Eye pain after diagnosis of Partial Transverse Myelitis

[Ian]

Hello:

I have recently posted about my condition of PTM as revealed by a C-Spine MRI taken in October. A brain MRI taken in mid June was normal.  Until a few days ago, my only symptoms were numbness on my right side (which has diminished somewhat)and some infrequent faciculations all over my body.

A few days ago I noticed that when I look to far to one side, (moving my eyes all the way to one side or the other) the area behind my left eye hurts. When I rub the left eye the same area hurts. In addition, the vision of my left eye seems a little cloudy, although I can still see pretty much as well as before and can distinguish colors just fine.

Of course I am worried this might be an optic disorder associated with MS.
Do you think this is serious enough to merit another visit to my Neurologist or take a wait and see approach?

Thanks again for your help,

Ian

[CCF Neuro[P] MD, RPS]

Dear Ian:

Usually with inflammation induced demyelination of optic nerves one gets decreases in visual acuity and eye pain.  There is a condition of transverse myelitis and optic involvment called Devick's and is a type of MS.  However, one should have seen something on the MRI.  But, I think that it would be a good idea to see or at least let your neurologist what is going on.

Sincerely,

CCF Neuro MD

[Ian]

Dear RPS
I called my Neuro and he said to come in and he will check it out.  Shoot, just when I was convinced that the PTM was going to be the end of this, this problem had to come along.  

Anyway, thanks for your help and I will let you know how it turns out.

Best,

Ian

[CCF Neuro[P] MD, RPS]

Dear Ian:

I am willing to bet that your eye pain is just eye pain and nothing related to optic neuritis.

Sincerely,

CCF Neuro MD

[Ian]

Dear CCF:

Once again you were right.

I had an office exam at my neurologist and other than the pain, all things with my left eye were normal (pupil function normal as compared to right eye, could see the color red, vision was normal).

My neurologist was originally quite concerned about this new development, but after the tests he now feels is is likley not ON.  Still, gave me a perscription for an evoked potential to be absolutley sure.

It's one heck of an unfortunate coincidence, to have this eye pain so close to my PTM diagnosis...I am certain the pain was not imagined, as I have had fairly severe pain when I moved my left eye which had been going on for a 4-5 days and never considered it to be ON, because I mistakenly thought that ON pain came from light sensitivity, not eye movement.  When I found out that a major ON symptom was painful eye movement, THAT was when I became really worried.

Do you think it is necessary to get the EP test in light of the office findings?  Any idea what this eye problem might be?

Thanks again,

Ian

[CCF Neuro[P] MD, RPS]

Dear Ian:

It would not hurt to get the evoked potential test, and it will give you piece of mind.  I am not sure what to tell you what is going on.

CCF Neuro MD

[VER Results]

Dear RPS:

I had the test done this (Saturday) morning.  Response time was 115 ms in right eye and 120 in the left (painful) eye.  The tech said 120 falls just outside the normal range but that a variance of 5 ms between the eyes is not unusual.  He further said that people with ON are usually in the 130ms range.
Can anything conclusive be drawn from these readings?

Thanks,

Ian

[CCF Neuro[P] MD, RPS]

Dear Ian:

I think this says that your eyes have good connections and there are no blocks in the nerve pathways.  There is no optic neuritis.

CCF Neuro MD