If it is ON, they probably won't be able to get your eyesight to 20/20. The problem with that approach (seeing the Optho, to determine if it is ON or just aging) is that sometimes the symptoms fluctuate with ON.

I went 3 times to get a rx, and every time they came up with a different rx and couldn't get it to 20/20 the first two. When she finally did, that just happened to coincide with a day on the road to recovery . . . so ultimately the the rx was too strong when they fully recovered.

I got my rx in Dec, and had my glasses made up right away. I think the ON recovered some time in early Jan, but it took till mid-way through March before I could finally get a pair of contacts that worked.

My rx before the ON was -5.75 in both eyes. In Dec, I got a rx for -7.50 in the left, and -6.50 in the right, and that is what my glasses were made up as. Contacts are always a little lower, but after several reductions, I am now at -6.50 in the left, and -5.75 in the right.

I guess what I'm trying to say is that if it is ON, this isn't the time to spend lots of money on new lenses/glasses.

Your optometrist should be able to help determine if it might be ON, based on whether she can get it to 20/20. Mine referred me to a neuro-optho, and I had a VEP and Visual Field Test. She saw the ON damage even before that testing, but it appeared to be "old" damage to the nerve. It is worth seeing a Neuro-optho at this time, if ON is a possibility ...

BTW, apparently our eyes do get worse in our 40's, for those of us who've always had eye problems, regardless of the MS.

And one more thing, from the upcoming AAN meeting next week:

[S57.004] Clinical and Ocular Imaging Characteristics of Eyes with Visual Loss over Time in Multiple Sclerosis

Esther Bisker, Sally C. Chang, David Long, Lauren Talman, Amy Conger, Girish Hiremath, Teresa Frohman, Michael Loguidice, Steven Galetta, Clyde Markowitz, Dina Jacobs, Yang Dai, Gui-Shuang Ying, Maureen Maguire, Elliot Frohman, Peter Calabresi, Laura J. Balcer, Dallas, TX, Baltimore, MD, Philadelphia, PA

OBJECTIVE:

The purpose of this study was to determine the degree of retinal nerve fiber layer (RNFL) thinning by optical coherence tomography (OCT) that is associated with losses of low- and high-contrast acuity over time in a multiple sclerosis (MS) cohort.

BACKGROUND:

Visual dysfunction and axonal loss are common in MS. The emergence of OCT has allowed us to capture the unique structure-function correlations provided by the anterior visual pathway in MS clinical trials.

DESIGN/METHODS:

Patients with MS underwent OCT-3 imaging at baseline and at 6-month intervals during a mean follow-up period of 1.5 years (range 0.5-3.7) at three academic centers. RNFL thickness was measured for 360 around the optic disc. Visual function testing was performed using low-contrast (2.5 and 1.25% levels) and ETDRS acuity charts. Eyes with comorbid ocular conditions or acute ON within 3 months prior to testing were excluded.

RESULTS:

Among 1,148 patients (2,296 eyes, age 4411 years) who underwent baseline assessments, 365 (725 eyes) have participated in longitudinal follow-up. Worsening of low-contrast acuity was noted in 237 eyes of 123 patients (33% of MS eyes). Approximately 1/3 of eyes with visual loss had a past history of ON. Two-line (10-letter) losses of low-contrast acuity were associated, on average, with 1.6 m decrements in RNFL thickness over time at 2.5% contrast (p=0.009, GEE models, accounting for age and within-patient, inter-eye correlations), and 3.7 m reductions at 1.25% contrast (p=0.02). Patients with worsening vision were only slightly older (age 45 vs. 43 years), and had slightly greater disease duration (12 vs. 11 years).

CONCLUSIONS/RELEVANCE:

Visual loss occurs in a substantial proportion of MS eyes, and may be present even in the absence of a history of ON. Reductions in low-contrast acuity are associated with RNFL thinning over time, suggesting that axonal loss may be a significant contributor to visual dysfunction in MS.

Supported by:

National Multiple Sclerosis Society Grants PP115, RG 3208-A-1, RG 3428-A-2 (Dr. Balcer), National Multiple Sclerosis Society Translational Research Partnership TR 3760-A-3 (Dr. Balcer), and National Eye Institute / NIH K24 EY 018136 (Dr. Balcer)

Category - Neuro-Ophthalmology/Neuro-Otology - Epidemiology

Thursday, April 30, 2009 4:30 PM
(thanks Agate)

Cherie