To have ON or to not have ON

[syndismilez]

That is the question :)
I had my appointment yesterday with the Neuro-Opthomologist.
He found a defect in my pupil dialation but no Optic Neuritis. Hmmmm????
My other Doc found swelling of the disc. Can swelling go away in
2 days?  Or was the other doctor wrong?  I am so confused!
I also thought that the pupil sign was a "sign" of optic neuritis.
I do have a Visual Field study in Tuesday.
I was wore out last night from all those swinging lights in my eyes!!!
He did it for at least 10 min!  Even had his assistant look at my amazing
pupils! Haha.
Well, I do know the pain I felt and my blurry vision is NOT normal
so he can knock my down but I'm not done looking for
answers!!!
Ugh. ;)
cyn

[Charley123]

I just went to the opthomologist because of the stabbing eye pain and she told me that there was no ON.  She thought my tear ducts might be blocked and gave me some artificial tears.  She said that if it didn't resolve itself that I would need to see my neuro to be seen for Trigeminal Neuralgia.  It seems that Trigemian Neuralgia sometimes comes as part of MS.  There are so many different conditions that can cause eye pain...my head spins.  Charley.

[Eyesnlegs]

I had retrobulbar ON dx twice and had no outward signs except I did lose my sight in one eye and was in LOTS of pain every time my eye moved.

The only evidence has been that it left me with a pale lens and the lesions were visible on the optic nerve on my MRI - this was done nearly 12 months later when I got to see the neuro.

My visual field tests I had recently were normal but my VEP was 'borderline' with a slight delay.............and yet I continue to have many visual problems.

I don't know if this helps but lots of luck, eye problems are worrying. You know yourself it is not right so keep going and be strong.

Pat

[PastorDan]

I've been describing my pain as feeling as though the back side of the eyeball is bruised.  No diagnosis, though.

[Deb61]

I'd get the records from that other neurologist who mentioned seeing this sign.  Eye headaches is a good way to describe the pain I had from optic neuritis.

[syndismilez]

Thanks everyone :)
I've had my first doctor for years. He has never
came up with anything before. But he is an optomitrist
with years of experience.
I do think I have had something before. I had a neurologist
find the Marcuss Gunn sign when I had a terrible "eye" headache.
I never pursued it. Hmmm  
So I will just keep plugging.
thanks again.
Well get it figured out :)
cyn

[Jenn0030]

IMHO...the pupil problem certaintly means something.  It could mean ON, a retina problem, a lesion on the optic nerve or somewhere else or numerous other things. Your Doctor should be able to explain the reson that is present.  It doesn't happen without a reason.

As for the swelling the the 1st doctor picked up, was it an optometrist or ophthalmologist who picked up the swelling? Was this the 1st time you saw the 1st doc or did he/she have a previous exam to look back on?   I just wonder if that was not there forte and maybe what they thought was "swelling" was just an irregular shape/size to your ON.

[Deb61]

I'm still scratching my head.

Ask this doctor what would cause the pupil defect and why the other doctor saw optic swelling when you see him on Tuesday.  

[Deb61]

Maybe you had ON before you went to the other doctor and it resolved before going to this doctor.  I think though that it is strange that you would have a pupil problem noted by this doctor and he told you that there was no evidence of ON--this doesn't make sense.  I wonder what a different doctor would say.  Perhaps a third opinion is needed???

I had a pupil problem when I had ON.  I didn't notice it until after my ON diagnosis and looked in the mirror.  It was certainly odd to see one pupil large in my right eye and the other eye with the pupil small.  

[essdipity]

I'm surprised that we don't have more discussions about the pupil dilation findings and ON. According to articles I've read, RAPD, also called Marcus-Gunn, is directly caused by ON. So yes, it would be a 'sign' of ON, among some other things. There has to be *some* reason for it.

For those unfamiliar, as I was till just now, the test for it involves swinging a flashlight back and forth from one eye to the other. The pupils are supposed to dilate and contract together, not independently according to how much light they're getting.

Here's how the mult-sclerosis.org web site describes it:

----------

Afferent Pupillary Defect (APD) or Marcus-Gunn pupil is a condition of the eye where the pupil doesn't dilate appropriately to the level of light reaching it. This will often result in one pupil appearing larger than the other (relative afferent pupillary defect - RAPD). This person with APD is often unaware of it except by looking in a mirror.

There are many causes of APD including Optic Neuritis (ON), glaucoma and optic nerve tumor. In multiple sclerosis, APD, is usually associated with damage to the optic nerve resulting from ON.

The reasons why afferent pupillary defect occurs with optic neuritis are complicated and involve the neuroanatomy of the visual pathways. Put simplistically, the eye in which the ON has occurred acts as if it is in a lower light situation than it really is and dilates more so that it can let more light hit the retina.
---------------

Cyn, keep at the neuro-ophth. to give you an explanation of your condition if it's not ON.

ess

[syndismilez]

Yup. That is what he called it. He did not find
a swollen optic disc. The referring doctor did.
So, I suppose I'll see what the test reveals if anything.
He did say it might be retrobulbar optic neuritis.
Cyn

[Jenn0030]

A swollen ON will not resolve in 2 days as well as a RAPD (Relative Afferent Pupillary Defect) will persist long after the ON is symptomatic.  I will assume that is the pupil defect that you were mentioning.

Jenn

[Lulu54]

Cyn,
From what little I know about ON,I don't think it resolves on itsown in 48 hours but I might be wrong....... good luck with the next round of   ttesting.

Lulu