Neuro ophthalmologist

[Katje]

Anyone in the Denver area who can refer me or know of a good neuro ophthalmologist?

I suddenly been having vision problems. One day I simply could not read close! Go see my regualt eye doc, he laughs it off, days I have myopia and dry eye.

Well 3 months later and a new eye doc, I still can't see! Far vision looks a little off and close vision is blurry but not all the time but still something seems wrong.

I am wearing air optix multifocal, because my vision is -4.25 nd -4.50 close vision is 1.75.

I had ON two times in the left eye about 15 years ago, it's a little shakey and doesn't track as well as the good eye, however I been able to see just fine for years!!!

I also had n optical migraine 2 months ago which seems odd since I never had one.

I am a bit nervous, I think it's time for a neuro opth.

[Toomnyhats]

Sorry I don't have any names for you, just wanted to agree that it's time for a neuro-op.

Maybe the MS Society has a name to recommend? Mine specialized in MS pts, maybe the Denver-area is big enough to have one?

[Redwings]

Hi Katje:
I don't have a recommendation for a specific neuro-ophthalmologist. But if it might help you in making a selection, the North American Neuro-Ophthalmology Society has a find-a-doc feature on its website: [url]http://www.nanosweb.org/i4a/member_directory/feSearchForm.cfm?directory_id=1&pageid=3390&showTi tle=1[/url].

Your post indicates that your situation is more complicated than your realize. You have several factors affecting your vision that are completely unrelated to neuro issues.

First, how old are you? Your new inability to focus close up suggests that you've hit the age where presbyopia begins. Presbyopia is the normal loss of the eyes' ability to pull focus from far to near. In general, it starts around age 40 (for me it was 41). For some people it onsets slowly, and for others it seems to hit overnight.

That you're wearing multifocal contact lenses also indicates that you're probably presbyopic. It makes me wonder if what you consider your eye doctor "laughing it off" was really him explaining to you about presbyopia and its inevitability.

The other significant issue is that you're trying to assess your vision through soft multifocal contact lenses. Because of the way they're made, the optics of soft multifocals are mushy. It's virtually impossible to get crisp vision through them at both far and near (and that's why I don't wear them). So if you're thinking that something about your vision is off, you're right, and that's based only on the nature of the contacts, without even adding in yet the effects of a possible neuro factor.

Dry eye degrades the optics of soft multifocals even further. Then, if there is a neuro issue, such as unequal best-corrected visual acuity between the eyes or a deficit in contrast sensitivity in one or both eyes, the optics of soft multifocals don't work well with those and make the visual problems even worse.

It isn't possible to base an assessment of your neuro function on your vision through soft contact lenses, especially multifocals, and with dry eye. The only way for you to know what your true vision is like is to assess it through a pair of glasses with the optimum prescription for far and near, and to treat the dry eye, since the tear film is an optical component. A lot of people who wear contacts are wearing them because they obviously don't want to wear glasses, and they don't even have backup glasses. And they don't want to go the expense of keeping up with glasses when they've already paid out a lot of money for contacts. But you'll never be able to get a true assessment of your vision if you don't do it through the stability of glasses.

Your optical correction is a major determiner of what your functional vision is like, so you'll have to rectify the situation somehow -- for two reasons. First, if you do have some neuro-ophthalmological issues affecting your vision (in addition to the optics of the contacts), your vision will never improve if you continue to try to see through optics that degrade your vision instead of maximize it. I wear glasses because they allow me to squeeze every bit of acuity and contrast out of my severely compromised eyes.

Second, understanding the effects of presbyopia and your contacts will give you more realistic expectations about your neuro-ophth exam and the findings of the exam. In the event that the doc doesn't find any significant neuro issues with your vision, you'll have the proper perspective to understand [I]why[/I] the trouble you're having with your vision isn't a neuro issue. Otherwise, you run the risk of blaming the doc for not being able to find a problem with your vision when you know there is one. Neuro-ophths are superspecialists, and the one you see isn't going to deal with your contact lenses and possibly not even with dry eye.

Because of all of the factors that contribute to vision, some neuro-ophths accept patients only by referral, to try to ensure that all of the issues that aren't neuro have already been ruled out or accounted for. Other neuro-ophths accept self-referred patients. That's handy to know as you research the docs in your area.

You have a lot of things to think about. I appreciate how complicated and frustrating it all can be, and I wish you all the best as you get everything figured out.

Caution: not proofread before posting.

[Katje]

Thanks for the reply Redwings. Most the things you stated were told to me by my Doctors regarding multifocal lenses.

As I type now, I feel like I am seeing slightly double but the letters are sharp. Without my contc ts this morning I could read the text on my phone just fine. I feel like I am losing my MIND! lol It is very frustrating, however I am not sure if the lenses are to blame 100% because I had this problem before I got the multifocal 3 months ago, seemed like it did happen overnight. Last night on my laptop I could see close ok, so if it is dry eye causing my vision to be inconsistent, the eye drops are not helping much.

I am going in for a brain MRI tomorrow to see if there is anything going on.


Also we did discuss progressive lenses vs the older style with the bifocal on the bottom, I am still thinking about it.

Right now my lenese are 4.25 4.50 and 2.00 for close. I feel really blind right now.

[Alicious]

There are two in the Denver area, both in Aurora at the Colorado Hospital Anschutz Outpatient Pavilion/MS Center. I saw Dr. Victoria Pelak; she was fabulous. Contact info is in the link.

http://www.ucdenver.edu/academics/co...ges/Pelak.aspx

[Katje]

I had an MRI, my neuro called and said no changes.

[Redwings]

Originally Posted by Katje

I had an MRI, my neuro called and said no changes.

Yay! That's great!

So here are a couple of questions for you to answer for yourself -- not for me: Why are you more willing to believe that your visual difficulties are due to a neurological problem rather than to normal presbyopia and bad contact lenses? And: With no changes on your MRI, what are you going to do about your visual difficulties now?

[Katje]

I assumed it was neurological because it seemed to happen overnight. Ok I admit for the past few years it's been harder reading pill bottles, instructions on cake mixes and shampoo bottles but never affected my vision on the computer or texting and my distance far away seemed odd too.

The eye doc said my vision has not changed except for close up. Problem is I cant see far so moving further away from the computer or books doesn't help.

We are stil playing with the power but I think we have it where I am getting used to it now. They said not let the 2.0 power in the contacts scare me because contacts too glasses are not the same. My glasses are weaker, but I was told the multifocal contacts my vision will never bve prefect but thats the price to pay wearing contacts vs glasses. SO I bought a new pai of true religion glasses and waiting for the RX lenses.

[Tawanda]

Originally Posted by Redwings

I wear glasses because they allow me to squeeze every bit of acuity and contrast out of my severely compromised eyes.

I have been struggling whether or not to put my DD in eyeglasses or contacts (DD does not have M.S.). My husband thinks that contacts correct vision directly on the eyeball and are the better choice and that glasses are just going to make her vision increasingly worse. This has been seemingly true in our case as I need a new Rx every year with my glasses and his contacts Rx never changes. I noticed my eye doctor has choses contact lenses for himself (hmmmmmmm....).

You seem to know a lot about eyeballs. I am guessing Katje likes the looks of contacts. I probably would, too, especially if glasses are doing more harm. Just curious about your opinion on this one...
Tawanda
p.s. I never proofread here...everything about M.S. comes from my unedited gut.