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Does MRI always show ON
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Does MRI always show ON

I was just wondering if optic neuritis can always be seen on an MRI?  I had an interesting visit with my neuro last week and he seemed to suspect something is up with me and ordered a brain mri with contrast and with orbits or something like that.  I asked him if it was really necessary because I just had an mri a year or two ago, and he said yes, sometimes these things take time to show themselves.  But my mri was normal, so good news bad news.  My vision is still blurry in my right eye (started 2 weeks ago) and I have noticed I see colors a little differently out of each eye but I don't know if that's just normal.  Does the normal mri mean I don't have optic neuritis or anything?  If so, then I wonder what else would cause this.  I've had headaches over the eye that I'm having problems with which is something new for me.  So I just don't know what to make of all of this. Do they do the mri to diagnose optic neuritis, or is it more to see if there are ms lesions or something else causing the vision problem?  And since my mri was normal does that mean I don't have ON?
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429700_tn?1308011423
I've had optic neuritis and an MRI shortly after and the MRI didn't show lesions on the optic nerve.  The opthalmologist saw the optic disc "swollen".  I did have lesions that showed up in other parts of my brain.

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634733_tn?1316629592
I have had ON twice and the second time I had an MRI which did show lesions on the optic nerve, but I am sure that like other MS sx this is not always the case.

The first time I had ON it was dx without an MRI by an opthamologist so I would guess that your negative MRI does not necessarily mean that you don't have ON.

Hope this helps a little.
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Avatar_f_tn
ON does not necessarily show on MRI. You can have lesions on the nerve that MRI can't detect. If you have MS, then that is almost certainly the cause of your ON.

They do the MRI on general principles when there are symptoms like yours. It's good if abnormalities are detected that way, but it's common for them not to be. If you have eye problems, you may well have other brain lesions as well, and the MRI often can tell that.

Very often ON is the first symptom of MS. Quix is doing a health page that explains this, and she can sure explain the details much more accurately than I can.

Has your doctor ordered visual evoked potential testing? That can tell you a lot about what's going on. It sounds as if he is very interested, always a good sign.

Hang in there.
ess
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Avatar_f_tn
Thanks for your comments, everyone.  My optician didn't see anything abnormal with my eye and did an OCT scan which I guess can show something with the optic nerve but not if the problem is farther back in the head.  

The optician said I may need to see a neurologist and may need an mri even though he found nothing wrong.  When they measured my eyes the measurement said my prescription was the same in both, so I should be able to see about the same out of both.  But the day this started I felt like I did back in the days when I had contacts and I had one contact in and one out.  

So then I saw my neuro and when he asked if I'd had any pain I said my eye gets achy and that I have started having headaches over that eye in the last few months or so.  The headaches are new for me and so he did seem concerned about those.  So he said we need to do a brain mri.  He also did some lab work and what has come back so far is normal, but some of it was sent out to mayo clinic and so I think they're still waiting on that.  

So I've not been told if this is optic neuritis, the optician just mentioned my optic nerve as a potential cause, and the only tests done are labs, mri and oct.  I just was confused on how optic neuritis is diagnosed, I'd like to know whether or not that's what's going on.  I haven't talked to the neuro since my mri was normal so I have no idea what he's thinking.  His nurse is terrible about calling me back, but my neuro has been really great.  I told him I hate doing testing because it stresses me out and he said he'd be stressed, too, and he promised to call as soon as the results came in and so they let me know the same day so I didn't have to wait over the weekend.  

I also have some swollen lymph glands in my neck that were checked out a couple years ago.  But the last few months they started aching and I have developed a mild cough if I talk a lot and sometimes when I go to bed at night.  So I don't know if this is related to the eye thing in anyway, and I don't know what my next move is.  I'm a singer and it's getting to the point where I end up coughing a lot trying to sing.  
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1221035_tn?1301004108
I was told by my Neuro that it is hard to diagnosis ON on an MRI. I was diagnosed with ON after the opthomologist saw afferent pupillary defect (pupil reaction to light) and difficulty with color charts.....even though my optic nerves looked fine. I guess there is a portion they cannot see called retrobulbar.(sp)

I too have enlarged lymph nodes.....one behind my ear and one on my anterior neck. They have been enlarged for the last 10 years or so. No one has ever seemed to concerned about them.

Anyone else with MS and enlarged lymph nodes?
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Avatar_f_tn
Thanks for the info.  I wasn't seen by an opthalmologist, just an optician.  The neuro looked at my pupils I think, but he didn't say if he saw anything abnormal, he just acted like something was up and talked like he suspected a problem.  But now that the mri is normal I don't know what he thinks.  

My lymph nodes have been swollen for years, too, and haven't been a problem.  For some reason they started aching in the last few months and I have a mild cough, and it feels like a couple of them have grown some so now I'm a little concerned.  I don't think they're related to ms in any way, though.  (I could be wrong.)
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429700_tn?1308011423
I hope you see an opthalmologist.  An optician can't treat ON.  If you have ON, you may need treatment for this, and an optician can't do this.  Plus, they're not experts on eye diseases like ON.

I would also see your GP about the lymph node thingy.  It sounds like you're trying to fight off an infection of some kind.  Maybe it's mono or something like that.  However, lupus can also make you feel yucky and have enlarge lymph node glands--not to mention neurological problems, optic neuritis, and headaches.  Another thing to get tested for is hypothyroidism.  Sometimes it will cause your neck to be swollen, and can certainly cause all sorts of problems if this gland isn't working well (which I know all too well about).

Deb
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