Old cases of optic neuritis?

[ashleyPT]

Hey guys,

Can old incidences of optic neuritis be detected on exam if you are no longer feeling any symptoms?  I assume the damage can be seen even if there has been some improvement of symptoms, but I just wanted to see.

[Quixotic1]

A couple corrections are needed.

The area of the eye that shows optic neuritis is the optic "disc".  This is the place on the retina (the back of the eye) where the optic nerve comes out.  The lens is the clear, focusing part of the anterior eye behind the pupil.  The iris is the anterior colored area that we see as blue eyes or brown eyes.

Retrobulbar neuritis is actually Retrobulbar Optic Neuritis.  The words Optic Neuritis refer to any inflammation on the optic nerve from where it leaves the eye all the way back to the brain.  Retrobulbar refers to that part of the optic nerve that is farther back behind the eyeball.  All the literature states that after optic neuritis heals (no matter if it is retrobulbar or not) it should leave a person with an abnormal VEP forever.  However, there is a lot of variability in how the VEP is performed and interpreted.  So, some people with a history of ON will have a "normal" VEP in the future.

Whether the disc is pale from loss of fibers is relative.  If the damage is very slight, the examiner may not be able to percieve the faint paleness.  There has to be quite a bit of damage before it is visible - hence the hope that OCT will be useful.

In general, anywhere in the central nervous system, when an area of demyelination heals, the healing is NOT PERFECT, so the function of that nerve will always be a little slow.  That is why you don't have to be having symptoms for an Evoked Potential to be abnormally slowed.

Does this help clear up some of the questions?

If you google

optic disc

you will see a site that show pictures of the retina and shows the disc.

Quix

[Erin0313]

Quix,

  Thanks for the scoop on ON. I think I get it.

   One more question if you or anyone else knows. As you know I have had 2 episodes of ON already this year requiring 5 days each of IV Steroids. I now have the beginning of a cataract in my left eye.

One doctor says it's from the ON and the other says it's form steroids.

I see a neuro-opthamologist next month but am curios which is it and should I say no to the steroids because they are giving me a cataract?


Thanks,
Erin :)

[essdipity]

I'll be interested in comments on this. I've never heard of cataracts being caused by either ON or steroids, so if someone has good info, please let 'er rip.

You are very young for a cataract, but at the same time, cataracts are not entirely an old people's disease. Babies have been born with them, and they can occur at any age thereafter.

The good news is that cataract surgery (if needed---not all are that bad) has become incredibly easy on the patient. Almost no discomfort or down time. Very few complications. And the best news of all is that once the surgery is done, the cataract can't recur. So from that standpoint you are set for life.

If you need steroids, I say get them. And please let us know what the neuro-ophth says about this.

Hang in there.

ess

[PastorDan]

Ophthalmologist I saw last December -- after the faintly hazy patch appeared to the upper right, but before I began to experience eye pain -- said I had the very faintest hint of cataract in each eye, but that it was very faint, and might never be a problem.

jdhecaj, these words hit me square in the face: "Many patients with optic neuritis may lose some of their color vision in the affected eye, with colors appearing subtly washed out compared to the other eye."  I've used very similar terms in describing the odd patch in my field of view, but I think this is the first time that I've seen a reference talking about the color vision issue.

[PastorDan]

Oh, and I forget where I mentioned it, but I learned today that I'm to see a neuro-ophthalmologist mid-May.  Yes, I told them to call if they have a cancellation.  They put me on the list, but warned it's a long list already.

[jdhecaj]

Thanks for clearing up the definitions of lens & optic disk. I had looked at diagrams of the optic disk and thought that must be the lens that people speak of. But it is different. I didn't have as much success a googling optic lens. I just got glasses when I tried it..