Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: optic neuritis?
Forum: The Neurology and Neurosurgery Forum
Topic Area:
Posted by CCF Neuro MD on December 21, 1997 at 12:36:12:
In Reply to: optic neuritis? posted by Barbara Tampieri on December 19, 1997 at 16:49:09:

: I'm 37, female and I've had a scotoma in my left eye for four months now. I see a grey spot
that covers objects below, and it's left-centered in the Amsler test.
I've already seen three ophtalmologists but got no certain diagnosis.
The visus is normal, pressure too, an alteration of the macula can be seen
but I wasn't advised to ask for neurological help.
Most doctors who are friend of mine suggest it could be an optic neuritis
and VEP would be needed, for a proper diagnosis.
I started to suffer from this visual problem last summer. I had something
of a virus infection that affected me with severe headache, high temperature
pain in my bones and muscles and a kind of rash. I also had pain in my
left eye and photophobia. I'm currently having blood tests done to determine
the kind of infection I had. Toxoplasmosys is negative.
If it actually is an optic neuritis, is there any therapy that might help?
I know ON is often related to MS, but can it come out of a simple virus
infection with no sight reduction?
I deeply thank you for your help,
Sincerely. B.Tampieri
:


There are a number of atypical features in your story which suggest that
this does not fit the typical profile of optic neuritis, for instance
there should be some blurring of vision in the early stages,
and optic neuritis is usually a much more short lived phenomenon,
resolving spontaneously within weeks.
It should not produce changes in the macula either.
Optic neuritis is such a common and well characterized condition that I suspect it would have been quite easily diagnosed by some or all of the ophthalmologist whom you have seen and who have had the opportunity to examine you.
One condition which does come to mind is one called neuroretinitis, this occurs in the context of systemic infections, its symptoms are similar to optic neuritis but it does cause changes in the macula. it is known as a parainfectious condition because of its strong association with concurrent infection.
If you wish to sort this problem from both neurological and opthalmological perspectives I would suggest an apopointment with a neoro-opthalmologist.


suggest you consult a neuro-opthalmologist
This information is provided for general medical education purposes only.
Please consult your physician for diagnostic and treatment options of your specific medical condition.

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