These fish are very sensitive to nitrate; 20ppm isn't normally a problem but may be for Rams. I'd seriously consider some water changes to get that down, at least whilst dealing with the problem.
check your tap first, see if you have nitrates in your tap. if you do, it may be moot. sounds like popeye. you can quarantine and treat with antibiotics. for what its worth, my nitrates out of my tap are 20ppm and my tank stays 20ppm-40ppm *shrugs* i havent had any issues with my rams.
It does sound like popeye, but popeye is not always caused by poor water conditions - I have had a fish with popeye caused by a bacterial infection. In that case, melafix + pimafix for a week did the trick. Though rams are sensitive to nitrates, I have never had an issue with them at 20ppm.
As I understand it the two work in combination with each other in a synergistic way, treating worse infections and quicker. But melafix is more indicated for bacterial infections, and pimafix for fungal infections (though it treats some bacteria as well). They are mild meds but I have had good luck with them.
Lucy, almost all cases diagnosed to be fungal infections, are bacterial infections. Meds that are designed for fungal infections will work in most bacterial infection cases.
SDM, is the fish still eating? What does it eat? How does it poo look? Any pics?
he is not eating right now, but also some of my other fish were starting to get pop eye but I think they will be ok, and I also bought some anti bacteria medicated fish food and all the other fish eat it right up
my ram looks like he wants to eat but I think its vision is distorted and misses when he launches at the food, ill try and get some pics but right now he is hiding in his little castle bridge