Sudden blurry vision of my right eye

Dear All,

kindly see hereunder my eye History problem

History: 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) 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, he checked and said that the retina is good and may be there is a retrobulbular neuritis!! or MS ( Multiblescelerosis) so he asked me to make MRI on both brain and orbit ( report are attached ) , i made too a visual field 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 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)

Now i just finished the steroids treatment after two week.....NO IMPROVEMENT AT MY RIGHT EYE.

The doctor said you should follow up next month and make another MRI after one month to see if found any progression of MS!!

i want to know:

is my case a RETROBULBULAR NEURITIS ?or MS?

could the MS causes RETROBULBULAR NEURITIS without appearing in the MRI?

2nd: Could it be no improvement in RETROBULBULAR NEURITIS with that regimen of high dose steroids?? what is the prognosis if it is RETROBULBULAR NEURITIS ?


Thank you in advanced

Hossam

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

1.  There are many causes of retrobulbar neuritis of which multiple sclerosis is the most common. the next most common would likely be anterior ischemic nonarteritic optic neuritis. I can't tell which you have
2. Yes you could eventually develop MS without it showing up on the tests now. Only time will tell
3. With retrobulbar neuritis with or without treatment at 2-3 months after the episode these are rough guidelines:   30% return to normal another 50% improve to good vision and 5-10% do not improve and the eye ends up with bad vision

JCH MD