Contacts/glasses/vision problem again

[Katje]

I posted about 5 months ago about my vision. I know vision problems are common with MS however mine don't seem to fit. Early spring I noticed I couldnt read close all the sudden, I was getting headaches and my regualr vision seemed weird as well with my contacts. I went into the eye doc and he said I just couldn t read close anymore.


fast forward to now, I have been trough numerous test contacts and I stil cant see normal and I have progressive lenses in glasses now and it feels like my eyes are being pulled out of my head.

My close vision is always a little off, sometimes with far s well. I cant get anyone to listen to me, because in the docs office I can read the lines, but they arent always clear and they feel thats good enough.

I am worried and also frustrated because they claim it's not ON from my MS and I don't believe it is but it's got to be something. It's hard to see an actual ophthalmologist because most do lazer and I am looking for a doctor who will take me seriously when I say my vision is off!


Anyone else have problems like this? Happened so sudden and I did have a brain MRI and nothing had changed.

[rdmc]

Katje,

I have vision problems, but not ON. I have double vision and when it's mild, it just looks like things are blurry, but if I pay attention , it's really like a ghost image beside each letter.

When it flares there's no mistaking it for double vision, and I do have prisms in my glasses that make things pretty normal most of the time.

If you're not having pain with movement and they don't see anything in the exam or on the MRI, and you've been examined and they say there's no ON, then it's probably not ON.

but that doesn't mean you can't have other eye problems with MS.

[ladibabe]

My vision is off as well. I don't think I have ON but my vision is definitly worse.

[Redwings]

Hi Katje:
I'm sorry to hear that you're still having problems.

As I said before, your situation is complex and there are numerous possibilities for what's bothering you. When you said earlier that you were even feeling a bit nauseous when using your vision, that changed the tenor of the possibilities. What makes your situation complicated is that the various factors that contribute to your "experience of vision" are contaminating each other, making it difficult for both you and your eye doctor(s) to identify each individual component and its possible contribution to your visual difficulties.

By now your eye doctor(s) should have been able to separate optical from nonoptical, normal from abnormal, and it doesn't sound like that's happened. You've spent a lot of time chasing this down from the primary eye care angle, and it doesn't sound like you're going to get any more out of those doctors.

If there were anything obviously wrong, your neurologist and/or your eye doctor(s) would have found it by now. So it sounds like it's time to get very specific and be evaluated by a neuro-ophthalmologist, who should (unfortunately, no guarantee -- I've read some forum posts about a few neuro-ophths doing bizarre things ) be able to separate the intertwined components.

The website of the North American Neuro-Ophthalmology Society (NANOS) lists seven neuro-ophths in Colorado, including three in Denver and two in Aurora. That's a high enough number that one or more of them might accept self-referred patients. However, many neuro-ophths accept patients by doctor referral only, to screen out things that aren't neuro.

To keep things inside the medical model, it might work better for you if your neurologist makes the referral to the neuro-ophth. If that doesn't work out, you can try self-referring or ask your other eye doc(s) for a referral.

As for your last question, yes, I have myself experienced some of the problems you're describing, and have also worked with and heard of other people who have. But the causes were normal, not pathological, and had simple solutions, so those experiences don't appear to apply to your situation.

It sounds like the only thing that hasn't been done is a neuro-ophth workup. It's time to have that done to identify neuro causes or rule them out. Otherwise, 1) you'll have made no progress in getting your vision issues sorted out, and 2) the speculation will continue to make you bonkers!

[MyGirlsMom]

Question: Have you seen an opthomologist or a neuro opthomologist? That would be my suggestion as the eye physicians that have that certification are best suited to diagnose and treat...whatever it is!! Best wishes!!

[gomer]

I have diabetes in addition to MS.

My blood glucose levels can and DO affect my vision. My vision problems are almost all MS related as I have very good control of my diabetes. While mine is not type-2, type-2 can creep up on a person as they age.

ITs probably not the answer to your vision problems, but it might be a good idea to check it out just in case its part of a larger puzzle.

Gomer Sir Falls-s-lot

[maitrimama]

I've been having lots of problems with my vision for the past year and a half and it has been very frustrating. After going to my GP, Neuro, Opthalmologist, Neuro-Opthalmologist and Psychiatrist (I seem him regularly anyway) & having MRIs, VEP, field of vision etc. etc. I just had to let it go. That doesn't mean the proplems have gone away but I can't let them drive me nuttier than I already am.

I have had a whole host of vision issues - decrease in visual contrast, some loss of color vision, decrease in my field of vision, worsening of up close vision, focusing problems, difficulty seeing at night and lights all look like big starbursts and the thing that I think is really weird is I will have several months where I don't need my distance glasses and then all of a sudden I am half blind again. Oh well, atleast they ruled out the "bad" stuff.

[Bob698]

In my experience, optic nerve damage is like looking thru a smokey or misty room. You can almost bring things into focus- you just have to get past the "static".
What you're describing sounds more sinister- the effects of aging!

I got the bifocals talk long before I got the nerve damage. No way, I was too young! Right, Doc, right?

I couldn't stand bifocals, tried progressive bifocals and later wound up using a more progressive Rx which I've been able to adapt to.

Just a couple of hints that may help-
Smaller lenses are better. It sounds backwards but its easier to adapt to them.

Take your time when the eye Doc says "Read this and find the distance where its comfortable". Full-progressive lenses are also better than bi- and trifocals.

[journeyman]

I too saw a Neuro/Ophth.

When I was first dx.d. I am partially blind in my right eye. I have yet to find much that works when the ON flares up. But the rest of the time I wore close up and distance glasses separately. I have about six pairs all over the house and car.

My problem with Neuro/Ophth is that ins. co. are reluctant to cover them. They only way I got in to see mine was my Neuro wrote "Medically Necessary" on the referral.

I hope things get better for you.
Dave
"Journeyman"

[Alicious]

FWIW, I saw Dr. Victoria Pelak (neuro-ophth) in Aurora earlier this year, and she was incredible. She practices out of the U of CO Hospital, and if getting to the office is possible, it's worth seeing if you can get a referral.

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

[Sunshyne]

Hi Katje...

When I started wearing progressive glasses, it took me two years to finally get used to them...with no exaggeration. I felt absolutely sick to my stomach, almost like I was sea sick. I hated them...I could never get relief...my eyes always felt strained and I always felt whoozy.

You may have been given advice to persevere with them, I know I did. I finally got tired of it and threw them in the drawer for a very long time and used my CVS readers instead. After some time though I did pull them out of the drawer and I finally did get the hang of it...your eyes will train themselves.

With that said...my eyes still feel a bit strained at times and I'm just resigned to the fact that I do not see perfect, and maybe this is the best it's going to get.

Now contacts...if you're wearing progressive lenses in your glasses, I assume you are wearing multi focal contacts as well? If you are, know from the very beginning that your vision will never be as clear with the contacts as they will be with your glasses. You may get close...but it will not be the same..the trick is to get it a close as you can.

It has taken me three years to get the contacts right....I got frustrated...I certainly couldn't drive at night with them...every car looked like one big headlight..some threw off my depth perception....when I went outside it was like looking through waves and glare....But my last trial pair...out of about 10 finally gave me what I needed.

Sometimes I have to wear a pair of readers over the contacts to read really really small print....but for every day use, for computer work, etc, they are good..not perfect...but good enough.

And the great news is that I can drive at night with them...and lo and behold the cars have two headlights.

It takes great patience to get both the progressive lenses and the multi focal contacts right. If you have to go back to the eye doc and he's willing to work with you, then keep going back. Also, if you're like me, sometimes I might switch to glasses at night after taking out my contacts...and that adjustment in itself can make your eyes go a little nuts.

There is nothing worse than being uncomfortable in your own eyes every day.

I know this post is lengthy...but I have been where you are. It is horrible to be that uncomfortable every day.

Keep trying...you will get it...

PS....I've also had ON in my right eye...so maybe that does make things a little harder...but truth is...the sight in my right eye is better than in my left!

[Redwings]

Hi Katje:
I completely believe that your vision is off. A while ago, we went over the main reasons why it's off, and that's without even getting into possible reasons we don't know about.

As a reminder, the optics of multifocal soft contact lenses are inherently compromised. With the current state of the art, it isn't possible for you to get clear vision at all distances with them. Ain't gonna happen. Yet it's months later and you're still trying to get perfect vision through imperfect optics.

The patient rejection rate for soft multifocal contact lenses is as high as 50% because the vision is unsatisfactory. I can't wear multifocal soft contacts because the optics are so bad, and I've tried several brands. One of the ophthalmologists in my area won't even allow his optometrist to fit multifocal contacts because it's such a waste of time for both the patients and the office. What surprises me is that your eye doctor let you keep trying lens after lens when they're all similar, and it was apparent early on that multifocals weren't satisfactory for you.

Also, it's common for it to take two or more weeks of full-time wear for some folks to adapt to progressive eyeglasses. It can take even longer for contact lens wearers who don't generally wear glasses and who don't/won't keep them on long enough to adapt to them. (Simpler, lower quality lens designs make it harder still.) And there are some people who can't adapt to them at all. There are enough people who can't adapt to progressive spectacle lenses that many optical labs will, within the first month, remake progressive eyeglasses into a standard bifocal (occasionally a trifocal) at no charge.

We also, a while back, covered presbyopia and its associated inconveniences. Sometimes the loss of near focus onsets seemingly overnight. From reading other posters' experiences, I hope you can better appreciate now that everything you've told us is completely typical of presbyopia and those associated inconveniences. Your experience is so typical that it's going to take a neuro-ophthalmology workup to prove that, in your case, it isn't presbyopia.

Of course, none of us is there with you to see what's happening. We can't know the details you've left out, and we can't know how closely what you've said reflects what you actually mean. But from what you've said, nothing suggests that what you're experiencing is abnormal or pathological. So you should be prepared to describe to the ophthalmologist why you believe that your visual difficulties are pathological.

As I said in my last post, the known and possible contributors to your visual difficulties are contaminating each other. There are specific troubleshooting steps that must be gone through to isolate the individual components so they can be ruled out. And from what you've told us, there's nothing to indicate that those steps have been done.

One of the reasons I recommended a neuro-ophthalmology evaluation is that it can bypass some of those contaminants and isolate some of the other components in a way that no other practitioner's eval can. If I'm remembering correctly, your neurologist is so unqualified for this kind of an evaluation that s/he was ready to prescribe methotrexate as a treatment for presbyopia. I'm just sayin'.

There's no question that your vision is off. Under the conditions you're judging by, it pretty much has to be. (Even your current eye doctor knows that, or s/he wouldn't have kept trying to find a contact lens that might give you better vision.) The only way you've given yourself to evaluate your daily vision is through imperfect optics. In that way, the entire methodology is so faulty that it's designed for failure. No wonder you can't see properly!

I hope you can get in for a neuro-ophth eval (try to make sure that you're booked for a full consultation, which should take a couple of hours) so you can deal with the issues that only the neuro-ophth can. Then you can see other providers to deal with the rest. And be prepared in case the solution to your vision issues is something other than what you're hoping for.

[maitrimama]

Redwing thanks for breaking down and explaining th. e vision correction process. Like you Journeyman I have given up on bifocal and progressive lenses & simplified things by having distance glasses ans 2 strengths of reading glasses. Some days are so crazy with my eyes that in the morning my left eye feels like it doesn't want to play nicely with my right eye and my eyes won't focus. Then I go through periods when I don't need my distance glasses. The oddest thing is at night when my eyes see words and letters in 3 dimension. Now it is a bother more than anything and I think there is connection to complex migraines.

[Special Kay]

My vision is terrible and has been since before I got MS.

Basically my eyes are corrected to the "best possible" which is that I mostly can't see clearly close, midrange, or far -- ever.

But I can see all of those ranges sort of OK. Mostly, I wear multifocal contacts and use reading glasses on top of those. I have a different multifocal contact prescription for distance (like driving at night) than I use for every day.

This is not an MS issue (as per my neuro-ophthalmologist), but just terribly hard to correct extreme myopia with complicating presbyopia. FYI, I started to get presbyopia when I was in my mid-30s.

[techie]

Old fashioned lined bi focals

Although they look as if it they have a wider field of vision.
The focused part of the progressives is very narrow in the middle of the lens.
I have found I don't need the wider lower part either.
I used to insist on them but I found with my sun glasses that the normal size works fine for reading.
I you get computer glasses because if you have to look down to read or see where your fingers are landing now, you can't focus! I found this out the hard way.
Awfully hard to look down to read directions to get the next step and not be able to read it
techie