I had the eye test to look for those rings. It's a very special kind of eye exam and took some time to do. Another type of eye exam would probably not show the rings. I don't think I got any drops in my eyes for the test, either.

Rarely, one can have Wilson's without the rings. They confirmed it with a liver biopsy in an article I read a few years ago.

Did you have your urine tested for copper? I collected my urine over 24 hours and had it tested.

I'm surprised you weren't tested for Wilson's much earlier. Best of luck getting a diagnosis, or ruling it out. They do chelation therapy for Wilson's, I think.

found this about copper tests:

http://www.labcorp.com/datasets/labc...o/bm004700.htm

Says serum copper is normal or low in Wilson's and high in urine. And "Liver copper is used to confirm Wilson disease".

And in another article:

My Dr. says I have high copper in my blood (serum copper). Could I have Wilson disease?

High serum copper is not an indication of Wilson disease. Since most Wilson’s patients have a low ceruloplasmin they actually have a lower than normal serum copper. Ceruloplasmin is the protein that binds with copper to remove it from the body. It is the unbound (to ceruloplasmin) copper that is free to roam around the body and accumulate in organs causing Wilson disease damage.

An elevated serum copper is more often due to an elevation of the level of serum ceruloplasmin since it contains ~90% of the circulating copper bound to it. Elevations of ceruloplasmin can occur with inflammation, in response to estrogen therapy and in pregnancy.

Note: The exception to this is when there is severe liver injury (acute liver failure) caused by Wilson disease. This causes very large amounts of copper to be released into circulation and causes markedly elevated serum copper. When this occurs, patients are very ill and usually have jaundice (yellow eyes and skin color) and very abnormal lab results with respect to liver function and blood coagulation.

Michael Schilsky, M.D.
Weill Cornell School of Medicine
WDA Medical Advisor

http://www.wilsonsdisease.org/conten...D=14&SUB_ID=27

My neuro wouldn't see me, so I went to the gp and she ordered a lot more tests including an abd. ultrasound and a 24 hour copper. Most of the blood tests should be back tomorrow.

You are right, Zucchini Flower, a liver biopsy is next depending on the results of this week's test. At least my husband will be home in a couple of days.

Now when I had the eye test before, he just looked into my eye with a slit lamp. What else is there?

Thanks for helping me sort it out,
mama

I added to my original post. Please read it! High copper levels don't indicate Wilson's unless you have severe liver disease with jaundice, usually. Do you have jaundice?

Yes, I had the slit lamp test, I think. It was different from my other regular eye exams. I thought that you had routine tests in the past, not the slit lamp.

I have high liver functions, but i am not sure about the jaundice.

Some info about liver tests:

http://www.atdn.org/simple/liverfun.html

Great resource, thank-you. I have elevated ASTand ALT.

mamafigure
this is all news to me - I am shocked that Wilson's disease hasn't already been ruled out. that was one of the first tests I had before my PD dx.

what's the latest?

Peggy

I find this interesting. When I was going through testing to find what was wrong, every doctor I saw took a good look at my eyes. When I asked what they were looking at they just said they were ruling out other causes. A couple of the doctors spent what I would consider a long time looking at my right eye (affected side).
Just a couple of weeks ago the MDS I have been seeing for the past few years took a longer than normal look at my right eye. I asked what he was looking at and really didn't get a good answer. He just sort of passed it off as part of the exam.
Now here is the strange part. I have worn glasses since I was like 8 yrs old. I've had countless eye exams over the years. If there was an eye problem, I think it would have been found.
So other than Kayser-Fleischer rings what else would be of interest in the eye related to PD or other movement disorders?

GregD

Sorry peg,
I started to email you no less than a dozen times. I am not sure what happened.

The latest is just waiting. The lab tech put a rush on the blood tests. She thought that they should have been back today, but my gp doesn't work on Wednesdays, so maybe tomorrow.

DH is in AK. His iritis is so bad that a local doc wanted to medevac him to Anchorage (he came out of the bush when it got worse). He talked him out of it, but the doc did call our opthalmologist here and got some new Rxs.

I was given the eye test before, and I think that I had the blood screen from my gp. This is the first time that the copper has been up, and the first time for elevated liver tests, too. Along with firsts, remember, the lnext to the last time I went to the neuro it was the first time I couldn't keep my balance in the test. (This last time he didn't try that test and he rescinded his dx of parkinsonism and said that it was likely that in the end that everything would be ruled as caused by psy).

I think that I am not going to see him anymore.

Email me when you can,

Mamafigure - I'll email you tonight.

Greg - to answer your concern about what was your doctor looking for in your eyes, I think it's how much dopamine loss has affected your retina.
(Read this abstract below)

Jackson GR, Owsley C.
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, 700 South 18th Street, Suite 609, Birmingham, AL 35294-0009, USA. jackson@eyes.uab.edu

The four most common sight-threatening conditions in older adults in North America are cataract, ARM, glaucoma, and diabetic retinopathy. Even in their moderate stages, these conditions cause visual sensory impairments and reductions in health-related quality of life, including difficulties in daily tasks and psychosocial problems. Many older adults are free from these conditions, yet still experience a variety of visual perceptual problems resulting from aging-related changes in the optics of the eye and degeneration of the visual neural pathways. These problems consist of impairments in visual acuity, contrast sensitivity, color discrimination, temporal sensitivity, motion perception, peripheral visual field sensitivity, and visual processing speed. PD causes a progressive loss of dopaminergic cells predominantly in the retina and possibly in other areas of the visual system. This retinal dopamine deficiency produces selective spatial-temporal abnormalities in retinal ganglion cell function, probably arising from altered receptive field organization in the PD retina. The cortical degeneration characteristics of AD, including neurofibrillary tangles and neuritic plaques, also are present in the visual cortical areas, especially in the visual association areas. The most prominent electrophysiologic change in AD is a delay in the P2 component of the flash VEP. Deficits in higher-order visual abilities typically are compromised in AD, including problems with visual attention, perceiving structure from motion, visual memory, visual learning, reading, and object and face perception. There have been reports of a visual variant of AD in which these types of visual problems are the initial and most prominent signs of the disease. Visual sensory impairments (e.g., contrast sensitivity or achromatopsia) also have been reported but are believed more reflective of cortical disturbances than of AD-associated optic neuropathy.

PMID: 13677819 [PubMed - indexed for MEDLINE

Peggy