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    Questions about ON

    Hi there. I am sort of limbo as well, as they told me I have too many symptoms, although since I have 'recovered' from whatever this is. Most everything has gone away or is very minimal. Worst symptoms. Balance is still off, some days worse then others, getting harder to 'catch myself' but still have not actually fallen yet. Slight intention tremors remain, but not all 4 kinds of tremors like it was during the peak of whatever this was.

    And then there are my eyes. When this first started that was my first symptom. It woke me up and hurt so bad, but no blindness, and now just occasional dull aches and sharp stabbing pains, still no blindness, but they do get very blurry and sometimes double vision. But my eyes are very bad to begin with. Could this be ON? or just my bad eyes? I think if that could be diagnosed I would get out of limbo. How exactly do they do that, just by looking in your eyes, can they see it? or is by symptoms only? I do have lesion in both my occipital areas.

    Thank you.

    #2
    If you have these symptoms again, or even now, go see an ophthalmologist so that they may examen your eyes. There are several tests that they do.

    1. They may do a visual field test to see if you have any loss of vision in your eye that is not noticeable to you. It entails looking into a half-cone like structure. They will do this one eye at a time. You will see dots come into your visual field, and you manually click a clicker that they give you to hold when you see a dot light up.

    2. They will look into the back of your eye to examine the optic nerve itself. If swollen, you may have ON. You can't see this with the naked eye, or do it yourself with equipment.

    3. They may do the ishihara color blindness test. This will test you sick eye's tolerance for color saturation.

    4. If they have the equipment, they may do a VEP (visual evoked potential) on you in the office to see if you have recently had ON.

    You can have ON without having blindness, blurriness is pretty common in ON.

    Will you be diagnosed if you get ON? doubtful. You may get CIS (clinically isolated syndrome). It depends on what your neurologist thinks about your MRI. If he thinks your punctate lesions qualify for MS lesions, then maybe. Its up to him.

    Lesions in occipital areas has nothing to do with ON. You have lesions on your optic nerves themselves in ON most of the time. Sometimes they are so small you can't see them.

    Hope I have answered your questions! Best of luck to you!
    Let us know how it goes, OK?

    Take care
    Lisa
    Moderation Team
    Disabled RN with MS for 14 years
    SPMS EDSS 7.5 Wheelchair (but a racing one)
    Tysabri

    Comment


      #3
      Stupid me

      I had an appointment in the mist of me feeling bad, but my eyes were so screwed up, I cancelled it, cuz I didn't think it would be accurate. I didn't want to get another increase in my prescription if it was going to get better. I feel so stupid now. Just goes to show you, how my mind was not working right during this 'whatever it was' phase.

      Will it still see things now, when they are almost all the way better, and I am hardly having those symptoms?

      Comment


        #4
        I moved your thread here, as this is where members specifically look for an evening dealing with vision.
        hunterd/HuntOP/Dave
        volunteer
        MS World
        hunterd@msworld.org
        PPMS DX 2001

        "ADAPT AND OVERCOME" - MY COUSIN

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          #5
          Yes, the visual field test will, the VEP will, and you may still have swelling behind the eye. Also, you may have a different eye condition altogether or in conjunction with it. It is still a good idea to go, let them know what your symptoms were, and let them go from there. Be sure to go to an ophthalmologist MD rather than an optometrist DO, the MD is the one you need to see. If you don't have one call up the MS society and see if they can recommend one.

          Good luck and let us know how it goes, OK?

          Lisa
          Disabled RN with MS for 14 years
          SPMS EDSS 7.5 Wheelchair (but a racing one)
          Tysabri

          Comment


            #6
            Originally posted by 22cyclist View Post
            Be sure to go to an ophthalmologist MD rather than an optometrist DO, the MD is the one you need to see.
            The previous poster has mixed up some health care specialists.

            A DO is a doctor of osteopathy also called an osteopath. DO's have been considered the equal of MD's (medical doctors) for many many years now and work in health care settings right along with MD's with no one being able to tell the difference.

            It's entirely possible that you might come across an ophthalmologist who is a DO rather than an MD. For the purposes of ophthalmology the two are exactly the same so there's no reason why you shouldn't see a DO instead of an MD.

            An optometrist is an OD - a doctor of optometry or an optometric doctor. An OD does exactly the same kind of eye exam as an ophthalmologist using exactly the same kinds of equipment. OD's perform computerized visual field testing and often do other tests that ophthalmologists don't usually do. Just like most ophthalmologists don't perform VEP's in their office, most OD's don't either. Either way you very well might have to go to a different facility to get a VEP.

            Because an OD isn't a medical doctor, they have to refer patients to medical doctors to take care of anything that requires systemic follow up. That means it takes longer to get you into the medical system, so it's probably better just to start with an ophthalmologist to begin with when you know there's a systemic problem involved. And you are definitely concerned about a systemic problem.

            The eye exam you get will be exactly the same whether you go to an ophthalmologist (MD or DO) or optometrist (OD). But the medical followup will require an ophthalmologist and a neurologist, so you will have a smoother experience if you just start with the ophthalmologist. If you don't have one your OD (optometrist) routinely refers to one or more ophthalmologists all the time so can certainly refer you to one. Your OD is probably in a better position to know which ophthalmologists are good and which ones aren't than your other health care providers are.

            But whichever ophthalmologist you end up seeing, it doesn't make any difference if the ophthalmologist is an MD or a DO.

            Comment


              #7
              I believe it makes a difference for the insurance

              I was told that an MD Ophthalmologist, since he is a doctor will be a co-pay like any other MD, but a DO would be subject to the vision plan, not the doctor plan. Be that as it may, thank you for explaining that, it does gets rather confusing.

              Anyway. I managed to find a neuro one that is an MD so I have an appointment for Feb. (Which is about the time frame I expected.) That next week, I go back to the neuro for follow up, so maybe we'll have something to tell him then that may help with a diagnosis.

              My biggest concern would be if he could find anything with my eyes when they are not bothering as they did in the peak of whatever 'flare' that was. Could I have residual scarring left? I don't think my fields are diminished, my colors may be, as my daughter keeps telling me: 'That's not Red or Purple that's pink. (or whatever color it is)' But that's not what I see, so who knows?

              Thank you everyone.

              Comment


                #8
                Originally posted by sayccrn View Post
                I was told that an MD Ophthalmologist, since he is a doctor will be a co-pay like any other MD, but a DO would be subject to the vision plan, not the doctor plan. Be that as it may, thank you for explaining that, it does gets rather confusing.
                Yes, and it sounds like you are still confused.

                The doctor that would be covered under your vision plan is the OD (optometrist) not the DO (osteopath). And that's because of the kind of contract your insurance has with the OD, not because of what the OD does or can do. It sounds like the way your particular insurance works, it doesn't pay OD's for medical procedures. Other insurances do.

                The insurance hassle is another reason why it's just easier to go straight to an ophthalmologist (whether it's an MD or a DO). That way you are in the medical system and everything automatically gets covered as a medical procedure.

                It's hard to say whether there will be enough signs and symptoms left over from your eye episode for the ophthalmologist to find. Maybe, maybe not. But the good thing is that you'll be going to be examined so the doctor can find anything that shows up.

                Comment


                  #9
                  I meant OD, :-/

                  Sorry, I meant OD not DO, I'm dyslexic, can you tell?

                  Thanks so much.

                  Comment


                    #10
                    update from late last night symptom

                    Now this is weird and strange and I'm not sure if it technically 'counts' as ON. But this is what happened. It was late last night, I was saying good night to my daughter. All the lights were out but hers, so it was dark. I didn't look at the light, just reached up and pulled the string like I always did for the past 14 years.

                    So, I pulled the string and went to walk out. "OMG it is really dark! What?..wait now?..I cannot see out of my right eye!?"

                    I covered my right eye and I could see with my left eye, it was dark, but I could see things, I uncovered the right eye, nothing, major blackness, splotchy, but mostly on the left field with a splotch of light then another dark. Almost like the pattern on a cow. I stood there, blinking fiercely. It was as if my rods and cones were severely delayed, and were slowly catching up to the rods and cones in my left eye.

                    When it started to catch up, I was testing my eyes by covering and uncovering each eye to compare, the right one could see, but it was darker like the contrast was turned down. It only lasted a few minutes, and no pain whatsoever. As a matter of fact it had been my left eye that was hurting me mostly all day with sporadic right eye pain.

                    I seem fine this morning, well not fine, but not like that. IDK, if there is a little black splotch stil, but it seems to be there when I blink. You know, like if you are driving and the sun is in your eyes, and you see it afterwards for a while when you blink.

                    Any ideas on what this 'episode' was and what the heck should I do? If my neuro cannot see it and my Eye doctor cannot see me til Feb. What now?

                    Thanks so much.

                    Comment


                      #11
                      It doesn't sound like ON, but if it continues, I would go see an OD (spelled right this time-as I also meant to the last time), although it looks like you may have to pay for it. They can at least look at your optic nerve, and they can also take a picture of the back of your eye that show the optic nerve so they can see if it is pale. At least that is a fast appointment. The other option is to go to the ER. ON though generally lasts more than a day as with most MS symptoms.

                      Hope you feel better.

                      Take care
                      Lisa
                      Moderation Team
                      Disabled RN with MS for 14 years
                      SPMS EDSS 7.5 Wheelchair (but a racing one)
                      Tysabri

                      Comment


                        #12
                        Thank you

                        Thanks so much. So far so good today.

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