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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
20222826
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Please help me! My 14 yo daughter has had a continuous(I mean

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Please help me! My 14 yo daughter has had a continuous(I mean has NEVER gone a way) headache for 41/2years. The headache started after a traumatic incubation and being on a ventilator for 5 days. This headache started after an emergency surgery to treat acute bacterial tracheaitis at Children's Hospital in Cincinnati Ohio when she was 10 yo. We have tried every medication and therapy possible w/ the help of our pediatrician!Now we have new symptoms along with her never ending headache...In the last 6 months her right eye has gone to poor vision and her eyes are now different colors (one green and one blue), they were both blue before. She also has a slight pitosis of one eye. Her optometrist(she has only seen once...today actually) is saying let's just watch it? Any suggestions????

Dr. James :

Hello.

Dr. James :

Has she seen an ophthalmologist?

Customer:

No.

Dr. James :

What is the reason for the vision loss in the right eye?

Customer:

The LensCrafter doctor did not know? Just an FYI I am an BSN RN and I was doing some research d/t this loss and found some info on Horner's Syndrome? Are you familiar w/ this?

Dr. James :

Yes.

Dr. James :

The symptoms of Horner's is ptosis, anhydrosis, anisocoria.

Dr. James :

The findings can be subtle however.

Dr. James :

Differences in eye color, aka heterochromia, however points to a congenital horner's syndrome.

Dr. James :

When was her last MRI?

Customer:

yes I found that out?

Customer:

She has had 3 MRIs the last being about 1 year ago

Dr. James :

What were the findings on MRI?

Customer:

They found a severe sinus infection and focused on that, it was treated w/ ATB's

Dr. James :

Anything in the brain?

Customer:

Actually nothing impressive, some likely gliosis within the posterior rt. frontal periventricular white matter.

Dr. James :

The most concerning thing you have list is the poor vision in the right eye.

Dr. James :

Most cases of vision loss will have an identifiable finding on exam.

Dr. James :

I would think the optometrist would have come up with a diagnosis.

Dr. James :

Vision loss originating from the brain can have a normal eye exam.

Customer:

I had a feeling you were going to say that.....

Dr. James :

Your daughter needs to see an ophthalmologist for a better exam.

Dr. James :

It is possible your daughter may have a Horner's syndrome as well, but the key finding in this is anisocoria.

Dr. James :

or difference in pupil size.

Dr. James :

I can't piece together the difference in eye color. This is usually a finding in congenital Horner's.

Dr. James :

But the eye symptoms have come about in the last 6 months as you say.

Customer:

The doctor did not say this symptom...i will have to look more closely at that.... but her eyes are also slightly different sizes. and yes this has happened recently, not at birth.

Customer:

She is a great kid...absolutely darling, highly motivated and intelligent, but she is just living w/ this headache and now these new symptoms and no doctor is helping us. i am in the medical field and it just seems everyone just follows their protocols and she is not fitting into any of these!

Dr. James :

Has she been to the academic medical center?

Customer:

No one wants to step on anyone's specialty...so interesting?

Customer:

Not sure what that is?

Dr. James :

Unfortunately, that is the trend of medicine today.

Dr. James :

University hospital.

Customer:

Yes I know i advocate for the elderly and I am constantly having to bring everyone together to get a proper Dx......Are you saying at University of Cincinnati?

Dr. James :

In complicated cases need coordinated multispecialty care, the university hospital is the best place.

Dr. James :

Your daughter first needs to see an ophthalmologist to determine the cause of vision loss.

Customer:

Yes I agree.

Dr. James :

Do you have any other questions for me?

Customer:

no

Customer:

We will just continue what we are doing....

Dr. James :

Best wishes to you and your daughter.

Please remember to press the accept button so I can receive credit for assisting you today.

Dr. James :

.

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