Difference between eye problems and brain problems

[Rena705]

I have been diagnosed with MS but been told by my neurologist that it is "in-active".  I believe I had a relapse in July of 2007 and since then I have been having difficulty with my vision.  I have had intermittent double vision and when I am tired my vision deteriorates drastically in that I am unable to read any print with my glasses on and I find myself having to squint to make out shapes on the TV.  My vision in general has deteriorated in that I am having difficulty reading street signs while driving and therefore driving has become something that I don't particularly want to do for fear of misjudging something and causing an accident.

My Opthamologist has told me in March 2007 and November 2007 that my "eyesight" has not changed in two years and the problems I am having are related to my having MS.  

My question is this...how can you tell if the problems I am having are from "my eyes" or from "MS"?  I saw the Opthamologist yesterday and was given a lecture on how lucky I am to not be in a wheelchair and that there are people worse off than myself with MS to which I responded with the question "but can they see?".  I was told that he feels that the difficulty I am having is due to the MS and that he will do a vision acuity test in two weeks because he didn't have time yesterday.  I would be very grateful if you could explain to me how an Opthamologist can tell the difference.

Sincerely,
Rena705

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

Two year wait to see a neuro ophthalmologist. My lord.

You can do what many Canadians do and come to the USA for treatment/diagnosis. There are fine neuro ophthalmologist just across the border.

JCH MD

[Rena705]

bump

[Rena705]

I also wanted to mention that I have an intermittent little neon white tadpole shaped image that swims through my vision of my left eye disappearing into my peripheral vision.  I also have bouts of my peripheral vision on my right eye seeming like I am looking through a thick clear liquid making everything appear wavy.  I don't know if these are symptoms that should be dealt with or not.  My Opthamologist hasn't asked me to date what my symptoms are...he has only looked at my eyes.  Should I make a concerted effort to ensure that he knows about these problems or are they of no consequence?  

I truly appreciate any assistance you can give me...I am stuck between a rock and a hard place and I don't see any way out in the near future...

Rena705

[Rena705]

I appreciate you both responding to my query.  I am living in Canada however so unfortunately the aao.org will be of no use to me.  When I orginally made my appointment with my Opthamologist I asked if he ever refers patients to a neuro-opthamologist and was told that he does not.  Apparently there is only currently one neuro-opthamologist in my city and it is a 2 year waiting period to see him.  I have been told that there is a new one opening a practice in the same hospital that my current Opthamologist does eye surgery in and this is supposed to happen in August.  I went to the Opthamologist in the hopes that he would be able to further assist me as my neurologist has stated that my MS is in-active and my gp (pcp) has no history in dealing with MS patients and has admitted to her lack of knowledge of MS.  Therefore she is taking what the neurologist as gospel and will not help me get a second opinion.  

I am quite concerned about this sight problem and I am not sure what my next step should be.  I have been told by many that MS is never in-active and when I mentioned this to my Opthamologist he stated that this is something that my neurologist would know about and that he really could not make a call on it.  He didn't suggest a second opinion and he seems to be brushing off my concerns the same as everyone else has that I have seen.  I feel that I have been treated very unfairly and have nowhere else to turn.  I don't know what he hopes to prove with a visual acuity test or how important this is to the well being of my eyesight but I guess I will have this test and see what he has to say after that.  I will let you know if he was of any assistance to me other than telling me that my eyes are fine yet again and that my MS is causing the problem.  I am terrified that since my MS is not being controlled by any of the disease modifying drugs that my eyesight could deteriorate to the point of disability...I feel like I am gradually getting close to that point now...but if the doctors don't want to help what is left to do?

Rena705

[Nancy T]

Sounds like you need NEW DOCTORS.

MS is not "inactive." It is going on in your brain all the time to some extent, even if you aren't having new symptoms.

And your eye doctor was wrong to compare your situation to others'. Lecturing someone because others are worse off is not something doctors should do. They should just deal with the patient in front of them on their own terms. HOW was it helpful to you to be lectured that some people with MS end up in wheelchairs? As if you didn't know that?

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

Frankly many of your problems described in your first paragraph are consistent with MS. I would see a neuro-ophthalmologist for a second opinion. Find one at www.aao.org

JCH MD