.

MRI brain and orbits normal

EEG normal

Had VEP, mfERG and all normal

Tried pizotifen, endep, sumitriptan, topirimate, magnesium, riboflavin, 

Then tried ajovy one injection and had numbness on left side and mgiraines but made no difference to superior field disturbance. 

 This is a schematic of what he sees in his vision binocularly. 

Regards

Dr Anthony Fok

Neurologist/Neuro-ophthalmologist

Original Message:
Sent: 11/4/2025 5:44:00 PM
From: anthony fok
Subject: RE: visual disturbance in superior field od and os

Thanks for this. Will look into this ?

-------------------------------------------

Original Message:
Sent: 11-04-2025 17:26
From: Christine Greer
Subject: visual disturbance in superior field od and os



Hi,

I understand it's bilateral, but has anyone done optos imaging with autofluorescence? Seems retinal or vitreous related. Agree. 

Christine 

Original Message:
Sent: 11/4/2025 4:52:00 PM
From: anthony fok
Subject: visual disturbance in superior field od and os

Anyone seen this? 

Superior visual snow? 

I have a 21yo male farmer with 2 years of constant superior visual disturbance initially intermittent now constant. Describes it as a waviness in both eyes. The waviness moves and drifts. 

Came on after waking. 

No headaches at the time. Not a headache sufferer. 

Has had a hx of migraine but not significant. 

Formal visual fields and OCT RNFL , macula and GCL are normal.

MRI brain and orbits normal

EEG normal

Had VEP, mfERG and all normal

Tried pizotifen, endep, sumitriptan, topirimate, magnesium, riboflavin, 

Then tried ajovy one injection and had numbness on left side and mgiraines but made no difference to superior field disturbance. 

 This is a schematic of what he sees in his vision binocularly. 

Regards

Dr Anthony Fok

Neurologist/Neuro-ophthalmologist