Eye Pain

[BubblesRN74]

Quick question from limbolander....Anyone experience eye pain without vision changes? Been reading through older posts on this topic but nothing sounds similar to what I am experiencing.

I have had eye pain for past 8 days, with noticable increase of my "goosebumpy" sensation on right side of head/scalp for the past 2 weeks.  No recent cold/sinus symptoms, visual changes that are noticable.  Pain worse with eye movement, not relieved by OTC pain meds, only lessened by rest. I saw my optometrist on Thursday morn, he says eye exam good, no prescription changes or optic nerve inflammation that he can see, but thought maybe retrobulbular neuritits.  I followed-up with my PCP on Thursday afternoon just in case it could be sinus related, he said no sinus inflammation, his concern was for optic neuritis d/t my other ongoing neuro symptoms, set up referral for opthamologist whom I saw on Friday.
Opthamologist said eye exam normal, dilated my eyes, said no optic nerve inflammation that he could see, so no optic neuritis, but probably some type of inflammation around the back of my eye that was not affecting the optic nerve or it's blood supply, but the muscles around my eye?   Told me to use Aleve 2x/day for pain and If pain persists through mid-week then he will order CT of my orbits/sinuses.
Anyone else experience this type of eye pain w/normal eye exam?  Should I give my neuro a call as well?  

Thank you in advance for any input!
~Bubbles

[PeninaD]

At the point that the scarring was found, there had already been multiple MRIs done at two different places over 3 months, and none of them showed the ON, it was that subtle.  Despite all that you read, ON visual changes or pain are not always the first sign of MS.

[BubblesRN74]

Thank you for your advice!  I am currently in limboland, so I am not sure my neuro would refer me to a neuro-opth, but it's worth a shot in asking if she will refer me on. :)   And I will inquire about the VEP testing as well.  
And my last MRI was Feb 2013 and was clear, so I am going to go ahead with that but good to know that ON doesn't always show up.  
Thank you again!  Your input is truly appreciated.

[Bubblebabe]

ON doesn't always show up on an MRI.  A neuro-opthamologist and a regular opthamologist can identify ON without any special tests. Neuros generally can't which is why they order tests but a VEP would be a better test than the MRI.
An appt with a neuro-opthamologist might be a better choice for you. They are a super specialist and have great knowledge of ON with the MS connection. If needed they can do a VEP and visual field test to confirm ON but they also know how to treat MS patients with ON. A regular opthamologist will confirm ON (they can order the VEP and VFT as well) but would refer you out to a neuro-opth or back to your neuro if its confirmed.
A VEP will definitely show current and/or past damage from ON while a MRI usually doesn't, personally I think a MRI for the sole purpose of identifying ON is a complete waste of time.
If it was me I would probably go ahead and do the MRI (if I hadn't in the past because you never know) but I would ask to be scheduled for the VEP by either the neuro or the opthamologist.
Good luck :)

[BubblesRN74]

So her visual changes were very subtle then?  And she did not notice these changes until another doc did more testing?  Sorry she had to wait for the dx but happy some doc took time out to double check her.  
I am concerned that now that I have started the Medrol pack that when I do have the MRI that any inflammation will now not show up :(   I am doing a little better today as pain is not completely gone.  Last night the pain radiated into my right jaw/back teeth and ear...that was horrible.  But still no visual disturbances..just brain freeze pain.  
Does ON always show up on MRI...I would expect it too?  And should this MRI be ordered w/or w/o contrast to make ensure proper diagnosis of ON or whatever?

[PeninaD]

My daughter did have eye pain without apparent vision changes.  
I say apparent, because all her doctors were checking for was acuity and double vision, but until she saw a optho department head in preparation for possible Gilenya use, no one had checked red color perception, and there we found a change in the eye.
Each eye saw the red color sample differently, darker with the painful eye.  Yes, on a special and very detailed set of photos of the optic nerve, they finally found a teeny scarred area that had been missed by everyone else on physical exam.  Additionally, this doctor noticed that that only that eye, while it did react to light by constricting appropriately (at first), then immediately partially dilated, despite the continuing level of light.  
None of these were things that numerous neurologists and neurology students who saw her daily over her weeks in the hospital, noticed.

[BubblesRN74]

Hi all, and thank you to those who have taken time to read and respond to my post. :)  Unfortunately I am on day 12 of this eye pain, but I saw my neuro this afternoon and she is thinking ON but certain some type of inflammation causing the pain, has ordered MRI to be scheduled asap, checking labs including Sed Rate, and prescribed 6 day Medrol pack.  I still have no vision changes, however she stated that pain often precedes the vision loss and that all cases are different.  
If MRI shows ON then I will need IV steroids for sure.  
She also mentioned pseudotumor cerebri and if MRI is clear then she will consider lumbar puncture to check intracranial pressures.  I did have a clear LP last February, so I am hoping I don't have to repeat it.  I don't want to relive the spinal headache I had after that procedure!  
Anyone experienced pseudotumor cerebri?  I know what it is, just curious of symptoms anyone has had.  
~Bubbles

[bubbles_04]

I had eye pain and it was O/N. The pain was bad whenever I moved the eye. The color red also faded in that eye.

[Sidesteps]

I have had chronic eye pain that wasn't ON and eye pain that was.

The eye pain I experienced first was atypical TN. That lasted 10 months. It was both sharp and constant pain that felt like a near constant headache. Hardly anything helped.

The ON came with sharp sharp pain, decreased brightness and color changes in my vision. My vision tests also showed damage that wasn't there 3 months before. My right eye did not dialate the way it should.

I hope that helps.

[LimboLurker]

I'll be interested in what you find out.  I've had pain around the front of my left eye off and on since last June when I had PVD and a tiny tear in the retina.  Ophthalmologist said no connection to the PVD and tear.  In the fall it seemed to also happen with jaw pain in the same plane as the eye pain.  Dentist says no connection.  Sometimes develops into a twitch.  Comes and goes a lot, often just a little discomfort in the background but doesn't seem to be going away either.

[BubblesRN74]

I am going to check in with my neuro tomorrow and will update soon.

Thanks for your input and support!
~Bubbles

[ghost39]

Optic is the optic nerve, retro is behind at the very back of the nerve.
Reto is very indicative of MS, or so I was told.
Definitely ring your neuro, often signs can be very small, but a neurologist may pick up deficits.
let us know how things go and what your neuro says.
:)

[BubblesRN74]

And does anyone know if there is actually a difference betweeen optic neuritis and retrobulbular?  Just curious, because everything I have read it seems to only be a small difference in location of the eye inflammation?

[BubblesRN74]

I do not have a confirmed Dx of MS. I do have a neure, have been through all sorts of testing over the past 3 years and this is my latest symptom.  Things have been relatively quite the past 3-4 months until now.  

With this eye pain I have had no vision changes or noticable color saturation change, still in pain though which makes 10 days.  And yes, this is deep eye pain, not superficial, like I have eaten way too much ice cream an have a permanent brain freeze type of pain.  I waited 6 days before calling my eye doctor because I hate to jump on every little symptom, but this is certainly different and new for me.  I am an RN in a busy doctor's office and I don't want to "be that patient"...lol!!

I have been "off" balance wise and cognitively as well throughout the past 10 days or so.  I think I am going to call my neuro to see what she thinks I should do.  
Thank you all for responding...I do really appreciate this site and the members :)  
~Bubbles

[ghost39]

I should add I get eye pain, deep behind the eye, but vision not affected. I know its neurological in origin.last January my pupil went big all the time, then only in the dark with a little bit of light. Not optic neuritis. Neurologist said probably caused by a lesion in the mid brain, but definitely MS.
Not all is always as it seems!!!
I hope you get your answers.
Remember you know your body best.

[ghost39]

I had retrobulbar neuritis and could not see bright lights, red to start, followed by all colours. It then worsened to almost complete loss of sight in that eye, which took six months to come back. 15 Yrs later came my next symptoms and being diagnosed with RRMS. I have had lots of little signs before this, which I ignored.
Have you been diagnosed with MS?

[johnniebear]

here is my old post,  I don't its what your going thru..  I know the pain however

http://www.medhelp.org/posts/Multiple-Sclerosis/Eye-pain-with-scleritis/show/1971946#post_9261680


take care
JB

[SarahL2491]

I can't come up with anything either, he's done a good job of checking out what I would have considered.  You might consider a neuro and an MRI, just to be sure.

Keep us posted and am so sorry you are in pain.

[Joiedecour]

Bumping for you. I'm interested in replies to this too. Currently experiencing eye pain too.