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Dr. David
Dr. David, Board Certified Physician
Category: Eye
Satisfied Customers: 29453
Experience:  Experienced Physician trained in New York City. I'm ready to help.
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Hi, I have had a very trying time these past months trying

Customer Question

Hi, I have had a very trying time these past months trying to get to the bottom of a medical issue that started with the discovery of an elevated optic nerve. Nothing seems to add up when different doctors say different things, and doctors also seem to be sometimes unwilling to answer my questions. I hope you can help.
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. David replied 1 year ago.
This is Dr. David

what do you mean an elevated optic nerve? did your doctors see this on MRI scan?

is the pituitary enlarged and pressing on the optic nerve?

the pituitary sits right below the optic chiasm.
Customer: replied 1 year ago.

I was told the optic nerve was elevated. It shows on the eye exam and the optic nerve scan photo. The MRI only shows a very little fluid near the nerve. My visual field tests are normal. There is a bit of an increase in ocular pressure in my left eye, which also has a mild distortion of vision. I don't even notice this distortion unless I cover my right eye. No other symptoms.

Expert:  Dr. David replied 1 year ago.
I would get a copy of the MRI report and see if the pituitary gland is enlarged which can elevate and rasie up your optic nerve.

can you get a copy of your MRI scan report?
Customer: replied 1 year ago.

Sure, I have it. I will give it to my new PCP next week along with the films. There is nothing on the report about my pituitary gland.

Expert:  Dr. David replied 1 year ago.
I see.

if you scan it in in word or pdf format, I would be happy to review it.

you can upload it here as well


type a word in the textbox and highlight it

then select the "chain" icon above the textbox next to the paper clip

this opens a window where you can click next to the text box to select the jpg or pdf file to upload
Customer: replied 1 year ago.

Do you mean the report or the actual pictures?

Expert:  Dr. David replied 1 year ago.
the report in word or pdf format.
Expert:  Dr. David replied 1 year ago.
why the poor service rating?

what other questions do you have?
Customer: replied 1 year ago.

No other questions. I've had two people look at the MRI films already. The report has no mention of my pituitary gland, so I don't need anyone to read it again.

Expert:  Dr. David replied 1 year ago.
is the optic nerve elevated when it enters the orbit?
Customer: replied 1 year ago.

I'm sorry to say that I don't know if it is or not. My main concern here is that a doctor has suggested I have a lumbar puncture for this, however, I don't have symptoms. The slight visual distortion is not listed as a symptom of papilledema due to IIH.

Expert:  Dr. David replied 1 year ago.
I would talk to your doctor about what they mean by elevated optic nerve.

I don't know what you are meaning by this and I don't think you know what they are meaning by this.

I would find out before doing a lumbar puncture.

I am not sure what a little clear fluid next to the optic nerve what that means.

I would be happy to review the MRI report with you, but you don't seam to want to upload it.

would you be willing to upload it?
Customer: replied 1 year ago.

I will look for the MRI reports. Two people did them, and they are different. You are right! I don't know what elevated means. I asked the doctor because he said elevated is different from swollen. The point is that he did not answer my question, so I am not having the lumbar puncture at this time. The doctor also did a tomography. That report I do have if it will help you.

Expert:  Dr. David replied 1 year ago.
anything you want to upload I would be happy to review with you.

I want to give you excellent service here at JustAnswers


type a word in the textbox and highlight it

then select the "chain" icon above the textbox next to the paper clip

this opens a window where you can click next to the text box to select the jpg or pdf file to upload
Expert:  Dr. David replied 1 year ago.
the MRI scan sees papilledema which is increased pressure and swelling around the optic nerves. this could be from inflammation of the area round the optic nerves. the question what is causing this. a spinal tap is definitely needed, but most likely will be negative.

papilledema is most often caused by increased intracranial pressure. this elevated cranial pressure can be measured when they perform a spinal tap.

for some patients, they just have elevated intracranial pressure for unknown causes. for other patients a cause can be found.

the spinal tap is the first step in trying to find the cause of the elevated intracranial pressure.

do you feel better about having the spinal tap now?

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