Optic Nerve Swelling/APD

[Arche]

I'm posting this in the neurology board because I'm following up with a neurologist for these symptoms.

I had my son (first child/pregnancy) almost 8 weeks ago.  I noticed a day or 2 after his birth that my vision in my right eye was fuzzy and black around the edges.  I had a c-section so I was still in the hospital and told the nurses about this new symptom but they weren't concerned.  My doctor even thought it might be related to hormones.  He did give me a referral to see an opthamologist which I saw a month later.

The opthamologist noticed I had severe optic nerve swelling in both eyes, but more prominent in my right eye.  He also observed Afferent Pupil Defect.  I don't really have pain at all in my eye.  Over the past 8 weeks my peripheal has slowly returned but I can't see much on the nasal side and the overall quality of my vision is still fuzzy.

Other medical things that have occured in this time is lower back/flank pain and possible UTI (which I was given antibiotics for).  I've also had constipation that sometimes goes to loose stools and back to constipation, but I've ridden that off as side effects of the C-section.

My pregnancy was uneventful other than high blood pressure which I had prior to the pregnancy.  I am taking medication for it but it is still on the high side, but it was ruled out that high blood pressure was a cause.  I had an LP done and they measured the pressure and it was normal.  I also had a CT Scan and MRI done and both of those have come back normal as well.  I also gained 30 pounds with my pregnancy and by week 6 I had returned to my pre pregnancy weight.  I am also breastfeeding.

I am following up with a neurologist on Thursday for all the blood work and spinal fluid that was taken on the 10th.  I just wanted to post to see if anyone has any ideas or have had something similar happen.  I will update of course, just worried until then what it could be.

[Cindi1shorty]

Thanks for the update and I hope that you get all of the test and treatments available .. Im praying all turns out well .. God bless and take care

[Arche]

I still have a positive ANA for lupus, but no other symptoms and specific bands of lupus were negative on blood tests

[Arche]

Thank you for the comments. After all the testing and consulting with the neurologist and eye doctor they have no known diagnosis for the swelling. There is some nerve damage in my right eye, so their only guesses are that the pregnancy caused the swelling, although it's just a guess. I can see color better and I feel like I'm adapting better, but the nerve damage hasn't changed which was expected. I have to follow up with the eye doc in 2 months and neuro in 4 months. unless my symptoms get worse. But I'm totally done with all the poking and prodding.

[Cindi1shorty]

Hi,  
               I just wanted to let you know that I also had the same symtoms off and on for several years , the eye doctor sent me to see a specialist when he seen a swelling of my optic nerve about 7 years ago but by the time I made it to the specialist the swelling had subsided and they said I did not need to return for follow up. This past June I went to another routine eye appt. with a new Eye Doc and he saw the same thing and called my Family Doc who called me in right away and they saw the same thing so I followed up with a Nuero Doctor and I was Diagnosed with Transverse Sinus Stenosis , I have come to learn that I had several on going symtoms that would periodicaly come and go for the past 10/15 years and it went undectected. So I would strongly suggest what the other Lady was saying and follow up with a Nuero.  Hope the best for you and congratulations on your bundle of joy ...

[Londres70]

Well...this just isn't really fitting the Lupus dx., however, you could be presenting atypical in regards to this Lupus dx......that's possible.  

I know you lost 30 lbs post pregnancy, but dear and this is not to be rude, being 240 lbs is pretty much asking for medical issues/problems.  Even if you are carrying the weight evenly it is still too much weight.  Plus, you have had this on for 10 years.  It needs to start coming down.  There are so many diseases and conditions that are being linked to obesity and morbid obesity.

I would find out if they ruled out any viral or bacterial causes for this.  

You can try my recommendations in my last post.  

[Arche]

Yes, I gained 30 pounds during my pregnancy and lost it by week 5 or 6 postpartum. The last time I was tested for diabetes was during pregnancy I think. I don't recall being tested recently.

I had a MRI done this morning, brain and cervical spine. I go in Tuesday for the repeated LP.

As for the bacterial or viral possibility, I know 2 weeks ago they ordered a lot of tests (9 vials worth) and I was told those were all negative except that lupus one.

[Londres70]

MS is a possiblility.....but, I can't really say this is any MS, however, they need to THOROUGHLY rule that out.  

[Londres70]

In my opinion, this isn't any Lupus.  

So, you were 30 pounds heavier during the pregnancy?  270 lbs?  

Have they ruled out the possibility of this being related to something bacterial or viral?  

I would recommend rechecking the possibility of Diabetes.  You should have a Glucose Tolerance test and an HbA1c test done alone with a FBS lab.  

I was also thinking Idiopathic Intracranial Hypertension, but your symptoms aren't really matching except for the issue with your vision.  

Definitely have the LP and MRI repeated.  Did the Neurologist mention anything about doing a MRA?  This is NOT an MRI.  

Consult a Neuro-ophthalmologist as well.

[Arche]

Hi there, thanks for responding.

I weigh 240 and have for 10 years, I've always been heavy but I do stay active as well so I carry my weight well but I can definitely afford to shed some pounds.

I had a couple family members with diabetes and I've been tested quite a few times (especially during pregnancy) and it's always been normal.

My appointment yesterday was a little frustrating. They discovered I have weakness in my left arm. My spinal fluid had a high level of protein (50 is normal mine is 150) and I tested positive for lupus but the doctor thinks that's only because of the inflammation. So I had more blood drawn for lupus types and they want to repeat the LP and MRI.

I don't have any symptoms of lupus so I don't know what to think at this point. I just want to see again and be normal.

[Londres70]

What is your pre-pregnancy weight or your weight now?  What are your latest bp readings and what meds are you taking?  

If the LP and MRI were clear, I would say this is probably related to your HTN (high blood pressure).  I am not sure if this Neurologist will order an MRA or not.  Sounds like something vascular or neurovascular to me.  

Any history of Diabetes in your family?  Did they do any blood sugar testing?  

Sounds like you probably should consult a Neuro-ophthalmologist as well.