RETRO.B.OPTIC NEURITIS..URGENT PLZ

kindly see herunder the history of my husband's eye proplem for your kind help:




History: 2 month ago, i felt an ache on my right eye with headache for 2 to 3 days then i took an analgesic to relieve the headache, but still i felt a pressure on eye ( ach on the eye ball specially during movement) after 3 days of that, i suddenly realized that my right eye vision is blurring and i couldn't see the near or the far things clearly, so i went directly to the ophthalmologist, he checked for my eye and ask for florescence ray on the right eye( it has shown a normal angiogram), he checked and said that the retina is good and may be there is a retrobulbular optic neuritis !! or MS ( Multiblescelerosis) so he asked me to make MRI on both brain and orbit ( both are normal and dosn't show any  abnormalities ) , i made too a visual field test which showed abnormalities in the right eye vision.

Another consultation  : after they saw the MRI, he said the MRI is good and didn't show abnormalities or lesions,  the diagnosis also was towards retrobulbular neuritis( by exclusion)
i admitted to the hospital for 3 days (after 4 days of the problem) to get IV infusion by solu-medrol 1000mg / day then followed by 12 days of hight dose predinesolone (80mg/ day for 3 day then 60mg/ day for 3 day , then 40 mg/ day for  3 day then 20 mg /day another 3 days)  I finished the steroids treatment after two week.....NO IMPROVEMENT AT MY RIGHT EYE.

I made a VEP test which show marked delay in the latency and magnitude of my right eye signals which supported the diagnosis of RBON

I got another consultation by 2 consultant neurologist and they wanted to know the cause of RBON by making a Lumber puncture ( spinal tap ) – MRI BY STAIN ON SPINAL CORD – ANA TEST, the result of all these tests was NORMAL

Now I feel eye pain, headache above the eye, the vision deteriorate after warm shower or due to hot weather, my visual acuity still ( 6/18) with blurry vision and poor contrast.( I can’t read for ex. Quran)

The doctor said WE HAVE NO ANOTHER OPTION,,JUST follow up next month!!


KINDLY I NEED YOUR SUPPORT TO KNOW:

Could the MS in early stages causes RBON without appearing in the MRI or if lumber puncture showed Normal result of presence of oligoclonal-band? ( please note that I haven’t any symptoms suggestive for MS except RBON).

What is the prognosis of my case if no improvement after 2 months and what I should do?

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

1. Yes MS could cause RBN with all other tests being negative. In some cases the MS does not develop for years.
2. You have been treated appropriated for RBN. The failure to improve at 2 months is not a good prognostic sign. Generally a decision that no further improvement will be seen is not done until 5-6 months post the onset of symptoms

JCH MD

[kjelltp]

If steroids don't reduce  / stop your symptoms, I would personally look for a natural way of healing (anti inflammatory diet, supplements).. seek holistic care. If its autoimmune related, research LDN.

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

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