Interesting visit with eye doc.

[kittysmith]

I have been having a lot of blurriness in both eyes. But, my right eye (the one where I had optic neuritis) is worse than the left. I made an appointment immediately. I was terrified it was ON again.

They did several tests. I did well on the visual field test. The dialated my eyes and couldn't see anything wrong. She told me it comes with age and to wear reading glasses.

Right before I left, the neuro optho decided to perform an RNFL (retinal nerve fiber layer) test to see if the thickness of the optic nerve was OK.

The doc was very suprised that I had a loss of thickness. She said she didn't expect those results b/c I have been on Avonex since 2008. She thought the DMD's would keep the optic nerve thickness in check.

They say this is a new procedure. The doc wanted to do it b/c they are usuing this test more and more for MS pts.

I was told that in 2009 my OD WAS 94. Tuesday, it was 79. I'm not really sure what any of this means. I see my MS doc next monday, so I hope he can help me understand these results.

Anyone else had or heard of this test? Am I eventually going to be blind in that eye? Could it be the beginnings of glaucoma?

[Alicious]

I had this done recently. My right eye came in at 64 and my left eye at 72, I believe. The test also looks at which portion of the nerve layer is the thinnest, as well as how thin. Weirdly, I've never experienced issues with my left eye, and my right eye has permanent visual damage, but the neuro ophth said that it is very normal for people with MS to have a decrease in both eyes, even if they never notice symptoms.

The neuro-ophth told me that studies suggest that routinely measuring the thickness of these nerve fibers is a great way to measure MS progression along with symptoms, MRIs, etc. many of us will have decreases even if we don't notice anything in our vision, and yes, even if we are on a DMD. I suspect as the years go on more and more of us will be having this test done routinely as it appears to offer even more data about how our disease is progressing.

FWIW, the thinness correlates to vision, but its not a perfect measure. Some people will see worse with a thicker layer than other people with a thinner one. Also, people who are naturally nearsighted, especially the very nearsighted, will have a thinner layer to begin with than someone with naturally better vision.

As to blindness--even with this thinness, I was told that I have a less than 10% chance of becoming functionally blind. 10% sucks, yes, but it isn't particularly likely that you will go blind. Asking your MS doc is a great idea because they know WAY more than I ever will, and of course they know a lot about you in particular. I just happened to ask the neuro-ophth that specific question last week, so wanted to give what reassurance I can.

The example she gave was this: MS patients have a 5% chance of needing a wheelchair in time. That's for all MS patients. The course of your disease in particular changes those odds. The same goes for blindness. I was told my chances are probably less than 10% based on my progress, and that 10% is the % for all MS patients as a whole. So, really, the doctors who see you personally can give you a better estimate, even though of course there is no certainty with MS.

[Sequoia]

Just wanted to add that I'm surprised your doctor was surprised! I'd expect a neuro-opthalmologist to know more about MS.

The DMDs don't keep anything "in check"...they only slow progression (for those for whom they work); they don't stop it altogether.

[kittysmith]

Just wanted to add that I'm surprised your doctor was surprised! I'd expect a neuro-opthalmologist to know more about MS.

The DMDs don't keep anything "in check"...they only slow progression (for those for whom they work); they don't stop it altogether.

Yes, I am very well aware of what DMD's can and cannot do. The reason she was suprised is because she hasn't seen me in years. And she does know a lot about MS or she wouldn't have given me the test in the 1st place.

In fact, we were all suprised b/c I've had several MRI's that showed no new lesions and no active ones. It has been this way since I was diagnosed in 2008. We were hoping that there had been no dammage from the ON. Apparently there was. No one caught it until Tuesday.

I respect my doc and thought she did an outstanding job. She is also working closely with my MS doc. I was just curious to see if anyone else had this test before.

[CatMom0001]

Thanks for posting. I'd never heard about this test.

I have to see my retina specialist (due to a torn retina) in April, so I'll be sure to ask him about the test.

[kittysmith]

And as an added bonus, you get really cool pics of your eyeballs. Now who wouldn't want that ?

[gomer]

I had been planning on seeing a local eye that is know to do pictures of the eyes, but I keep stalling and putting it off. She is at a local vision store, just for a base-line. Funny thing is NONE of my MD type eye docs have ever photographed my eye insides. I think its a good idea to have it, for future use to detect changes if nothing else.

Maybe I need to get off my butt and get'er done.

Gomer

[Alicious]

The graphs, charts, and pictures really are cool.