Ok, Eye dr. said my eyes are fine, this means what?

[jenniferk86]

So, I have been having blurred vision intermittently for about the past 3 weeks and it will last anywhere from 30 min to a couple hours in just my left eye.  Then for the past 2 weeks i experienced 3 separate episodes where my left eye got dark just like I put a really dark sunglass on it and the other eye was fine for about 15 min or so and slowly faded back to normal.  I went to the ophthalmologist who dilated my eyes and said my nerves look fine and everything else looks good.  If I had ms, would my eye exam show something abnormal or is this a typical finding for ms patients that have vision problems... and what could explain my vision changes with a perfectly normal eye exam?

[jenniferk86]

still just being considered for MS, right.. actually just recently being considered.  He told me that if my eye exam was normal, then I stop taking lamictal to see if that is causing my vision issues, then if that doesnt go away, then do mri for possible ms testing....

[COBOB]

Optic Neuritis (ON) can be a sign of MS and is a separate disease and can be treated on its own.   IVSM is considered a recognized treatment for ON since a controlled clinical study called the ONTT was completed.  It is not needed, but the ONTT showed that IVSM speeds recovery and it also showed that low dose oral steroids were of no benefit.

The major findings of the ONTT included:
"Combination drugs speed recovery. ONTT helped define the role of corticosteroids in the treatment of acute optic neuritis. When the study originated, many doctors were treating the condition with oral corticosteroids. The study looked at oral prednisone vs. high-dose intravenous methylprednisolone vs. placebo and found that the IV methylprednisolone followed by a tapering course of oral prednisone accelerated visual recovery by a few weeks.

Recovery of vision occurs with or without treatment. The investigators found that the choice of regimen has no effect on final visual outcome. Most patients in the placebo group recovered vision, on average, in six to eight weeks. Oral prednisone alone was no better than placebo with respect to visual recovery and, in fact, was associated with twice the risk of recurrent optic neuritis. It is no longer recommended for an initial episode of typical, presumed demyelinative optic neuritis. The therapy should include either high-dose methylprednisolone or nothing, Dr. Beck explained.

White matter lesions predict MS. The initial findings, published 16 years ago, in 1992, still apply today, said Dr. Beck. But in addition to determining a therapeutic regimen, the ONTT defined the risk factors for development of MS among patients with optic neuritis. The presence of asymptomatic white matter lesions on the MRI scan is the strongest predictor for MS. Few patients at the start of the study had any history of MS, but over time the numbers grew.

Outcome favorable and stable. For the majority of patients, even those with MS, the visual outcome is good. Those who develop MS are more likely to exhibit abnormal visual function findings, but their vision is normal about 60 percent of the time.

There was little or no change in visual acuity in the affected eye between the 10- and 15-year examinations, in most patients. After 15 years, 72 percent of patients with optic neuritis had visual acuity of 20/20 or better; and 66 percent had acuity of 20/20 or better in both eyes."
http://www.aao.org/publications/eyenet/200807/neuro.cfm

Bob

[COBOB]

Talk to your neurologist first.  In many places, it is hard to find a Neuro-ophthalmologist.  In Denver there are only two in private practice outside the local hospitals.  If the symptom is paroxysmal,  it may be difficult to nail down.

I have an seen a neuro-ophthalmologist and currently see an experienced ophthalmologist that consults with my neurologist.

Bob

[jensequitur]

You could see a neuro-opthamologist, although there really is no treatment for optic neuritis.  Your neuro can prescribe steroids, although I think you're still just being considered for MS, right?

[jenniferk86]

So, do I need to see a neuro-opthamalogist? my vision is 20/25 and always has been.... no permanent blurry yet, should I be  referred to a specialist or wait and see.  Thank you so much for all of your input... you seem to know a lot about all of this and I am kind of just looking for answers.  

[jenniferk86]

Anybody have any insight here?  Does eye problems associated with MS usually cause an abnormal eye exam?