Abnormal electro-diagnostic findings

[STAN676]

Patient : F aet 76,since auto impact 08/2006, marked decrease VA OD (from 20/30 uncorrected to 20/100)--VER OD 115.5ms;OS102.5. Electroretinogram abnormal bilaterally;Electrooculogram abnormal(Arden ratio 1.22 on right and 1.49 on left).On a daily basis,patient reports feeling "wind in eyes" and has marked blinking. Funus findings indicate no retinal abnormalities. Neurological tests indicated extra-axial mass seen along the apex left of midline (17x9mm),thought to be meningioma.
As of today,no one has a clue why difficulties are present or course of action. What specialty would be next option.

I am an O.D. Patient is my wife.

[John C Hagan III, MD, FACS, FAAO]

Well from the progression you can tell that its not a common or easily diagnoses problem. Certainly Jules Stein is a world class eye center and a home for difficult to diagnose problems.

Take some heart in that many of the very serious problems are relatively easy to diagnosis. Better a little uncertainty that a iron clad diagnosis of an untreatable or life/sight threatening problem.

Good luck. If you find out a Dx let us know.

JCH III MD

[STAN676]

I do very much appreciate your reply - to alleviate a possible tear film disorder,an Rx was given and produced no apparent results. The real problem is where do we go next.Through the line of referrals,we started with an ophthalmologist (general),then to a retinal specialist,then to a neurologist,and finally a neuro-ophthalmologist who suggested going to Jules Stein Eye Clinic in L.A.
The findings indicate small field loss in right eye,abnormalities in the conductivity of visual responses to the brain,no evidence of macular degeneration,unexplained diminished acuity in right eye.
MS or lupus was suspected some 40 years ago and a "wait and see" approach was used.
MRI brain studies were done twice this year and changes due to MS apparently were not seen.
She does have a cataract in the right eye,but the diminished acuity was after the auto accident,

[John C Hagan III, MD, FACS, FAAO]

As you are aware a comlaint of the eyes feeling like wind in the eyes strongly suggest tear film disorder.

Your best option would be an evaluation by a neuro-ophthalmologist.

JCH III MD