Eye test??? not vep

[wally8]

Hi, I had a neuro appointment yesterday to go over my brain and spinal mri's, had a bit of a shock to find that the radiologist only reported 1 new lesion suspicious of ms, according to my neuro and another neuro who's oppinion my neuro wanted I have at least 3 new lesions suspicious of ms

He wants me to have a spinal tap and also a eye test where I have to wear glasses that measure the response time of my eyes to see if one is lagging.

Has anyone here had or know anything about that test?
I've never come across it here on the boards.

Cheers
Kathy

[Dayna]

Hi Kathy!

I'm a little confused. Your radiologist said you have one new lesion (be happy about that!) and your Neuro wanted you to have at least three?
I'm guessing this is because you're being suspected of having MS, and they're wanting to get the final diagnosis?

If so, in my opinion, the spinal tap and ALL eye tests are all wise decisions to rule out any other illnesses/diseases, so you get the proper treatment.

There's quite a few people out there who are diagnosed with MS, as well as another disease such as Lyme, Sarcoidosis, RA, Fibro, etc. Get all the tests you can, especially if your insurance covers it! If your Neuro is suggesting that you get these tests done, that means s/he is being thorough and cautious, and that's what we all want in a Neurologist! Yes, the waiting process stinks, but it's better to be safe than sorry!

The test I'm thinking your doctor wants to do is called the Visually Evoked Potential (VEP). This test measures the speed of the optic nerve. The patient has to focus on the center of what looks like a TV screen or small monitor. The screen has a whole bunch of checkered squares on it that you'll be staring into the entire time.

You'll wear a patch on one eye for a while and then on the other, so that the speed of both optic nerves can be measured. I believe the squares move around and there's a bright light involved, but it's been quite some time since I had it done, so things could have changed. One thing I do remember is that I felt a little dizzy and both my eyes ached during and after, but it was a muscular ache behind the eyes, and not something I'd call painful or need medicine over. Quite simple, actually!

I hope I was helpful, and I wish you the very best!

[Dayna]

I'm really sorry, Kathy. I totally missed that you wrote "Not VEP" in your thread title. The only other tests that I know are the Brainstem Auditory Evoked Response (BAER), SomatoSensory Evoked Potential (SSEP), visual acuity or the Visual field testing. Gosh, there's so many!

I wish I could have offered more help to you. Now I'm curious myself and I'll be sure to come back to hopefully learn something new. It's bothering the heck out of me now because I'm looking everywhere!

[Redwings]

He wants me to have a spinal tap and also a eye test where I have to wear glasses that measure the response time of my eyes to see if one is lagging.

Hi Kathy:
Some part of the test's description appears to have been jumbled and/or gone missing in translation because there is no eye test for which glasses themselves measure the timing of anything. I'll take the individual pieces of the description and give you my best estimate of what they might refer to.

The most obvious questions about the missing information are 1) response time of what function, and 2) response to what stimulus? The other question that strikes me is, if the response time is so important that it has to be measured, then wouldn't the timing itself (normal vs. abnormal) be more important than just finding out if one eye is "lagging" (in some function) behind the other?

Considering MS (or demyelinating diseases) specifically, the only "eye test" for which "response time" is measured, and for which timing is important, is the VEP/VER. But you already said the test isn't a VEP (if I remember correctly, you've already had a VEP), and glasses aren't normally used for a VEP anyway. So that one can get crossed off the list.

In testing for vestibular problems in general (not necessarily related to MS), eye tracking is evaluated. It can be done plain -- by simple observation -- or fancy -- with goggles that contain infrared cameras. The images captured by the cameras are converted into hard data printouts of the eye movement's measurements and can be displayed/recorded as video. So it's possible that the test you're referring to is electronystagmography or videonystagmography. You might recognize the "nystagmo" part as relating to nystagmus.

The fact that nystagmography uses goggles suggests that this might be the test you're going to have. But there are still things that don't fit the description. In nystagmus, the eyes move in unison -- one doesn't lag behind the other. Also, "response time" of the eye movements is relatively unimportant, so there isn't a pressing need to have an absolute measurement of how fast it is. In addition, I might have missed it, but I don't remember you mentioning that you have dizziness, vertigo or balance problems. Without those symptoms, it isn't clear why your neuro would so specifically want to test your vestibular system.

Another possibility goes back to the plain way to evaluate eye movements. (I actually laughed out loud when I first found out about this one.) Apparently, at some time in the past, physicians -- especially neurologists -- weren't very good at simply observing patients' eye movements. So they developed a pair of glasses with magnifying lenses to put on the patient that enlarge the patient's eyes so the eye movements can be seen more easily. (From where? Across the room? ) They really do function just like those joke glasses used in movies and TV shows to make someone's eyes look huge. (I can't remember what they're called, but I swear I'm not making this up!) Although some doctors still use these glasses to observe patients' eye movements, this probably isn't what you're referring to. (Actually, I hope not! ) It would certainly help your neuro to see if one of your eyes lagged behind the other while moving, but a simple lag isn't necessarily pathologic (so it wouldn't be helpful in a diagnosis) and there's no measurement of timing involved -- by the doctor or the glasses. (I had to add this one for completeness. I hope you got a laugh out of it. )

Based on limited information, I'm inclined to think the test is nystagmography. It surely could be something else, but I can't think of anything else based on your description. If you find out more about it, please let us know.

[wally8]

Hi Dayna, sorry to have confused you, my brain was'nt fully functional when I wrote this post
My neuro did'nt want me to have 3 new lesions...he was surprised that the radiologist only reported 1 when there were clearly more.
I am still at the dx stage, but these new lesions have changed the pace of the game my in office neuro exams are all normal, so my neuro wants to be absolutely sure so is sending me for the L/P.

The eye test came about because both neuros couldnt be sure of what they were looking at when they made me do that eye thingy when you have to look from one finger to the other repeatedly. Also it was making me very dizzy while doing that test.

Redwings I think you may be right about the infra red goggles. They did'nt really say too much about it, only that the test will tell them what they cant see with the naked eye and it did involve wearing goggles So glad my neuro do'snt have a pair of those joke glasses I think they were called coke bottle glasses, i would not have been able to keep a straight face
My neuro is making an appointment for me at the hospital in Melbourne and says we will do both tests the same day so not sure when that will be, but I will definatly let you know, when I know some more.
Thanks for the replies
Kathy