Question by mohindersobti: Question for an ophtalmologist: my friend is turing blind, below are some details of the tests… pl advice?
Female patient
DOB: June 7, 1973
Poland
In the hospital they diagnosed the problem as a retrobulbar inflammation of left optic nerve

Some tests done are detailed below:

MRI of the head – the result: everything is ok, MRI shows no changes (we have everything on CD)
Ultrasonic blood flow detection in carotid arteries – generally OK but because they wasn’t 100% sure, they ordered angio-TK (angio-CT)
angio-TK (angio-CT) – the results: no pathology, everything is OK there ( we have it on CD)
angio-MRI of the head – again, everything is OK, no pathology (we have CD)
Rtg of nasal sinusem – OK
stomatological consultation – 2 dentists said – everything is ok, but even so docs in the hospital sent her to another dentist and she ordered to remove 4 teeth (two of them because they could press the nerve, two of them because they were devitalized, dead)
blood tests:
InG and IgM – negative, no borreliosis
CRP 2,0 0,6 (whatever it is)
Hematocrit 30,8
Hemoglobin 11,00
Erythrocyte 3,82
Leukocyte 13,6
WR (Wassermann Reaction) – negative
Na (sodium) 139,6
K (potassium) 4,96
RF (rheumatoid factor) 7 (0-14)
ASO (Antistreptolysin O) 24 (0-200)
FT3 1,8 ( 2,02 -4,43)
FT4 1,55 (0,93-1,71)
TSH 0,364 (0,27-4,2)
Anty DNA negative
They were giving her: Cavinton (Vinpocetine), Dexaven (Dexamethasonum), Solu Medrol (Methylprednisolone Acetate), Lendacin (Ceftriaxone), Polfilin (Pentoxyfiline), Metypred (Methylprednisolone Acetate)
Leaving hospital the patient was ordered to take Metypred (Methylprednisolone Acetate), Cavinton (Vinpocetine) and Controloc (Pantoprazole)
Looking for focus of inflammation patient visited: laryngologist and gynaecologist – everything is OK, we have made USG of abdominal cavity – everything’s OK
Finally, patient has visited endocrinologist. Because she suspected the empty sella syndrome (ESS) – she ordered MRI of pituitary gland – the results, everything is OK ( we have CD) patient had blood test again – TSH 2,19 (0,27-4,2), FT3 5,33 (3,1-6,8), anty-TPO 9,8 (<34,0)
Patient also had some kind of test which shows electric impuls in brain when your eye is looking at the moving white and black chequered pattern on the monitor screen (We think it is called F-VEP, we have scan of the results (in English))

That’s all. Generally nobody knows why my friend has that problem with her eye and why she can’t see much with it or if she will ever be able to see more? Please advice with your expertise, what tests can be done, to detect this problem & how or if we can try improving her conditions!

Best answer:

Answer by gangadharan_nair
Damage along the optic pathway causes a variety of visual field changes. Optic neuritis is inflammation of the optic nerve. Symptoms are usually unilateral, with eye pain and partial or complete vision loss. Diagnosis is primarily clinical. Treatment is directed at the underlying condition; most cases resolve spontaneously.
Outlook (Prognosis):-
Patients who have optic neuritis without a disease such as multiple sclerosis have a good chance of recovery. Optic neuritis caused by multiple sclerosis or other autoimmune diseases such as systemic lupus erythematosus has a poorer outlook.
Possible Complications:-
* Body-wide side effects from corticosteroids
* Vision loss
About 20% of patients with a first episode of optic neuritis will develop multiple sclerosis.
Please note that I am not a medical professional.

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