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Answered in 1 minute by:
7/2/2011
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2,453
Experience: Eye Physician and Surgeon
VerifiedDr. 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
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2,453
Experience: Eye Physician and Surgeon
VerifiedDr. James and 87 other Eye Specialists are ready to help you
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