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jml945 wrote:Is all this related, and what kind of doctor should I see if this progresses? I've not been diagnosed with MS because of a lack of any findings on my MRI's but I'm pretty sure this might be optic neuritis which I hear is a very, very common symptom of MS.

You're likely to see an ophthalmologist for a definitive diagnosis.

jml945 wrote:I went to an ophthalmologist about a year ago and he said he didn't see anything indicative of ON... of course that was back before my vision started to get as bad as it is today.

I've heard that it's better to see a neurological ophthalmologist... is that true? What do they check for when searching for ON?

You're likely to see an ophthalmologist for a definitive diagnosis. The ophthalmologist may perform the following eye tests:

• A routine eye exam. Your eye doctor will check your vision and your ability to perceive different colors.

• Ophthalmoscopy. During this examination, your doctor shines a bright light into your eye and examines the structures at the back of your eye. This eye test evaluates the optic disk, which is the area where the optic nerve enters the retina in your eye. The optic disk becomes swollen in about one-third of people with optic neuritis.

• Pupillary light reaction test. Your doctor may move a flashlight in front of your eyes to see how your pupils respond when they're exposed to bright light. Pupils in eyes affected by optic neuritis don't constrict as much as those in healthy eyes do when stimulated by light.

Other tests to diagnose optic neuritis may include:
• Visual response test (Visual evoked potentials test). To perform this test, you sit before a screen on which an alternating checkerboard pattern is displayed. Attached to your head are wires with small patches to record your brain's responses to the visual stimuli. This type of test is able to detect the slowing of electrical conduction resulting from damaged areas on the optic nerve.

• Magnetic resonance imaging (MRI) scan. An MRI scan is a test that uses a magnetic field and pulses of radio wave energy to make pictures of your body. During an MRI to check for optic neuritis, you may be injected with a contrast solution to make the optic nerve and other parts of your brain more visible on the pictures. An MRI is also important to determine whether there are areas in your brain where the myelin has been damaged (lesions), which indicate a high risk of developing multiple sclerosis. An MRI also can help rule out tumors or other conditions that can mimic optic neuritis.

• Blood tests. A blood test is available to check for antibodies for neuromyelitis optica. People with severe optic neuritis may undergo this test to determine whether they're likely to develop neuromyelitis optica. An erythrocyte sedimentation rate (ESR) blood test is used to detect inflammation occurring in your body. This test may help determine whether optic neuritis is caused by inflamed cranial arteries (cranial arteritis).

jml945 wrote:Maybe 6 months ago? I've had MRI's done so many times now... probably about 4 separate times. I don't even know if my insurance will keep covering it, and even if I do I have to pay 10% for the procedure, which comes to several hundred dollars. I have to weight whether or not it's worth it to have another MRI done.

jml945 wrote:Maybe 6 months ago? I've had MRI's done so many times now... probably about 4 separate times. I don't even know if my insurance will keep covering it, and even if I do I have to pay 10% for the procedure, which comes to several hundred dollars. I have to weight whether or not it's worth it to have another MRI done.

Why can't doctors diagnose MS clinically based on symptoms? I would think that if I do have optic neuritis it would be a slam dunk diagnosis. I'm really starting to think that doctors aren't as interested in diagnosing and treating as they are about doing expensive testing which fatten their own paychecks.

jml945 wrote:Are opthalmologists usually pretty keen on sensing when someone has ON? Because the last time I went it seemed like they were just looking for ordinary vision problems and didn't bother much with neurological issues.

An Optometrist is a health care professional who is licensed to provide primary eye care services:

•to examine and diagnose eye diseases such as glaucoma, cataracts, and retinal diseases and, in certain states in the U.S., to treat them;

•to diagnose related systemic (bodywide) conditions such as hypertension and diabetes that may affect the eyes;

•to examine, diagnose and treat visual conditions such as nearsightedness, farsightedness, astigmatism and presbyopia; and

•to prescribe glasses, contact lenses, low vision rehabilitation and medications as well as perform minor surgical procedures such as the removal of foreign bodies.

An optometrist is a Doctor of Optometry, an O.D. (not to be confused with a Doctor of Medicine, an M.D.). To become an optometrist, one must complete pre-professional undergraduate college education followed by 4 years of professional education in a college of optometry. Some optometrists also do a residency.
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An Ophthalmologist is an eye M.D., a medical doctor who is specialized in eye and vision care. Ophthalmologists are trained to provide the full spectrum of eye care, from prescribing glasses and contact lenses to complex and delicate eye surgery. They may also be involved in eye research.

After 4 years of medical school and a year of internship, every ophthalmologist spends a minimum of 3 years of residency (hospital-based training) in ophthalmology. During residency, the eye M.D. receives special training in all aspects of eye care, including prevention, diagnosis and medical and surgical treatment of eye conditions and diseases. An ophthalmologist may spend an additional year or two in training in a subspecialty, that is, a specific area of eye care such as:

•Cornea and External Disease: The diagnosis and management of diseases of the cornea, sclera, conjunctiva and eyelids, including corneal dystrophies, microbial infections, conjunctival and corneal tumors, inflammatory processes and anterior ocular manifestations of systemic diseases. Training frequently includes corneal transplant surgery and corneal surgery to correct refractive errors.

•Glaucoma: The treatment of glaucoma and other disorders that may cause optic nerve damage by increasing intraocular pressure. This involves the medical and surgical treatment of both pediatric and adult patients.

•Neuro-ophthalmology: The relationship between neurologic and ophthalmic diseases, neuro-ophthalmology also deals with local pathology affecting the optic nerve and visual pathways. Over 50% of all intracranial lesions involve the visual or oculomotor pathways.

•Ophthalmic Pathology: Training in both ophthalmology and pathology. Because of the unique combination of skills involved in this subspecialty, it is usually the ophthalmic pathologist, rather than the general pathologist, who examines tissue specimens from the eye and adnexa (related structures).

•Ophthalmic Plastic Surgery: Includes orbital surgery, lid and upper facial reconstructive procedures following trauma and tumors and cosmetic lid surgery. Oculoplastic surgeons combine ophthalmic surgery with plastic surgery and are trained in the use of radiotherapy, chemotherapy and chemosurgery to treat ocular and orbital disease.

•Pediatric Ophthalmology: The medical and surgical management of strabismus, amblyopia, genetic and developmental abnormalities and a wide range of inflammatory, traumatic and neoplastic conditions occurring in the first two decades of life.

•Vitreoretinal Diseases: The medical and surgical treatment of retinal and vitreoretinal disease. The types of diseases treated include manifestations of local, systemic and genetic diseases as they affect the retina and vitreous. Diagnosis involves the use and interpretation of ultrasound, fluorescein angiography and electrophysiology. Treatment methods include laser therapy, cryotherapy, retinal detachment surgery and vitrectomy (removal of the vitreous).

jml945 wrote:The only thing they told me was that in my left eye my vision was a lot worse than in my right eye, which they told me was because of a stymatism.

Definition
By Mayo Clinic staff
Astigmatism (uh-STIG-muh-tiz-um) is a common, mild and generally easily treatable imperfection in the curvature of your eye. The condition can cause blurred vision.

Astigmatism occurs when the front surface of your eye (cornea) or the lens, inside your eye, has a slightly different surface curvature in one direction from the other. Instead of being even and smooth in all directions, the surface may have some areas that are flatter or steeper.

Astigmatism blurs your vision at all distances. Astigmatism is often present at birth and may occur in combination with nearsightedness or farsightedness. Often it's not pronounced enough to require corrective action. When it is, your treatment options include corrective lenses and surgery.

bartman wrote:Not to be repetitive but have you checked out neuroretinitis? Bartonella loves the eyes. Do a google search of Bartonella and neuroretinitis. It's very possible that you have an eye infection. Ask your doctor to treat your eye infection until it's better

bartman wrote:Well I guess it would be better to just assume it's MS. Doing that will get you steroids and that will only make your probable infection worse.