Possible Optic Neuritis? or ???

[Kim703]

About two weeks ago, I started feeling like something was in my eye (left).  The feeling persisted for a week, getting gradually worse until my eye hurt all the time, especially when moving them.  I have pretty bad vision to begin with (myopic) and have had many floaters for over 10-15 years.  So, I trotted myself over to the eye Dr. (opthamologist).  After a very frustrating and long visit, they told me my eyes were "dry" and gave me lots of eye drops, which didn't help the PAIN in my eye.  They didn't even bother to dilate my eyes or order any other tests.  After looking in my eyes and under the lids, they determined that there was nothing there.

I started thinking maybe I had a sinus infection, so the next day, I headed to the GP.  I got a scrip for a z-pack, but I don't think they even thought that was my problem.  It's gotten to the point that by the end of the day, I can barely open my eyes.  I feel like there are weights on my eyelids, everything feels swollen, but it's not swollen to look at.  

Since the early spring, I have been tested for all kinds of autoimmune problems, as I have been having pain in my joints, fatigue, and lots of other vague symptoms.  And I am currently in the middle of a "flare" of symptoms -- every joint hurts right now.  I have not yet been diagnosed -- only my ANA has come back borderline, and at one point my CRP was high.  They still think it may be early stages of ... something (RA, lupus, thyroid...???).

So, my question is...how long should I let the eye problem go on?  Should I find another eye MD for a second opinion?  Go to my rheumatologist?  Some other dr?  

In addition to pain, I feel like the floaters are more pronounced right now, and that eye has problems with focusing.  I have to blink several times to see something, and even then it's not so clear.  Any help would be greatly appreciated.

[Kim703]

Thank you very much for your quick response.  Although, I probably should have mentioned my age, which is 40 (and I'm female).  Which I think is rather young for temporal arteritis and/or polymyalgia rheumatica.  I have been diagnosed with fibromyalgia, but we (the drs and I) feel that these other symptoms are unrelated.  The only reason I mention the health issues, is because I feel very strongly that the eye problem is related in some way.  Also, I last had a full eye exam in June, and there wasn't much of a change in my prescription at that time.

Should I ask for an MRI or CT scan at this point?

Thanks again for your help.

[Sandy Feldman, MD, MS]

Dear Kim703,

I would recommend that you seek the care of an eyeMD to determine the cause of your symptoms.  I would recommend a complete eye examination including determination of a prescription, and dilation.  Possible diagnoses may include optic neuritis, temporal arteritis, polymyalgia rheumatica, and many others.  

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California