Hi,

I'm trying to understand if I should pursue a neuro-opthomologic physician review. I've seen several neurologist and my opthomologist and none indicate they would necessarily send me to a neuro-opthomologist, but they are not adamant.

The symptoms that I'm concerned about are:
-intense increase in headache with vertical scanning of Right eye (and tightening in back of head). Some increase in headache with vertical scanning of left eye
-intense increase in headache with reaction time test without voluntary eye or head movements.
-trouble with reading and dealing with rolling screens
-limited reading endurance unless prone with neck supported
-balance (could be vestibular)

My PT believes the balance issues are more towards a neurological issue than vestibular (ENT physician scheduled for Dec 2019). She's been working with me for 4 months.

My vision therapist has diagnosed me with convergence insufficiency and vertical strabismus left eye. I also have keratoconus in both eyes (right eye is severe) which is complicating things for some testing.

My headache is mostly eliminated except with visual engagement (e.g. Vision therapy). The cervical area is returning to normal range of motion, except when exacerbated by various stressors (visual being one).

I'm now 5 months past my last big bump.

I've sustained several bumps on my head in the past 12 months, along with a car accident 3 years ago (from which I thought I'd fully recuperated within several weeks). The most recent larger bump in May '19 was accompanied by additional symptoms of dizziness (not vertigo), vision changes, balance issues, and mild nausea, in addition to original headache, fatigue, tinnitus, noise sensitivity, cognitive inefficiencies, slower reaction time). Many of my symptoms have lessened over time, but it is whack-a-mole (some go away, others recur).


I've been to a number of physicians:
3 neurologists, all of whom say something different, but nothing has been clearly diagnosed. My first 2 recent bumps are so inconsequential, several are pursuing other potential diagnosis.
Primary care
Physiatrist (rehab center)
D Osteopath, neuromuscular manipulation - really helpful for cervical tightness!
PT
OT
Speech Therapy
Vision therapy
Opthomologist
Optomatrist

While I would love to understand what is going on, I admit that what can pragmatically be done is a reasonable threshold (e.g. could a neuro-opthomologist actually do something, rule out complicating factors and just affirm current direction, or possibly find something that would help with paperwork).

Other types of healthcare recommendations would be appreciated if you're so inclined to share. :-)