ON and MS

About one year ago I was having a problem with persistent ocular migraines with the absence of any other symptoms, including absence of the headache that usually accompanies migraines.  I only had the aura and it would last for 15-30 minutes then go away.  My primary care doc sent me to a neurologist who ordered an MRI.  The results showed "significant periventricular white matter disease," that she explained could just be consistent with a person who has migraines.  
Flash forward 8 months .... I have been experiencing blurred vision in my left eye for 5 days now.  Is this ON?  Should I be worried that I have MS?  Who should I see:  my primary care, the neuro doc with whom I don't really have a relationship, an opthamologist?  I 'm kind of freaking out here.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Optic neuritis is inflammation of the optic nerve caused by demyelination. It is associated with decreased color vision and pain with eye movement. The pain may last 3-5 days. A study called the Optic Neuritis Treatment Trial showed that the 5 year probability of developing MS was 30%.  The diagnosis of MS requires symptoms to be present at different times and locations. MRI of the brain is commonly used in the diagnosis as well as a procedure called a lumbar puncture. There are many reasons to have white matter disease on MRI. MS is only one cause.

The blurred vision may also be related to your underlying ocular migraines (which are commonly called acephalgic migraine). These headaches are commonly found in people with past history of migraines with aura. Do you take any medications for your migraines such as beta blockers, SSRIs, antiepileptics, etc to prevent these headaches? If not, you may wish to speak to your neurologist about migraine preventive and abortive medications.

There are other causes of blurred vision that are outside of my expertise that would be best diagnosed by a medial physician or ophthalmologist. I would recommend having an evaluation done by your primary care physician. He/she should then be able to direct you to the right specialist whether it is an ophthalmologist or neurologist.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[achilles2]

If I were you I would go see an ophthalmologist. Especially since your MRI did not show anything alarming.

good luck,
achilles2

[katie4242]

Thank you so much for taking the time to answer my question.  You message was full of great information and hope, as I, being a pessimist, have only considered the worst case scenario.  My color vision in my left eye is reduced, and I failed an on-line color blindness test that my Primary Care MD recommended.  However; I did have an ocular migraine the day before I noticed the blurred vision, so maybe the two are related.  My primary care doc  also advised me to just go ahead and see the opthamologist I have an appointment tomorrow, so hopefully all will go well.
Thank you again for your knowledgeable and timely response.

Katie