Eye pain

[Lyn2]

Thank you for your time. I am a 35yr. old female.  I have a pacemaker, I take amiodarone, cardizem, midodrine, lasix, coumadin, inhalers for asthma, fosamax.   Last weekend, I suffered with extreme left eye pain.  I could not move my eye correctly, when I looked down my vision was doubled, and the eye movement was terribly painful just above my eye.  I took migraine med, put an ice pack on my eyes, and tried to stay still.  I woke up during the night in pain, and in the morning it was still there.  I took 2 vioxx over the course of the day.  
I went to see my PCP for a follow-up for a sinus infection that I had the last 3 weeks.  I mentioned the eye pain and he said it did not sound like migraine.  He sent me to an opthamologist.  At that point (4 days after the pain began) my eye still hurt on movement but not as severe.  
The opthamologist said there was a muscle and nerve inflamed and I am having a ct-scan in a couple of days.  One thing the doc. did was comparing a red bottle with both eyes.  In the unaffected eye it was red, and the other was brown.  Since then I have discovered that could be a sign of optic neuritis.  Today and yesterday, for the first time my eye is blurry and sore, not just behind it.  
So my questions...
Wouldn't the doc. be able to see optic neuritis by looking into my eye?  Or is it not necessarily visible?  How do they determine if that is the case?
What other problems can cause inflamation behind the eye?
Any input would be helpful.
I cannot have an MRI because I have a pacemaker. Will a CT be sufficient?  Thank you so much!!!!

[t_anunson]

Hi all. I`ve had an intermittent eye pain in my right eye for 2 weeks now. It is a dull slight pain that comes and goes. No vision problems that I know of. Seen an opthamologist, didn`t see anything wrong supposedly. Could this be a sinus infection? I haven`t been that stuffy, but nose has slight intermittent stuffiness and slightly running here and there. Had MS like symptoms recently. Had brain MRI, C-Spine MRI, both normal. Thanks....

[majwilliams]

A related discussion, Intermitten pain in right eye was started.

[CCF-Neuro-M.D.-JT]

Optic neuritis is certainly a physical exam finding that ophthalmologists and neurologists should be able to see on exam with a funduscope (those funny little instruments connected to the wall that docs use to shine light into your eye and stare into it for a long time until you're blind). Furthermore, an opthalmologist should be able to dilate your eye and use more specialized instruments to take a look. Consdier seeing a neuro-ophthalmologist or just another ophthalmologist if yours isn't sure. Your history does sound a lot like optic neuritis - painful on attempted movement, decreased vision, and color desaturation.  

As you may know, optic neuritis has a strong association with MS and that's probably why they're pushing for imaging of the brain.  A CT however is not enough to make or break the diagnosis of MS.  You will likely need a spinal tap, a formal neuro exam, and evoked potentials as well as lab work to help rule in the possibility of MS without an MRI. If you don't absolutely need the pacemaker (depends on what you have it for) some insititutions like the Clinic do turn it off for patients who need an MRI and have a cardiologist standby just to make sure everything is ok.

Amiodarone is also well known to cause optic neuropathy as well as other eye complications and the need to continue with this medication in the current setting of an optic neuropathy should be discussed with your PCP and cardiologist. Good luck.