hi sir ,i hope i can finde the answear here because i almost give up that my son is normal by mny doctors here in qatar ,my 5yrs old son had a blue vission fter head truma and blurred vission but fundoscopy and ctscan head was normal ,he cant see the first number in the teste but hes eyes is completly normal in electronic exam and after dilatation of the pupies...is is reversable?any thing i can do for him?your answear is vital
notice :he can see the colour only if he take it and approach it to he`s eyes around 20cm only.
dr.mohamed zuhdi abu-khalil
Dear Dr. Zuhdi,
I think I can explain what is going on with your son. First, let me say that there is a good chance his vision will return to normal in a few months at most. What has probably happened is, the trauma that took place has done something to his optic nerve, which transmits information from the eye and to the occipital cortex of the brain. This can be called either optic neuritis or another condition called traumatic optic neuropathy. These can be caused by inflammation or swelling of the optic nerve, and in your son's case happened because of trauma, and this will resolve either on its own in time or can be speeded up by steroid medications. There is also a chance his optical cortex was damaged... but the MRI apparently said otherwise.
To diagnose those conditions, first let me tell a little bit about problems with determining if it's optic neuritis. Optic neuritis is basically inflammation of the optic nerve, which according to an article about it at medicinenet.com, the typical way of looking at the optic nerve is with an opthalmoscope, but in tow-thirds of patients with optic neuritis, inflammation is not visible. So, if the opthalmoscope doesn't see a problem with the optic nerve, then an MRI with "gadolinium enhancement" may show an enlarged optic nerve. Also, if color testing is checked, which your son only sees blue, then this contributes to the diagnosis of optic neuritis. In addition, since he cannot see the letters in the eye chart, this also points to optic neuritis.
With traumatic optic neuropathy, in addition to the opthalmoscope viewing of the optic nerve and the other regular eye tests, it is specifically required that the physician do "visual field testing," according to an article at opthalmic.hyperguides.com in the tutorial section. Results from visual field testing is the certain indicator of traumatic optic neuropathy. And again I need to mention the possibility that the optical cortex may have been damaged from trauma, and a neurologist can determine if this is the case perhaps from the scan pictures you already have.
Whatever condition your son has, inflammation/swelling is one of the cores of an optic nerve problem, so treatment is very similar, which one of them is basically to give IV steroid medications, like prednisone, so as to speed up recovery, since that kind of drug reduces inflammation in a hurry. I might add that anytime steroids are given to a patient, it has to be balanced with the risks of that drug, which are higher anytime a trauma has occurred, so the physician who treats him needs to weigh risks carefully.
I hope this will help you. Keep in mind I am not a physician, I just have read about these things, and so an expert in optic neuritis and traumatic optic neuropathy, as well as in problems from damage to the optical cortex of the brain, needs to be the doctor you consult with about proper diagnosis and thus treatment of your son, plus he can give you far more accurate information about the prognosis for recovery of vision, how bad the optic nerve is possibly damaged, or if it's the optical part of the brain that has been affected, and so forth. I hope your son's vision gets better soon.
Just today I noticed flicking lights, as a example I was on my cell the lights was going off/on split seconds, I went to bed woke up I started seeing low lights flicking I turn to see if the tv was on it wasn't...what's going on should I be concerned after all just had a eye exam the optical didn't say anything was wrong
After following the suggestion of seeing a Opthamologist about the eyes, You need to take him to a Neurologist and have MRI and SPECT scans done on his head. If there is some mild brain damage look into Hyperbaric Oxygen Therapy (hbot) that is used by scuba divers who get the bends.
In Ft. Lauderdale there is Neubauer's Neurological Center on the Beach (http://www.oceanhbo.com/) who have been doing this for years. There is also Ray Cralle's Physical Therapy in Delray Beach who connects PT with the hbot (http://www.raycralle.com/).
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