Possible Optic neuritis?

[Carolyn_H]

I recently had bronchitis, laryngitis and a mild ear infection, and at around the same time I noticed my vision didn't look quite right in one eye but I couldn't really tell how. I was referred to an ophthalmologist who checked my IOP and did a fundoscopy/retinal examination. He said the inside of my eye was normal, some conjunctival injection, marked blepharitis/chemosis and impaired tear film affecting my vision (thick oil over my cornea). I used artificial tears for symptomatic relief but my vision began to get more different (though I only noticed it if I closed my good eye) and I developed pain on movement of my eye, photophobia and lightning flashes in the dark. I went back to the op a week later, same exam, still blepharitis and impaired tear film, maybe a little corneal swelling, take some corticosteroid drops. I had slight colour desaturating and a mild pupillary defect by then. He said neuritis unlikely because the inside of my eye was still normal. Ten days later and I have had a marked decrease in visual clarity, like everything is bright and faded. I particularly have blurriness in the lower left quadrant with a bit of central scotoma. Mostly it is like the brightness is up but the contrast is way down. The pain on eye movement persisted for about a week but is pretty much gone now. My pupils are fairly normal (slight anisocoria which I think I have always had). I am fairly sure I have optic neuritis, but how long will these vision defects persist? They worsened for about 10 days before plateauing but reading/using a pc worsens it, esp. when I am tired.

[CCF-Neuro-M.D.-CS]

The symptoms you describe could be consistent with optic neuritis. I would recommend having a consultation with a neurologist who can evaluate this condition. Also, a neuro-ophthalmologist would be reasonable. A MRI of the brain may be of some use, especially with special attention on the eye/optic nerve. This should typically be done with contrast. Regarding the recovery if this is optic neuritis, it is not predictable. If this is optic neuritis, a course of IV steroids will help to decrease the recovery time and relapse risk. Good luck.

[Carolyn_H]

I should mention also I had an illness that may well have been viral meningitis (though no definitive lab dx) a few months ago and my health has not been great since then. I noticed sometimes transient visual weirdness in that eye (like there was something in there) straight after the meningitis but it only lasted a minute or so.

Just to add, reflection of light in the cornea of the affected eye (when looking in a mirror) is different, diffuse image (like ghosting) on the surface of the eye. The affected eye often feels dry and burning with a foreign body sensation in it. I don't think the topical corticosteroids are helping much.

Is this an optic neuropathy or some strange conglomeration of other eye problems?

[Carolyn_H]

Thanks for your answer. I think it is (very slowly) starting to improve, though it fluctuates throughout the day depending on light level and how tired my eyes are.

I did have one other question related to my symptoms (if it's not too much trouble) - when I try to look just through my bad eye, it takes a few seconds for everything to click into focus, for the haze to dissipate a bit when I'm trying to read something. Would this be part of the (suspected) neuritis or should I see an optometrist about that when I can see better?