I don't think my vision issues are ON...

[Pressednotcrushed]

Hi, I have been wondering off and on about some vision issues I have been having since shortly before MS made itself known to me. I have noticed over the last year and a half or so I have been getting blurry vision probably 50 times maybe more because it feels so frequent.

Usually my eyes get really heavy and I have to use all my concentration to focus on things close to me, a headache usually accompanies the blurred vision. When this happens I generally have no trouble seeing a few feet away or further. They last until I get a nap or a second wind burst of energy so I attributed them to being tired.

While that is inconvenient and I got a strange sense of relief when the MRI showed not tumors, lesions etc... that affected my eyes I am not very bothered by them.

However, in the last 3 months I have had some issues that have kinda freaked me out. The first only lasted 20 min or so but I was reading and it was like I got 5 or 6 blurry spots on my eyes but only about one letter wide and when I moved my head or the book I could read.

The reason I am asking about it now is that for the last 3 hours I haven't been able to see clearly up close. Far away is better but not clear either. If I try real hard to focus I can figure out words but generally in front of me is blurry.

From what I understand about ON my symptoms don't really fit. I tried to do a little research but since I am struggling so hard to write this I wasn't very successful. Thank goodness for spell check. What do you guys think? I have a call in to my neuro but experience tells me that it will be a few days before they get back to me.

[sportsfan]

I'm no expert but I've had ON and none of my symptoms were like that.

[barelracer]

maybe...

could you be experiencing scotomas? thats sort of what it sounds like...

or problems maybe from migraine with aura? you dont even need to feel the migraine/headach for it to affect you vision..

just an idea!

[SonnyC]

I'm have ON right now (2 weeks).. That doesn't sound like it to me.. Although there are as many descriptions of ON as MS..

[Redwings]

Hi Pressed:
You're right -- those are not symptoms of ON. And -- very, very important -- those are not symptoms your neurologist is trained or equipped to evaluate or treat. Your neuro might end up getting involved at some point, but you're describing functional vision problems that are way out of a neuro's territory.

The kinds of problems you're describing aren't anything you can properly evaluate for yourself. You'll have to see an eye doctor or two to have that done.

The 20-minute nature of some of your symptoms is highly suggestive of transient ischemia (including migraine). Your neuro is the doc to deal with the cause and treatment of it, but isn't the one to deal with the visual effects.

The sustained loss of near vision while distance vision is clear can have several causes, all of which need to be evaluated for individually. If you're over 35, your age is a factor.

How you proceed depends on your insurance coverage and personal preference.

Some people prefer to have an ophthalmologist do their physical eye exam, even though a competent optometrist is as equally qualified as a competent ophthalmologist to perform and interpret physical eye exams. It seems that few ophthalmologists do any functional testing themselves anymore. It isn't practical with today's health-care realities.

If you go to an ophthalmologist's office that also has an optometrist on staff, you can have the ophthalmologist do your physical exam and the optometrist do your functional/refractive exam. If you see an ophthalmologist who doesn't do functional testing, it's possible that the doc will examine you and tell you your eyes are "fine" (because they might be physicially) while leaving you with no answers about how to deal with the blurry near vision. Then you'll have to see a different doctor (an optometrist) to do your functional evaluation anyway.

If you feel comfortable with an optometrist, you can see them for everything and get some basic, timely visual answers in one place. The optometrist may have to refer you back to your neuro or PCP, but your visual problems will be taken care of.

If your medical insurance requires that you have a referral to an ophthalmologist, you'll have to go through your neuro, PCP or optometrist to get one. A neuro-ophth (blurry close-up vision isn't a neuro problem) will most likely require a referral because neuro-ophths like to be sure that everything that isn't neuro is screened out first.

As for timing, you can probably find an optometrist in your area who will see you within a day or two and won't require a referral (don't go to the doc in the high-rent retail space). A nonemergency appointment (yours isn't a medical emergency) with an ophthalmologist might take several days to a couple of weeks. A nonemergency visit with a neuro-ophth can take weeks to get, and there's no guarantee that the office will also include a full-scope of functional evaluations.

Bottom line, you'll need an evaluation by at least one eye doctor. If you're interested in getting timely answers, don't wait for your neuro.