Is there a connection, j i a and optical nerve swelling?

[mummy4]

my son is now 9 yrs old and he has had his share of problems! he had heart surgery at 14months to close a large vsd and still has mild pulmery stenosis. He has asthma. Then when he was 5yrs old a light was dedected in a photograph in his left eye, after lots of hosp visits and scans to our local hosp then great ormand st and now moorfields, london he was diagnosed with optical nerve swelling, the problem is he has had every test under the sun including our prof taking his notes to europe and the usa and still they cannot find the cause of the problem and say apart from the patching he has done, there is no treatment as there is no other person on record with the exact same condition! Then to add to our problems earlier this year my son started having severe pain around his heels and under his feet, he has bin having physio for the treatment of plantar facitas, but after seeing  a specialist yesterday he has now been diagnosed with J Arthritis..........as a friend of mine's son also this i have spoke to her about it only for me to find out that when children have J I A they have there eyes checked for swelling behind the eye!!! As i cannot get an earlier app for my son than oct at moorfields, could you tell me if there could be a connection even though he had the eye problem first? PLEASE HELP!!

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Juvenile rheumatoid arthritis can be associated with a condition called chronic anterior uveitis, which is an inflammatory condition of the eye. It is a condition that can be devastating. Thus, frequent eye examinations are crucial. If noticed on examinations, urgent treatment is required.

Optic nerve swelling, i.e., papilledema, is a different finding. There are many things that can cause papilledema such as a brain tumor, head trauma, infection, and blockage of the normal flow of the CSF. It can also be a benign finding. If it was noticed that your child has this, he/she should have an MRI if not already completed. Additionally, frequent eye examinations is important in order to monitor vision. If the optic nerve swelling is causing symptoms, a VP shunt may be placed.

I cannot comment if all of the conditions your child has are related or not. I do recommend that he/she be seen by a physician (i.e., PCP) and also by an ophthalmologist and perhaps a rheumatologist. Additional imaging (i.e., MRI) and visual fields are needed to complete the workup.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[mummy4]

thank you for your answer. My son cannot have an MRI as he has metal wire in his chest from heart surgery he had at 14mths, but has had a 'cat scan' and has now had a 'bone scan'. I still cannot get an earlier app with his eye proff but as he is one of the top in the country i am hoping that he would already have made the connection and tested him for this before!! his finding is benign and does get checked but we havent seen the prof since he started having all the pains in his feet/knees..........