Help with diagnosis

  • Country:

    USA (United States of America)

  • Age:

    43

  • Gender:

    Male

  • Do you suffer from pre-existing illnesses in the eye:

    Yes

    Central Serous Chorioretinopathy
  • Did you perform any surgery for the eyes:

    No

  • Do you use any eye drops:

    No

  • Do you wear lenses or glasses:

    Yes

    Recently prescribed progressive lenses due to decreased vision
  • Do you suffer from any diseases in the body:

    No

 

Question

 

 

 

Hi,

Around mid April I woke up and had decreased vision in my right eye. Specifically it was like looking through a blurry gray or brown fog. The discoloration continued to darken over the next week. About a month later, the "greyness" decreased but vision is still blurred and darker if I'm out in bright light or get over-exerted. About the time that the color issue improved, I started noticing pain behind the same eye.

The pain has increased - feels like a stabbing sensation - mostly when I move my eyes but is now to point where I feel dull pain always and sharp pain with movement. I've also noticed that colors are more muted in that eye (example bright yellow in left and pale in right and if I just look through right eye at car tail lights, I can't tell when they are lit up). Eye is also painful to the touch.

Its now been about 2 1/2 months since the initial onset. I've seen a retinal specialist (one that dx me with CSR) who said he didn't know what the cause was and referred me to Neuro-Opthamologist. I can't get in with them for another month and a half. Pain was so bad that I was in ER past weekend - had an MRI that was basically negative.

Eye exam by ophthalmology was unremarkable except that vision field test clearly shows decreased vision in center of right eye and a small amt of possible scar tissue on my retina which could cause the blurriness. Said my optic nerve looks fine, but did mention that MRI showed something with my optic nerve sheath but it was "maybe, could be, ill-defined"...nothing noteworthy they said. Ophthalmologist suggested that maybe my headache was causing eye pain but I only seem to get a headache after eye pain.

Any ideas on what could be causing the pain and blurriness if optic neuritis seems to be ruled out? I'm in tremendous pain....

Thanks in advance for ANY input!

 

Answer

 

 

 

Thanks for your question

From what you said I wouldn't rule out optic neuritis due to the following reasons which most likely are features of optic neuritis:

1- Pain with eye movements.

2- defects in color vision.

3- optic neuritis cause central visual field defect.

4- anterior optic neuropathy has blurred margin optic disc while posterior optic neuropathy which is common in adult has a normal optic disc but in MRI, abnormalities of optic nerve can be seen.

Retinal scar most likely cause by Central serous retinopathy which also can cause central visuals defect in visual field and also can cause color vision defects but it doesn't cause painful eye movements and headache and doesn't cause ill defined defect of optic nerve in MRI.

Most of the time,optic neuritis will be cured by itself within 2-3 weeks.

One of the cause of optic neuritis is sinusitis which can explain severe headache that you have.

Visiting a neuro-ophthalmologists will be very helpful for you to find the correct diagnosis. I wouldn't wait for another month to visit Them.

 

Web Eye Clinic
 



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