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optic nerve
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optic nerve


Posted by A patient on April 27, 1999 at 10:33:36
I start to see a black line in my right eyes one year ago.  My right eye has nearsight about -12 and left has -7.5.  I went to go see a doctor and have a check, he didn't say much and just said coz of my serious near sight etc.  then few months later there is another black line appear close to the perious one, so i found a friend who is a doctor, she introduced another optic doc to me, and that doc has a very detail check for my eyes.
Accoding to the result she gave me, the arden ratio of my both eyes are 1.40, but i don't know what's that mean, and she said my eye nerves are not very good too, the function even worse than a 60 years old person's eye nerves.  But the macular is in a good condition.  However, she didn't suggest the way to cure or to ease the depression.
There is one more line appear at the lower part.  I always feel my right eye, at the up left concer pain, its the surface of the eye ball and it seems something stick to my eye ball.  Sometimes when i open my eyes in the morning when i wake up, i saw a big net( like a large whole net) but it only last for few seconds.  I am extremely scare of sunlight, i can't open my eyes even i stand under the shadow and look at the place under the sunshine.  And when i saw some zerba shape like lines (black and white lines, or white and any colors lines), i always see the white line "jumps".  If i look at the chequers that consist with white color, I will see the chequers are winking.  When i look at something with bright background, i can see alot of small white dots (not bigger than the needle pin) runs around quick.  I always see some dark shadow appears, sometimes it is white color, not big, but will last for few seconds or half a min.  And I always see some thing little drop very quick from top to down.  
I have seen many doctors and they have my retina check, and said its ok.  I really would like to know what's up with my eyes, how can i fix it?  It worries me alot, and I feel lot of pressure, I am only 26 years old, I am afraid one day I will suddenly go blind just like how the TV broke down.  Would you please tell me what's low arden ratio mean and what's the possible diease i would have?  Is my optic nerve dying out?  And if possible, could you tell me how to cure it?  or whether it can be cured?

Posted by CCF MD mdf on April 27, 1999 at 23:35:56
I don't think you have seen a neuro-ophthalmologist. The precise nature of the visual field defect should be defined and then if there is a problem with the optic nerve or the brain processing circuitry, it should be localized.
Migraine comes to mind, especially at your age. It would be worth seeing a neurologist to get a very clear precise history and appropriate neurologic exam. Of course, a neurologist won't examine much in the eyes per se, but would look for other signs of neurologic dysfunction as clues to your problem.
If you are not far from Cleveland, you are welcome to seek a second opinion here - just call 800 223-2273 and ask for neurology appointments (though neuro-ophthalmology would be at a different phone number).
I hope this helps. CCF MD mdf.



Posted by A patient on April 29, 1999 at 20:26:03
Thanks for your help.  But i am almost never have headache, unless i have it but i didn't feel it.  and would you please explain what is low arden ratio means?  
I also experience that sometimes the envirnoment is brighter to me, its like someone just suddenly turn one more light on, so you can feel suddenly its more light.  but sometimes it the reverse case, its like someone suddenly turn the light off, so i see nothing for one or two sec and then i can see things again.  and when i look at something in pain color, especially it is far away, i can see a frost in front of it.  I know I need a check on the nerve, but I would like to know based on the sytom that i descripe, what would be the possible diease i would have?

Posted by C. Taylor-Jenkins on May 11, 1999 at 16:49:20
To A Patient:
I am not a physician, I am a patient who sympathizes and would like to make a suggestion that would perhaps make things a bit easier for you.  A really good Oculo-plasty Opthalmologist might be able to shed some light (no pun intended) on your dilemna.  I have no idea where you live, but wherever it is, there has to be a major hospital facility with good clinics.
One must remember that good physicians are great detectives and some physicians are virtual Sherlock Holmes's and Doctor Watson's who took the time to become specialists on every part of the human anatomy.  Please call the nearest hospital clinic and ask if they have an Eye Clinic.
Be aggressive and explain what's going on.  You are your own best friend and a best friend would go to any lengths to help you save your vision.  So, don't allow the bad friend pull the plug on your TV set.  If that happens... it means you aren't aggressive about your ownself.
Call an Oculo-plasty Opthalmologist or a Neuro-Opthalmologist immediately, if not sooner because... I care... and I am about to undergo a difficult surgery to remove tumors that have eaten away my orbital floor.  So bad that I am going to need facial reconstructive surgery... and then, I'm not guaranteed sight when the bandages come off.  All I know is that I have sight now, and my self-assertiveness led me to... the Oculo-plasty Opthalmologist.  And I believe I will see afterward because of the relationship that has developed between us and the fact that he told me, "I'll let you put it off (surgery) for as long as you can stand the pain... and be advised, I will not let those tumors rob you of your sight."  And he isn't.
Assert yourself, A Patient... and get your job done.  Somebody at the Cleveland Clinic, or at Emory, or at the Med College of Georgia, or Johns Hopkins, or Cedars... only you know who you are close to.  If I lived near Cleveland... and by near, I am referring to a radius of 200 - 300 miles.  Same for
Emory in Atlanta, etc.  Just get there.  Because your eyes are your windows of the world.  I would rather be deaf than blind.  At least you would  be able to see  the pages of a book, or photographs you've taken.
Take care,
C. Taylor-Jenkins

Posted by Elizabeth on July 07, 1999 at 14:04:56
Good God, Girl! Hang in there!! Comparing my annoying difficulties with a person like yourself puts things into perspective.....Hope all goes well! Elizabeth

Posted by C. Taylor-Jenkins on July 11, 1999 at 12:16:55
Hey hey Ms. Elizabeth!
Thanks for your boost of enthusiasm!  The surgery went superbly!  The only exception concerned the sorest tailbone ever in my 45 (soon to be 46) year history of plopping into chairs on this earth!  It was from the surgical position I held during the 6-7 hour craniotomy which entailed the removal of the entire left side of my forehead (from bridge of nose straight up to behind my hairline across to above temple down to above ear and over to the corner of my eye).  The incision will eventually be totally concealed by hair.  All bone work was done via the incisional flap I descibed.  One BIG long external one with the major work via it.  AMAZING, HUH?
The orbital floor reconstruction went fabulously.  My eyeball is reseating itself in a slow-go beside the surgical inflamation (inflammation) recedence.  Best of all, girl... my eyesite remains intact!  Words cannot describe the total elation I felt through the discomfort of WATCHING that danged breathing tube leave my mouth in intensive care!  What was even better than that occurred when my eyes shifted right from that crummy tube and lit upon my husband standing against the wall wiping his eyes in the crook of his arm because the first words out of my mouth were:  "Hey...(cough)...hon...(cough)... I pressed...(pointing finger)...that shirt last!!!!  Then I said, "I can see."
So... I recommend Oculo-plasty Opthalmalogists to the moon and back because they "can fix"... plus Neurosurgeons... plus dedicated Maxilofacial Plastic Surgeons.  I had a truly special trinity of docs on my case.  I guess when ya need, ya receive.  Again... thanks, and...  Eye 2 use AOL, so... if you email me, I'll email you.  Let me know what's going on physiologically with you.  I might be a boost for you in the same manner.
Again... many thanks,
C. Taylor-Jenkins

Posted by CCF MD GS on July 20, 1999 at 11:02:02
Thanks for the input everyone. I think that we have determined that you need to see a neuro-optholmologist in your area. The Cleveland Clinic does have an international center if you wish to travel here and you could call 216 444 2200. I'm not sure that neurologist are well versed in Arden ratios at all but I know they do have something to do with the retina and if low could indicate a retinal pigment problem. Therer is also something called a Arden Grading system that looks more at optic nerve function but these are weel out of our area of expertice. If an experienced neuro-opthol can not help you then you should see a neurologist. You may need an MRI scan depending on the findings. Hope this helps and good luck.
This information is provided for general medical education purposes only. Please consult your doctor regarding diagnostic and treatment options.



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