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Eye and Vision Care

Swollen Optic Nerve

12/21/2009

Question:

My daughter has several problems with her eye including uvitis and now has a swollen optic nerve, but her uvitis is not active enough to be causing the swelling per her doctor. She has been tested for everything from chicken pox to syphilis to HIV. She has had 3 MRI`s and orbits done in the last couple months. All blood tests and MRI`s have come back with no indication of what is causing this. Last week she had the steroid IV`s for 3 days and is currently back on steroids but this also does not seem to be doing any good. The next medication they are putting her back on is the methatrexate(sp). I am a little concerned since the steroids are not doing anything but causing bone loss and swelling that the methatrexate will not help this time either. She has had cronic steroid use over the past 10 years and her bone density has decreased over this time along with all the other problems that come with taking steroids over this period of time. Is there a "best doctor" in the Houston area that possibly we have not tried that you may know of? Don`t take this wrong, we are very pleased with her doctor but maybe they are just out of ideas and a little push with a new idea. She has also seen a neuro-op and he seemed to think the uvitis is causing it but the uvitis doctor does not think so. This paticular problem has been ongoing for about 3 months or so. She also has a steroid implant and glaucoma tube but this is checked regularly and does not seem to be causing the problem.

Answer:

I apologize for the late response to this message, but I was trying to find the name of a good neuro-ophthalmologist in the Houston area. This is rather difficult in that I am located in Columbus, Ohio. I do personally know two optometrists in that area and one of them specializes in pediatrics. This doctor recommended her favorite neuro-ophthalmologist and his information is below.

This sounds like a very complicated case that cannot be diagnosed via a computer response. From your description of all the tests your daughter has endured, it looks as though they are trying their best to isolate an infective or inflammatory/autoimmune cause for her conditions.

The name of the neuro-ophthalmologist is Dr. Andrew G. Lee at Methodist Eye Associates (Methodist Hospital System). The contact information is below:

6560 Fannin Street
Scurlock Tower
Suite 1840
Houston, TX 77030
713-441-8843 phone

I hope that you get some answers as to what may be causing this condition and I hope that it is resolved soon for your daughter's sake.


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Response by:

Aaron  Zimmerman, OD, MS Aaron Zimmerman, OD, MS
Clinical Associate Professor of Optometry
College of Optometry
The Ohio State University