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MS vision issues
Hi all,
I have a question that I'm not sure anyone here can answer (no offense to anyone implied) because it's so weird.
I have been suffering from double vision. Initially it was very infrequent but seems to be picking up speed. The first 2 events that made me sit up and pay attention happened when I was driving and I could not tell which lane was the proper lane nor where the oncoming car was. I was extremely lucky the first time as a state trooper was behind me. I have driven that road a thousand (literally) and never had seen a trooper. Anyway, she approached my car after the blue light special and asked for my ID . I was expecting the breathalyzer test but instead was asked one question, "Do I have any medical illnesses?" To which I nodded yes. The trooper had me follow her to a vacant parking lot close by where my DH picked me up.
The medical workup that day went from PCP to general neurologist to MRI scan and the final decision was migraine because they couldn't see anything else that fit. Didn't matter that I didn't have ANY head pain what so ever.
The second double vision incident didn't surprise me as much. It was my last scheduled PT appt that insurance would pay for and I didn't particularly want to pay for a "no-show". I did fine in therapy and received a list of necessary exercises, etc. On the way home , down back roads, the double vision reappeared but only briefly. Briefly was enough. I haven't driven independently since then.
Went to my academic center, neuro-ophthalmologist who had just finished his fellowship the week before. I didn't know this at the time, which was a good thing. His resident did the complete work-up and then "DR. Know -it all-" waltzed in. He told me my issue was migraines (acceptable and my predicted answer) but then had the cajones to tell me I didn't have MS . To stop going to my neuro (in the same building) because I had migraines not MS. He even told me to stop taking my DMD. If I had the day to do over again I would have had the newbie call my neuro and tell him face to face. This was all based on my entire medical chart at this institution erroneously claiming I had migraines over and over again because "my lesions" were "too" round to be MS.
But, instead I sat there dumb-founded by his proclamation. The new Fellow in the room who had done all the testing , would NOT make eye contact . He simply looked in his lap the entire time Mr. Know -It -All talked. Of course, when I read his report to the neuro , who gladly shared, it had nothing to do with what he told me , just that I had a normal exam.
So, present day. Still skittish about neuor-opths but need something done. Last night at a Christmas cantana, my vision went wacky. First it became blurry, then there were "ghost images" of the two performers. Covering one eye relieved the double vision but not the blurriness of vision. Once I grew tired of looking like I was taking an eye test on the Snellen chart, I remove my hands and saw 2 blurry images that then morphed into one figure. I know , sounds weird, I was in church , I was NOT inebriated or otherwise impaired.
Has anyone ever experienced this or know anything about it? I am assuming it may have to do with muscle spasms of the muscles controlling the eyes movements (thanks Michelle) but does any one else have any other experiences to share?
I am scheduled with a new neuro-opth next week but you know how it is....you want to know now!
Thanks to anyone who can shed some light on this issue. The inability to be independently mobile is taken for granted by so many people , including me before this mess. Never again, will I take the simple things for granted.
Ren
I have a question that I'm not sure anyone here can answer (no offense to anyone implied) because it's so weird.
I have been suffering from double vision. Initially it was very infrequent but seems to be picking up speed. The first 2 events that made me sit up and pay attention happened when I was driving and I could not tell which lane was the proper lane nor where the oncoming car was. I was extremely lucky the first time as a state trooper was behind me. I have driven that road a thousand (literally) and never had seen a trooper. Anyway, she approached my car after the blue light special and asked for my ID . I was expecting the breathalyzer test but instead was asked one question, "Do I have any medical illnesses?" To which I nodded yes. The trooper had me follow her to a vacant parking lot close by where my DH picked me up.
The medical workup that day went from PCP to general neurologist to MRI scan and the final decision was migraine because they couldn't see anything else that fit. Didn't matter that I didn't have ANY head pain what so ever.
The second double vision incident didn't surprise me as much. It was my last scheduled PT appt that insurance would pay for and I didn't particularly want to pay for a "no-show". I did fine in therapy and received a list of necessary exercises, etc. On the way home , down back roads, the double vision reappeared but only briefly. Briefly was enough. I haven't driven independently since then.
Went to my academic center, neuro-ophthalmologist who had just finished his fellowship the week before. I didn't know this at the time, which was a good thing. His resident did the complete work-up and then "DR. Know -it all-" waltzed in. He told me my issue was migraines (acceptable and my predicted answer) but then had the cajones to tell me I didn't have MS . To stop going to my neuro (in the same building) because I had migraines not MS. He even told me to stop taking my DMD. If I had the day to do over again I would have had the newbie call my neuro and tell him face to face. This was all based on my entire medical chart at this institution erroneously claiming I had migraines over and over again because "my lesions" were "too" round to be MS.
But, instead I sat there dumb-founded by his proclamation. The new Fellow in the room who had done all the testing , would NOT make eye contact . He simply looked in his lap the entire time Mr. Know -It -All talked. Of course, when I read his report to the neuro , who gladly shared, it had nothing to do with what he told me , just that I had a normal exam.
So, present day. Still skittish about neuor-opths but need something done. Last night at a Christmas cantana, my vision went wacky. First it became blurry, then there were "ghost images" of the two performers. Covering one eye relieved the double vision but not the blurriness of vision. Once I grew tired of looking like I was taking an eye test on the Snellen chart, I remove my hands and saw 2 blurry images that then morphed into one figure. I know , sounds weird, I was in church , I was NOT inebriated or otherwise impaired.
Has anyone ever experienced this or know anything about it? I am assuming it may have to do with muscle spasms of the muscles controlling the eyes movements (thanks Michelle) but does any one else have any other experiences to share?
I am scheduled with a new neuro-opth next week but you know how it is....you want to know now!
Thanks to anyone who can shed some light on this issue. The inability to be independently mobile is taken for granted by so many people , including me before this mess. Never again, will I take the simple things for granted.
Ren
well im no doctor but it is a common medical symptom, my mother has MS and had this problem for the past 10 years or so. i was tested for MS about a year ago and it was a simple MRI of my brain in an effort to see if there were any lesions or scars. its very common for doctors to be complete jerks about an MS diagnosis, so dont be afraid to throw a fit and demand more, before my mother was diagnosed, she actually had a doctor tell her that, "you are an out of control housewife who isnt getting enough attention from her husband" but the best of luck to you, if its any consolation, my mother found several coping mechanisms for her vision problems and was able to return to driving and continued to drive for about 9 years
Hi Ren, I have had the very same issues, both with Double vision, and the opthomologists,
and there apparently is such a thing as a " SILENT MIGRAINE", or that is what they told me.
I do think the stress, especially at this time of year, contributes to the double vision for me, anyways.
I had the double vision , and it lasted 1 1/2 months, and I had to wear a patch over my eye, and that is why I don't drive any more, cause I never know when it will attack next, and if I can't see, I for sure can't drive.
It is a horrible thing to happen, but I was told by my NEURO ... ( lovely person that she is) ..... she said, " it is what it is" ............ and tdhat was that...
HUGS to you, and a Very Merry Christmas, maybe a stiff drink or a glass of wine might help, ( at least it won't hurt) ....
Cheers, Candy
and there apparently is such a thing as a " SILENT MIGRAINE", or that is what they told me.
I do think the stress, especially at this time of year, contributes to the double vision for me, anyways.
I had the double vision , and it lasted 1 1/2 months, and I had to wear a patch over my eye, and that is why I don't drive any more, cause I never know when it will attack next, and if I can't see, I for sure can't drive.
It is a horrible thing to happen, but I was told by my NEURO ... ( lovely person that she is) ..... she said, " it is what it is" ............ and tdhat was that...
HUGS to you, and a Very Merry Christmas, maybe a stiff drink or a glass of wine might help, ( at least it won't hurt) ....
Cheers, Candy
During the refraction. (when they have the big metal thing in front of your face), they are checking to find the best "type" of glasses for each eye.
We do this one eye at a time. At the end of what we and you have chosen what we think is "perfect" refraction, we double/triple check to make sure again that is what you "like".
We induce a vertical image (with using the prisms in the phoropter), so both eyes get a chance to see what is better. All along until this point, we have blocked off an eye, so it is all monocular.
We induce a vertical diplopia, so the person can use both eyes and decided if one is clearer that the other. If one is "better than the other" we change the lenses until both are perceived as the same by the patient.
That is why we give you double vision :)
Michelle
One more thing, Monocular double vision is not a neurological symptom. It is a problem with the "front" part of the eye. (such as uncorrected astigmatism, a focusing problem with the lens, cataract, dry eye, anything that can affect the cornea, the list goes on...)
Binocular diplopia is generally a problem with the muscles of the eyes (this is where the neurological issues might present themselves). There are 6 muscles in each eye, and any can "act up" do to numerous things. Binocular diplopia is when you cover an eye and the second image disappears.
We do this one eye at a time. At the end of what we and you have chosen what we think is "perfect" refraction, we double/triple check to make sure again that is what you "like".
We induce a vertical image (with using the prisms in the phoropter), so both eyes get a chance to see what is better. All along until this point, we have blocked off an eye, so it is all monocular.
We induce a vertical diplopia, so the person can use both eyes and decided if one is clearer that the other. If one is "better than the other" we change the lenses until both are perceived as the same by the patient.
That is why we give you double vision :)
Michelle
One more thing, Monocular double vision is not a neurological symptom. It is a problem with the "front" part of the eye. (such as uncorrected astigmatism, a focusing problem with the lens, cataract, dry eye, anything that can affect the cornea, the list goes on...)
Binocular diplopia is generally a problem with the muscles of the eyes (this is where the neurological issues might present themselves). There are 6 muscles in each eye, and any can "act up" do to numerous things. Binocular diplopia is when you cover an eye and the second image disappears.
I think Quix has said that OCT changes are likely to reflex a corresponding atrophy in the brain. I don't think it can be specifically linked to MS activity - at least not right now.
Ren, my bet is with Michelle on this one. It would seem that episodes of double vision that are so sporadic and short lived would be from a functional cause rather than specific pathology. Muscle spasms seem a likely culprit.
Was there any common thread in your activity before or during each episode? Are you having trouble adjusting quickly between near and far focusing? Driving and watching a play might be times when you are doing a lot of scanning with your eyes?
That two images morphing into one reminds me of when sometimes during a refraction they will put up two images then start to move them closer together and have me say when I just see one. I don't know what that is testing though. Michelle???
Eyes are a wonderous mystery to me. My vision is blurry with a ghosted image to boot all the time these days. It gets worse if I'm tired, it's late in the day or when I've looked at the computer screen too long. I have an astigmatism, surgically corrected vision, old eyes and an abnormal VEP so I never know how much of it comes from what source.
Yes, migraines can cause symptoms without pain. They also often co-habitate with MS in the same brain! This guys problem was with using migraines to explain a problem he couldn't diagnose and to also rule out MS with one broad swipe. Sounds like he was way off base and had some hidden personal agenda.
I'll be interested to hear what you find out from someone who may actually have a clue.
Mary
Ren, my bet is with Michelle on this one. It would seem that episodes of double vision that are so sporadic and short lived would be from a functional cause rather than specific pathology. Muscle spasms seem a likely culprit.
Was there any common thread in your activity before or during each episode? Are you having trouble adjusting quickly between near and far focusing? Driving and watching a play might be times when you are doing a lot of scanning with your eyes?
That two images morphing into one reminds me of when sometimes during a refraction they will put up two images then start to move them closer together and have me say when I just see one. I don't know what that is testing though. Michelle???
Eyes are a wonderous mystery to me. My vision is blurry with a ghosted image to boot all the time these days. It gets worse if I'm tired, it's late in the day or when I've looked at the computer screen too long. I have an astigmatism, surgically corrected vision, old eyes and an abnormal VEP so I never know how much of it comes from what source.
Yes, migraines can cause symptoms without pain. They also often co-habitate with MS in the same brain! This guys problem was with using migraines to explain a problem he couldn't diagnose and to also rule out MS with one broad swipe. Sounds like he was way off base and had some hidden personal agenda.
I'll be interested to hear what you find out from someone who may actually have a clue.
Mary
I don't know if this is your problem or not, but I frequently have problems with double vision, either in one eye or in both. Here's my theory - I think that the muscles of the eyes are weak, and they get tired. When they get tired (or when I'm fatigued) they start crossing and having trouble focusing.
Here's a cool thing - I'm scheduled for an optical coherence tomography test in January! That's the test that looks at the thickness of the nerve fiber in the eye, so they can check for atrophy. You might ask your neuro-opthamologist about it. They say it's a better predictor of MS activity than the MRI.
Here's a cool thing - I'm scheduled for an optical coherence tomography test in January! That's the test that looks at the thickness of the nerve fiber in the eye, so they can check for atrophy. You might ask your neuro-opthamologist about it. They say it's a better predictor of MS activity than the MRI.
Welcome to my world! Eye patches are useless for me. The good news if it persists you can get a Polly dog, just not my Polly.
But it is my humble opinion you were really plastered! LOL.
Alex
But it is my humble opinion you were really plastered! LOL.
Alex
I guess I'm "Lucky?" I have persistent monocular vertical double vision. I notice it most of the time and the 2nd image is overlapping the main image by about 60%. I think mine is a constant companion, but I notice it more later in the day and when I'm really spent (some days that is 10:00 AM)
I guess I can see how a doctor "could" diagnose bouts of visual disturbances as an ocular migraine. They can come on with or without "headache" pain. I guess the difference is that I know mine is due to damage of the Optic Tract and Optic Nerve. That damage ensures that part of the image gets to the brain later than than the first part. You seem to have normal vision that occasionally goes double. Is your Vertical or horizontal?
The one course of IVSM made me feel great and really helped my legs and spasticity, but did nothing with my vision. I guess that damage is there and not related to inflammation or an active lesion.
Bob
This is the key thing that made the call to start DMDs. I could not risk more damage to my neurovision.
I guess I can see how a doctor "could" diagnose bouts of visual disturbances as an ocular migraine. They can come on with or without "headache" pain. I guess the difference is that I know mine is due to damage of the Optic Tract and Optic Nerve. That damage ensures that part of the image gets to the brain later than than the first part. You seem to have normal vision that occasionally goes double. Is your Vertical or horizontal?
The one course of IVSM made me feel great and really helped my legs and spasticity, but did nothing with my vision. I guess that damage is there and not related to inflammation or an active lesion.
Bob
This is the key thing that made the call to start DMDs. I could not risk more damage to my neurovision.
Sorry, Ren. All I can say after reading your post is...the guy is a jerk and you sure don't need him in your life. I hope your neuro calls him on it.
Thank you ladies for your responses.
JJ- There won't be a repeat of last time, I'm a seasoned veteran of big egos now, so I WILL walk out of there with an answer or a referral; to someone who CAN dx me.
Sumana - I've had several rounds of steroids for several MS related symptoms and they never do a whole lot. It appears I don't have much acute inflammation.
The new doc ran the Neuro-opth department at the academic hospital for over 10 years. Won " Teacher of the Year 5 years straight and was voted Top Docs in America by fellow doctors for 4 years straight. I like the Teacher of the Year awards...to me it shows that he knows how to get a topic across to someone and do it nicely.
I'll let you know........
thanks again,
Ren
JJ- There won't be a repeat of last time, I'm a seasoned veteran of big egos now, so I WILL walk out of there with an answer or a referral; to someone who CAN dx me.
Sumana - I've had several rounds of steroids for several MS related symptoms and they never do a whole lot. It appears I don't have much acute inflammation.
The new doc ran the Neuro-opth department at the academic hospital for over 10 years. Won " Teacher of the Year 5 years straight and was voted Top Docs in America by fellow doctors for 4 years straight. I like the Teacher of the Year awards...to me it shows that he knows how to get a topic across to someone and do it nicely.
I'll let you know........
thanks again,
Ren
Personally I think the thing can be settled one, two, three. Your neuro could put you on a course of steroids. I assume the steroids help because it is MS causing it. It cleared mine up after a 5 day IV. I have never gone to a ophthalmologist. I just assumed it was part of MS. My vision has returned to normal unless I am way overtired.
COMMUNITY LEADER
HI Ren,
I just looked up 'sudden double vision' and came across this publication, it covers a few things not sure if it answers your question though. see below....
"The following questions will help provide direction to the final diagnosis: • monocular or binocular – if the diplopia continues when one eye is closed the condition is monocular. If the diplopia disappears it is due to a breakdown in the binocularity of both eyes • onset – sudden onset may indicate vascular origin while gradual deterioration may be due to a progressive neurological disorder such as progressive supranuclear palsy or a slow growing tumour
• vertical or horizontal – the direction of the double image may indicate the specific involvement of an extraocular muscle. (Similarly some extraocular muscles will dominate with either close or distance vision. For example, a sixth nerve or lateral rectus palsy will be more noticeable when the patient is viewing at a distance."
http://www.racgp.org.au/afp/200312/20031218hodge.pdf
I did see an eg photo of double vision, the image was of a boy and then the same image again overlapping, it sounds the same as what your saying you saw looking at a distance. I see the same but for me its like that looking at things close, the closer the more pronounced it is, words are problem too but so far my vision isn't such a problem looking at a distance.
I hope you get an expanation at your appointment and dont get a repeat of what happened with the neuo-ophthal.
Cheers.........JJ
I just looked up 'sudden double vision' and came across this publication, it covers a few things not sure if it answers your question though. see below....
"The following questions will help provide direction to the final diagnosis: • monocular or binocular – if the diplopia continues when one eye is closed the condition is monocular. If the diplopia disappears it is due to a breakdown in the binocularity of both eyes • onset – sudden onset may indicate vascular origin while gradual deterioration may be due to a progressive neurological disorder such as progressive supranuclear palsy or a slow growing tumour
• vertical or horizontal – the direction of the double image may indicate the specific involvement of an extraocular muscle. (Similarly some extraocular muscles will dominate with either close or distance vision. For example, a sixth nerve or lateral rectus palsy will be more noticeable when the patient is viewing at a distance."
http://www.racgp.org.au/afp/200312/20031218hodge.pdf
I did see an eg photo of double vision, the image was of a boy and then the same image again overlapping, it sounds the same as what your saying you saw looking at a distance. I see the same but for me its like that looking at things close, the closer the more pronounced it is, words are problem too but so far my vision isn't such a problem looking at a distance.
I hope you get an expanation at your appointment and dont get a repeat of what happened with the neuo-ophthal.
Cheers.........JJ
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