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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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My daughter is a type i diabetic since she was one year old.

Resolved Question:

My daughter is a type i diabetic since she was one year old. she is 28 and developed optic neuritis, (she works with animals) she has had this now for 6 mos and both eyes are affected. Where is the best doctor, hospital to take her? thank you
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. James replied 6 years ago.
Dr. James : Hello.
Dr. James : Where do you live?
Customer:

san francisco bay area

Customer:

do you have any suggestions?

Dr. James : Yes, you have many being in the bay area.
Dr. James :

Hello?

Customer:

which is the best?

Dr. James :

is the optic neuritis related to the diabetes?

Customer:

Is there an eye clinic in us that specializes in optic neuritis?

Dr. James :

UCSF is a well respected place with a good ophthalmology department.

Dr. James :

Dr. Hoyt is there. Not sure if he actively seeing patients, but he wrote the textbook in neuro-ophthalmology

Customer:

the doctors were quick to say that it was but the onset was loss of vision over night. they tested for cat scratch, toxo neg did a spinal (2mos later) neg cultures bacterial and viral. at this point the rt was recovering but the left optic nerve showed swelling. we have see a opthalmologist /neurologist, neurolgist, retinal specialist etc. she has had four laser procedures to stop micro bleeds. the weirdness of this is her eyes were fine last year. the pictures showed just a few red dots and the optice nerves were clean visually. my daughter has seenthe same opthamologist since she was ten. she is veryfamiliar with my daughters eyes . this is really scary . she just had a PSVEP and it was abn in both eyes .

Dr. James :

It sounds like a difficult diagnostic dilemma.

Dr. James :

The testing she's had is right on and extensive.

Dr. James :

It is always good to get a second opinion.

Customer:

yes it is. the easy answer is diabetes, but she is never easy, forgot to mention that she has a pituitary adenoma ( its shrinking )

Dr. James :

The adenoma can cause an optic neuropathy as well.

Dr. James :

I'm sure she's had a MRI of the brain and orbits already.

Customer:

It can? is there atreatment?

Dr. James :

Depends on what the adenoma is composed of. The most common is a prolactin secreting adenoma and can be treated with a medicine called bromocriptine.

Customer:

Yes she has had several over the past 8 years , the most recent showed no evidence of MS lesions, and the tumor is shrinking

Dr. James :

It can also be treated surgically.

Customer:

she had been on dostinex for 8+ years. just recently was told to stop taking it

Customer:

It is less than 10mm

Dr. James :

Good. Less than 10mm is classified as a microadenoma.

Dr. James :

Certainly, a neuro-ophthalmologist is the best doctor to try to tie everything together.

Customer:

thanks so much .any other reccomendations?

Dr. James :

None other. I wish her the best.

Customer:

would steroids be helpful?

Dr. James :

Since it is 6 months out already, may be less effective. Typical optic neuritis usually gets better by it self in 1-2 months.

Dr. James :

The steroids may complicate her diabetes management as well.

Customer:

thank you and good night dr james

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