Elevated/Swollen Optic Nerve

Hi, I am a 28-year-old female. I went to an Opthamologist recently because I have been experiencing pain in my left eye for approximately 8 months. I didn't think much of it at first but it has gotten progressively worse and I am experiencing more and more symptoms. It feels like there's a lot of pressure in/on my eye and I started getting "floaters", flashes of light and blurry vision. I am now experiencing headaches on the left side of my head and it causes my left ear and left side of my neck to be painful also. The pain seems to be primarily worse at the top of my eye socket and when my headache gets bad the entire area around my eye hurts and the pain is worse with movement of the eye. At first the pain was sporadic and mostly occurred in the morning but now it seems to be almost constant. The Opthamologist did some tests and said my left optic nerve was swollen and I needed to go see a Nuero-Opthamologist. I went to the Neuro-Opthamologist 4 weeks to 5 weeks later and he did tests and told me my optic nerve was NOT swollen. He told me my optic nerve was elevated but was probably that way since birth and referred me back to my Primary Care Doctor. I am really confused because one Doctor told me my optic nerve was swollen and the other said it is elevated and now I am going back to my Primary Care Doctor, who is not an eye specialist. Any thoughts on this?

[John C Hagan III, MD, FACS, FAAO]

Evaluating subtle optic nerve swelling is can be very difficult. Often a referral by a general ophthalmologist to al neuroophthalmologist is needed for a second opinion. However if you are still having the pain the NO should have told you "what's next to do" and sent a copy of he/her consultation to your GP and general ophthalmologist.

If you call back and ask for advise. Also ask about orbital inflammatory disease. Ask about getting a CT or MRI of the head, orbits,sinus.

JCH MD