VEP shows mild delay in both eyes

[CCforever]

Hello,

I have been struggling with getting a diagnosis for months, and I was hoping someone could help me. In March 2010, I experienced an episode of sharp pain in my left eye, followed by sudden blurriness in that eye that last for around a month. I underwent 3 MRIs (though none of the spine), 1 MRA, 1 CAT scan, and 2 sets of blood tests. Although the first round of blood tests showed a low white blood cell count and borderline low vitamin levels, by the time I had the second test a week later, the white blood cell situation had corrected itself, and my PCP had put me on a multivitamin. (I was also seeing an neuro-opthamologist and neurologist.) Other than that, everything else was normal, and the neurologist did not think I was showing any other clinical symptoms than the blurred vision and the accompanying pain.

Everything seemed to resolve itself for a few months until I felt another similar sharp pain and experienced about 1-2 weeks of blurred vision at the beginning of September, followed by another episode at the end of the month. The neuro-opthamologist I am seeing did see some signs of dry eyes, but she sent me to have VEP, and that showed mild delays in both eyes--despite the fact that all my symptoms have presented in the left eye to date. She ran another round of blood tests (including lyme disease, autoimmune disease marker, HIV, vitamin B12 deficiency, anemia, diabetes, syphillis, etc--she was very thorough), and everything was normal. I also went for a carotid artery test, and that showed no blockage.

I am really scared and frustrated. I am mentally exhausted, and sometimes quite dizzy nowadays. I know there is something wrong with me, but no one can seem to figure out what exactly. Despite the fact that these delays are mild, I don't want to sit here and just wait for them to progress into total blindness in both eyes.

Is anyone able to help or shed some light on this? Any help would be extremely appreciated!

Thank you.

CC

[CCforever]

Thank you for answering my question. My neuro-opthamologist did originally think I have optic neuritis, but now she is not so sure, because every single test I've had done but the VEP has come back normal. She actually referred me to another specialist, who I am going to see next week, because she is not sure what is causing these issues.

I asked the neurologist I was seeing in conjunction with the neuro-opthamologist to do a spinal tap, but she wouldn't do it. Is it worth asking about this again?

Thanks again for your help!

[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 on a disorder called optic neuritis.

Optic neuritis is an inflammation of the optic nerve, the bundle of fibers in your eye that transmits information to your brain. Symptoms include pain in the eye and vision loss. Color vision loss can also occur. Optic neuritis may be viral, may have no known cause, or may be a manifestation of multiple sclerosis. Most people who have one episode will recover their vision. While eye exam may be entirely normal, another test, called the visual evoked potential, which gives information as to how long electricity takes to move along the nerve, will be abnormal and will point to the diagnosis. If the diagnosis is still in doubt, a lumbar puncture (i.e., spinal tap) to study the CSF is helpful.

It is good that your neuro-ophthalmologist is working on your diagnosis. Many times, diagnoses may not be apparent until later in the course, which is frustrating.

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