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Eye Care (Expert Forum)
Have MS and double vision
Answered by
John C Hagan III, MD, FACS - Ophthalmology
Discover Vision Centers
Kansas City - MO
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Have MS and double vision
by doublevision1, Jan 15, 2008 08:58AM
Hi,
I haven't been able to post a question in the Neurology expert forum so I thought I would try here.
I have had double vision since Sept 07. I was officially diagnosed with MS in Oct 07. At that time I had a 5 day course of Solumedrol to deal with my multiple symptoms. Most of these were alleviated within a few weeks, but the double vision persists. I was told by various doctors that it would improve in a few weeks, a few months, up to a year, or maybe never. My neurologist does not seem to think I should expect much improvement; my ophthalmologist was very optimistic however he thought it would have resolved in 3 months and here I am, 4 months later.
I have had my eyes tested every 3 - 4 weeks and my ophthalmologist's technician is telling me there is very slow improvement at each appt. I don't understand the measurements but a couple of months ago she mentioned a measurement of 40 ? and most recently, 25. I'm not sure what this means and she had trouble explaining it it to me. She said it is still too early for prisms but these may be an option, if things continue to improve.
I am seeing a regular ophtalmologist. Given the root cause of my problem, should I be seeing a neuro-ophthalmogist? Is there anything they could different that they can do for me?
In the meantime, I am coping with a patch. I find my eyes get very tired from reading, watching TV and using the computer, and try to rest them frequently.
Also, is strabismus surgery a possible option for diplopia caused by MS, should this gradual improvement cease at some point? I have been told conflicting things about this.
I would be really grateful for any insight you can share with me.
Thank you
doublevision1
I haven't been able to post a question in the Neurology expert forum so I thought I would try here.
I have had double vision since Sept 07. I was officially diagnosed with MS in Oct 07. At that time I had a 5 day course of Solumedrol to deal with my multiple symptoms. Most of these were alleviated within a few weeks, but the double vision persists. I was told by various doctors that it would improve in a few weeks, a few months, up to a year, or maybe never. My neurologist does not seem to think I should expect much improvement; my ophthalmologist was very optimistic however he thought it would have resolved in 3 months and here I am, 4 months later.
I have had my eyes tested every 3 - 4 weeks and my ophthalmologist's technician is telling me there is very slow improvement at each appt. I don't understand the measurements but a couple of months ago she mentioned a measurement of 40 ? and most recently, 25. I'm not sure what this means and she had trouble explaining it it to me. She said it is still too early for prisms but these may be an option, if things continue to improve.
I am seeing a regular ophtalmologist. Given the root cause of my problem, should I be seeing a neuro-ophthalmogist? Is there anything they could different that they can do for me?
In the meantime, I am coping with a patch. I find my eyes get very tired from reading, watching TV and using the computer, and try to rest them frequently.
Also, is strabismus surgery a possible option for diplopia caused by MS, should this gradual improvement cease at some point? I have been told conflicting things about this.
I would be really grateful for any insight you can share with me.
Thank you
doublevision1
Doctor's Answer
by John C Hagan III, MD, FACS, Jan 15, 2008 12:41PM
, Jan 15, 2008 12:41PM
I think a neuro-ophthalmologist would tell you the same thing as your regular EyeMD. The treatment you are receiving (watchful waiting) is appropriate. Most MS patients with double vision I have cared for cleared up eventually and did not need surgery.
Most Eye MDs would wait at least 6 months before considering surgery. Bear in mind that surgery will normally not make the eye perfect just lessen the double vision is some fields of gaze.
If it reduces to a small amount prismatic glasses may help.
JCH III MD
Most Eye MDs would wait at least 6 months before considering surgery. Bear in mind that surgery will normally not make the eye perfect just lessen the double vision is some fields of gaze.
If it reduces to a small amount prismatic glasses may help.
JCH III MD
"In primary gaze, the left eye is intorted. There is horizontal diplopia present in primary gaze and worsens on left lateral gaze. There is no diplopia in right lateral gaze. On horizontal saccadic eye testing, there is a latent left intranuclear ophthalmoplegia. With the OKN strip in the left direction, there was decreased fast recovery movement seen. Vertical saccade movements are normal. On smooth pursuit, there are square wave jerks present bilaterally, especially towards the left. As well, there is downbeat nystagmus bilaterally. Convergence is normal."
I thought I would add this in case this info would assist in your response.
Thank you.
doublevision1