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Optic neuritis or something else?

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    Optic neuritis or something else?

    Some background information: I am currently in limboland, my brain MRI came back clear, and I have a follow up appointment with my neurologist in 2 weeks. My neurologist told me before my mri, that unless he sees other evidence to explain my symptoms (all very characteristic of MS), then he thinks I most likely have RRMS.

    I have been feeling fine these past 5 months or so, except for some strange tingling/trembling (during a recent heat wave, but ended as the weather cooled off a bit).
    Last thursday, I was playing on the floor with my toddler. I stood up, and suddenly developed a terrible headache that seemed to be coming from my right eye. It immediately went blurry. I was not dizzy at all, and the intense pain ended after about 20 seconds, and the blurriness subsided a bit during this time. At first I thought that maybe I had had a stroke! Over the next few hours, I had some nagging pain in that eye, it was a little sore to move it, it was still slightly blurry and things seemed darker, like I was wearing a very slightly shaded glass over it, but I was able to get on with my day. The next day, it was still there, so my husband suggested I go to the emergency room. I did, and spent a delightful 8.5 hours there, all to be told, they didn't know what was wrong with my eye. I had a CT scan, and a very basic eye check (they put some kind of drop in it, but not the kind that dilate your eye).


    Today, 3 days after the initial blurriness began, it has almost completely gone, things are just a tad darker than my left eye.
    Could this have been optic neuritis? Would a basic eye exam have been able to show this? Would it have shown up on a CT?
    I should add that back in summer 2009, when I was having a "flare-up" of sensory symptoms and fine-motor problems, I would see flashing lights if I moved my eyes sideways in a dark room. In fact, I thought someone outside was flashing a flashlight at my window, and I spent one particularily frustrating night getting in and out of bed to try and find the source of the flashing before finally realizing it was coming from inside my own eyes.
    Thank you for any information you can provide.

    #2
    Something else. What you've described isn't typical of optic neuritis. ON develops over hours to days and takes weeks to months to recover (although a relatively few people who catch it early and treat it with steroids have recovered in just a few days). ON doesn't onset within seconds or minutes or clear up in seconds to minutes to hours. You can compare your experience to descriptions of ON on reputable medical sites (not forums or discussion boards).

    A problem-specific (not basic) eye exam would have ruled out causes that were visible to the examiner. Anything that occurred behind the eye wouldn't be visible and would have to be evaluated for in a different way -- such as with a CT scan. A CT scan wouldn't have shown ON, but your presentation wasn't suggestive of ON. A stroke was a possibility -- and potentially more serious than ON -- so a CT was appropriate. A stroke was considered because of how your symptoms started. Conditions with a vascular cause can change in literally a heartbeat.

    A detailed eye exam would also have quantified your vision loss. Knowing specifically how your vision was affected could have given the doctor some clues about the cause. Even if you were examined by the ophthalmologist or optometrist on call (and it doesn't sound like you were), you wouldn't have had that kind of exam in the ER because the full array of testing equipment isn't called for in an ER.

    The best time to have seen the ophthalmologist was when it happened or at least while your vision was still blurry. It might still be a good idea to have an ophthalmologist check out your eyes next week.

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      #3
      Redwings must be busy as he usually answers this type of question. I hope I can stand in for him.

      The ER is not going to be able to dx with O.N. They do not have the ability or equipment to do so. You need to go to an eye doctor --ophthalmologist or a ophthalmologist-neurologist

      I suggest you search for Redwings posts on O.N. on this message board as he has much better explaination to why these are the doctors to see.
      MS is not a crisis in my life. It is just a chapter within my life.

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