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Can you have ON without vision impacted?

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    Can you have ON without vision impacted?

    Hi all,

    I have been having pain behind my left eye for a few weeks and an occasional buzzing feeling in the eyeball itself. And mild issue with light sensitivity and glare. But no real vision issues. Also have no sinus issues or teeth problems, at least I think not.

    I had my routine MRI last week and just read the report. It references hyperintense signal left intraorbital optic nerve.

    I was told I had prior ON in the left eye. I never remember having vision issues and always just thought it may have been when I had bad vertigo for 6 weeks and just didn't notice because everything was spinning. I do remember now that I had this type of pain right after the vertigo and was told ocular migraines. It resolved and never had them again. Until now. The vertigo is now thought to have been undiagnosed MS, 13 years prior to diagnosis. So the eye pain was right after a flare.

    Has anyone had optic neuritis without vision issues?

    I will probably call neuro to see what he thinks and whether I should head to opthalmologist.

    Thanks for any input.
    Kathy
    DX 01/06, currently on Tysabri

    #2
    Hi Kathy, I am still recovering from a moderate to severe case of optic neuritis of my left eye, that began last September. My presentation was severe pain in the back of my eye that worsened with any eye movement. The next morning, I woke up with very blurry vision in that eye, loss of visual field and significant color desaturation. By the time I was seen by the ophthalmologist, my vision had gone from 30/20 to 120/20. My VEP's were very abnormal and I had an afferent pupillary defect. My emergent brain MRI showed new brain lesions but none on the optic nerve, strangely enough.

    I remember my neuro-ophthalmologist telling me that some patients with optic neuritis have minimal vision loss while the pain is present in 90% of cases. I would definitely contact your neurologist and ophthalmologist. My case happened on a weekend so I ended up waiting until Monday morning to be seen. I just wasn't sure if my situation warranted an ER visit since I couldn't find an opthalmologist or optometrist that was open on the weekend. My neurologist told me I should have gone to the ER immediately(large teaching hospital) where neurology and ophthalmology could have seen me. Now I know better, in the event it ever occurs again. Good luck. I hope you get some answers tomorrow.

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      #3
      Thanks polopuppy. Interesting what your opthalmologist told you. I reread the report. It said the signal was there in 2018, and 2018 said no new lesions. So I am guessing this is old lesion. Of course, we didn't do contrast to avoid any unnecessary risk. And my MRIs have been stable for years.

      I hope you continue to heal. How is your vision now? Did you have IV solumedrol to help recover? Were they able to do anything else for you or just time needed to heal? I am sure scary and frustrating experience for you.

      Thanks again!
      Kathy
      DX 01/06, currently on Tysabri

      Comment


        #4
        Hi Kathy,

        I'm glad it doesn't appear to be a new lesion but you may want to let your neurologist know about your eye symptoms.

        My ON is getting better but slower than expected. I did do 3 days of IV Solumedrol followed by a 20 day oral steroid taper. My neurologist then had me start the drug Clemestine to see if it would improve my recovery. During my last neuro-ophthalmologist visit, my acuity was still around 60/20-70/20 but better than it was. The visual field showed 17% improvement but he said they would have expected 75% by that point. The last OCT showed the optic nerve is swollen, VEP's are still delayed and the pupillary defect is unchanged. I will see him again at the beginning of May.

        I was started on Rituximab in November so that may have helped my eye. The MRI done 2.5 months after the Rituximab was the first stable on in 14 months so that was very encouraging. My droopy eyelids seem much better, as is my foot drop and urinary incontinence. I will be re-dosed in May with Rituximab. I have been found to have immune deficiency and may restart IVIG. I did great the 4.5 years I was on it but had to stop after an anaphylactic episode. Keeping my fingers crossed.

        Have a great day!

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