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I have a question for Dr. Noon.
I was diagnosed with some type of a “cone-rod dystropy” 2 years ago at age 35. (I also have severe nearsightedness since age 9 with astigmatism.) This is a devastating dx, but even more so when you are a working mother of 3 very young children. I have educated myself as much as I can, but what is even harder, is trying to find out how to live the rest of my life. This is the first website I have seen with so much information. I have bulls-eye maculopathy with total blindness in this area. It can be very difficult to read at times and depending how fatigued I am, sometimes the words will “disappear” from the page for a few seconds. I have night blindness and difficulty adjusting to the slightess changes in light. I have alot of flashes when I am on the computer for very long and I have migraines on a frequent basis. My question is this: am I able to get disabilty or is this something I will just have to continue to work with? It is very stressful to deal with all of this daily. I recently mentioned my visual problems at work, and after being with a company over 2 and 1/2 years of excellent work history, I have now been written up 3 times in 2 weeks. I feel very afraid that I will not have a job soon. But I also do not feel that I can easily move into another position due to my visual difficulties. I am a nurse and my job requires that I am able to see accurately. How do someone cope with this loss at work? Now, not only do I worry about working with the loss, I worry about not having income. This is as much frightening as the vision loss itself.
Dear Jennifer,
I am sorry to hear about your diagnosis. It can be frightening when you do not know the services and options that are available. It is unfortunate that your current eye doctor cannot offer you more guidance.
In order to collect Social Security Disability, you must meet the criteria for Legal Blindness. The new rules state that a person must have a best corrected visual acuity of worse than 20/100 in the best eye or a visual field of less than 20 degrees to qualify for disability benefits. Keep in mind, a diagnosis of Legal Blindness does not mean that you have no usable vision; it is only a legal definition to qualify people for this benefit. Many “Legally Blind” people are able to work and some even drive. Your eye doctor can tell you if you meet this criteria. If you meet this criteria, you can apply for disability benefits. You may also choose to continue working while using the correct low vision glasses and products.
If you are not considered Legally Blind by the above definition, it does not mean that you do not have a visual impairment. Most people with low vision still have useful vision and should seek out the care of an eye doctor who specializes in low vision rehabilitation. A low vision examination differs from a basic ocular health assessment or eye glass examination in that it focuses on how the patient functions visually in day-to-day life. The goal of the low vision examination is to help the patient remain independent so that they will be able to perform their desired daily living tasks and hobbies. Eye doctors who specialize in low vision rehabilitation help their patients enhance their remaining vision by prescribing special low vision eyeglasses and microscopic and telescopic low vision aids. They will also recommend electronic magnification products, other optical and non-optical low vision products, training in the use of these products and referral to appropriate low vision services. Studies show that people are more successful and more likely to remain independent when they start using low vision products early in the course of their vision loss. Even if the closest doctor is not near by, it will be worth the trip. I frequently had people who came to my office from different states and hours away. To ensure the success of the patient, all optical low vision products should be prescribed by an eye doctor. To find a doctor who specializes in low vision rehabilitation:
1. You can find a low vision rehabilitation specialist at the American Academy of Optometry website: http://www.aaopt.org/section/lv/diplomates/index.asp or by phone at (301) 984-1441). The American Academy of Optometry lists eye doctors who have received advanced education and certification in this specialty.
2. Most optometry and ophthalmology schools have excellent low vision rehabilitation clinics. To see a list of optometry schools in the United States go to the following link: http://healthguideusa.org/optometry/optometry_schools.htm.
3. Call your states optometric or ophthalmology association for an eye doctor in your area who specializes in low vision rehabilitation.
Most states have Vocational Rehabilitation programs set up through the Department of Economic Security or your state’s Commission for the blind. These programs may pay for your low vision products if you wish to continue working. You do not have to be legally blind to qualify for services. You will also learn about other services that are available to you.
Good luck in your search to find the needed help and resources. In the meantime, don’t be afraid to use your eyes for reading, using the computer, watching TV, and other routine activities. Normal use of your eyes will not cause further damage to your vision.
To learn more about resources and low vision rehabilitation, use our LowVision.com website (www.LowVision.com) and download our latest Low Vision Solutions catalog at Download a PDF of the Daily Living Products 2008 catalog (10MB). You may also order a free copy of this catalog by calling toll-free 866.999.9188. Vision rehabilitation products can be found at: www.ShopLowVision.com .
Hello Dr. Noon,
When billing Medicare or any other private insurance, is it best to bill for the low vision exam as code 99204 or 99205, or as a low vision examination code 92499? And for follow up visits for 30 minutes for example, which code is best for that visit?
Thank you for all your help.
Michael Bourgoin, O.D.
Dr. Bourgoin,
Nice to hear from you. Since different insurance carriers have different policies there is no answer to fit all situations. Please give me a call when you get a chance so that we can discuss billing. You have my phone number, I look forward to talking to you.
My wife and I are considering a move to Lake County, Florida. I am seeking guidance as to whether I could obtain a drivers’ license in Florida.
This
license would be used for short distance, personal/essential driving over familiar routes.
Current age is 56. General health is good. My vision is stable. I currently hold an unrestricted Michigan drivers’ license (18 years with no tickets, 1 accident). My vision is 20/40 -2 in the left eye. I have no vision in my right eye (since birth). I assume that my visual field is in excess of 130 degrees as that is the minimum requirement in Michigan.
Can you give me assistance in determining how Florida DMV will handle an applicant with slightly under 20/40 vision. Names, phone numbers, addresses would be appreciated. I have called numerous DMV and doctor’s offices but have been given no more information than is generally available on the internet.
Thanks in advance for your assistance.
From the information that I have, Florida requires a minimum visual acuity of 20/40 with both eyes combined and a minimum visual field of 130 degrees.
Your only problem is the 20/40- in your only eye. If you fail at the motor vehicle office, you can go to a doctor and have a doctor fill out your vision form. You can also bypass the motor vehicle dept and go to an eye doctor’s office and have the doctor take your acuity and submit the information to the motor vehicle department. Quite often, doctors have better eye charts than the motor vehicle department and the patient is able to read more easily.
If you have measured 20/40- on an eye doctor’s chart, you may want to go to an eye doctor that specializes in low vision rehabilitation as they use higher contrast charts which give the best acuity. When the time comes, we can help you find a doctor in your area.
I hope this helps,
Lynne Noon
Dr Noon,
Thanks for your prompt response to my inquiry placed through your web site today regarding restricted vision driving in Florida. Since you are a doctor, I thought I’d share a bit more of my history on the subject. I’m hoping this might further enable you to direct me to an individual or group who might facilitate some sort of discussion with the Florida DMV people toward obtaining at least restricted driving privileges should we decide to move to Florida.
In a nutshell, I was born with bilateral cataracts in 1951. I underwent multiple surgeries using that vintage technology to remove the cataract from my right eye. Complications developed including glaucoma that necessitated removal of my right eye at age 13. You may be interested to note that between the ages of 14 – 35, I did use telescopes mounted individually at the top (for distance) and bottom (for reading) of plain carrier lenses and frames. In about 1982, I did take drivers’ training while using a single telescope but voluntarily backed off because both the instructor and I concluded that while I could be trained to pass the road test, I would probably not be a safe driver. I continued functioning relatively well (B.A, M.A, house, wife, kids, etc.) until age 35 when the cataract in my left eye started growing. At age 37 the left cataract was removed, bringing my vision from 20/400 to almost 20/40 virtually overnight. In order to minimize risk, my eye surgeon recommended not using a lens implant. Since then I have relied on a traditional cataract lens for correction. Much trial and error in my doctor’s office indicates that the current 20/40- is probably as good as it’s going to get unless some sort of telescope could be integrated. Is that an option?
In 1988, I was granted an unrestricted Michigan drivers’ license based on the 20/40- acuity and an otherwise normal (single eye) field of vision. My driving has been done predominantly over well rehearsed routes such as to and from work, shopping, medical appointments, etc. As you suggested, the state required vision exams have been performed by my Ophthalmologist in her office. Recently, I have begun using a dashboard mounted GPS receiver with text to speech capability to help me “read” street names and house numbers, the only visual aspect of driving that restricts my mobility. Is the use of GPS with text to speech something that may be of benefit to your patients?
With the above in mind, do you have any further recommendations as to eyewear, mobility counselors or DMV people that might assist me in staying on the road were we to move to Florida? All I’m looking for is limited mobility over well rehearsed routes in a relatively uncongested area (Lake County). As I read the FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES REPORT OF EYE EXAM (http://www.hsmv.state.fl.us/hsmvdocs/vision.pdf ), I do see the State asking for the doctor’s professional judgment as to whether a license should be issued and under what restrictions, if any. What does your experience in this area indicate? What would be your recommendations?
Thanks you in advance for your kind attention to this matter.
I am a young OD who is trying to build a low vision/neuro rehabilitation practice in Nashville, TN. I would like to know if it is possible to be listed as a low vision resource on your site? I’d also like any advice on how I can market to myself to other professional as well as the public. Thanks!
Dear Dr.
Thank you for asking to be listed as a resource on our website. Please send me information regarding your practice and I will have it placed on our website. Please call me so that we can discuss some marketing ideas for your practice. My number is 800.826.4200X176. I look forward to working with you.
Lynne Noon
Dr. Noone,
Could you please clarify how peripheral field testing, such as the perimetry bowl or tangent screen, may guide treatment strategies? I understand that these tests give precise data concerning field loss versus a simple confrontation test. However, when instructing patients for systematic scanning, it’s not feasible to instruct them to move their eyes 20 degrees temporally, etc.
Thanks,
Rhonda
Bowl perimeters can test both the central and the peripheral visual field. The Tangent Screen will test only the central 30 degrees when placed at 1 meter. For the most part, visual fields are used to detect or follow pathology. However, in low vision rehabilitation, they are used to direct treatment strategies. A visual field loss only becomes a problem when the field loss is bilateral and the image falls in an area of visual field loss. There are three types of visual field loss:
1. Hemianopic or sector defects are generally acquired after head trauma or stroke. The goal of rehabilitation is to place information present in the non-seeing visual field into the seeing portion of the visual field. This is accomplished by several methods. Prism placed in or on lenses acts to move images into the seeing field increasing patient awareness. Training involves teaching the patient to develop both head and eye scanning techniques to improve awareness of the surroundings. All three techniques should help with orientation to surroundings and mobility.
2. Over all field constriction is usually caused by retinal diseases such as retinitis pigmentosa, advanced glaucoma or optic nerve disease. It is difficult to treat and clients generally need referral to a mobility specialist. Generally, overall field loss develops slowly and most patients develop compensatory head and eye scanning techniques. Rehabilitation treatments include training in effective head and eye scanning. Prism can also be place in glasses to increase awareness of the missing visual field. To further increase the visual field, reverse telescopes or minus lenses can be use for temporary viewing of surroundings. While a telescope or minus lens can increase the size of the visual field, they also decrease visual acuity and are only used for spotting.
3. Central field loss is most often due to macular degeneration. Central field testing may locate the position of scotoma relative to the fovea. Training involves increasing the patient’s awareness of the scotoma and having them develop appropriate eccentric viewing techniques.
Please contact me directly so that we can discuss your needs. I can be reached at 800.826.4200 X 176.
Dr. Noon, I have been seeing Low Vision Patients here at Kasier for a long time, but have not really had the opportunity to prescribe many bioptic telescopes. I am in need of some help/guidance in prescribing bioptic telescopes to two of my patients.
One is 52 yr. old patient with Stargardts disease. He has best corrected vision of 20/150 in each eye(using eccentric fixation)I do not have a telescopic fitting set her yet, however last time he was here I had him look through a specwell 6 X 16 monocular, and he was able to get down to 20/20 in his right eye, and about 20/40 in the left eye. In looking through the Designs for Vision Catalog, I guess it would be between a 4X and the 3X Wide Angle. I am not sure if magnification is going to be more important, or if field of view will be more important. What do you recommend?
The other patient is an 18 yr. old patient with a congenital rod-cone dystrophy with a high hyperopic astigmatic correction. Best vision of 20/150 in one eye, and 20/200 in the other eye. He is wanting to drive now. I have not done any telescopic work with him. What do you recommend?
Hi Dr. Noon,
I am an optometrist employed by an ophthalmologist who is starting a low vision department from the ground up. We currently do not have any low vision equipment and currently have a tight budget. There is such an incredible amount of information out there on low vision that it is difficult for me to assess what are the particular devices that are “must haves”. If you have any suggestions on what a low vision department should have to start with, I would so appreciate any information that you can share.
Also do you know what medicare covers for low vision? The practice is in the state of New Mexico.
Thank you so much for your time. This website is just fantastic!
Thanks again,
Adrienne
Dear Adrienne,
I have had a full-time low vision rehabilitation practice in Arizona for 15 years. Now with LowVision.com, I am offering free practice consultation to doctors who want to start a low vision practice. Call me at 800.826.4200 X 176 so that we can discuss your needs. I look forward to working with you.
Dr. Noon:
As a low vision optometrist, could you give me your opinion as to how an occupational therapist trained in LV rehab should approach an optometrist or ophthalmologist when marketing services? Since you are an optometrist who values the contributions OTs can make in the LV community, your perspective would be most helpful.
I’ve been an OT for 13 years and am also currently a student in the graduate certificate program for low vision rehab at the University of Alabama at Birmingham.
Thanks very much.
Paul Scaglione
Dear Paul,
I am thrilled to see so many OT’s interested in the field of low vision rehabilitation. I have seveal ideas for your marketing, but feel it would be more benefical to discuss over the telephone. Please call me at 800.826.4200 X176. I look forward to talking to you.
Lynne Noon
Hello Dr. Noon
I am seeking some advice as to which magnifying product would be best for viewing a screen on a palm pilot or cell phone. The person who would benefit from this has mentioned problems with these tasks, as she has some degree of visual impairment.
Thanks in advance for your help!
Rhonda
Dear Rhonda,
Many devices will magnify a Palm or cell phone. Hand magnifiers, strong reading glasses or portable video magnifiers (such as the Compact+ by Optelec) are all good choices. However, just like prescription eye glasses, all of these magnification products are available in many strengths. The exact power that a person needs depends on their eyesight or visual acuity. If you simply pick a drugstore magnifier, it may not be strong enough for the task.
To ensure sucess when using magnifcation products, a magnifier or reading glass should be prescribed by an eye dotor a professional who specializes in low vision rehabilitation. See our resources list to find low vision resources in your area.
Hello please help I need a directory of doctors who will perform laser eye corrective eye vision surgery, lasik or other on a patien who has had optic neuritis in her left eye in 1999. I live new york can anyone help me. I know the surgery is being performed I just don’t know who is doing it. Thanks
Dear Npemb,
Unfortunately Lasik or similar surgeries to correct a refractive error will not help optic neuritis. These surgeries correct an eye that is not in focus so that the person no longer needs to wear eyeglasses.
Optic neuritis damages the optic nerve leading to poor vision; this is not correctable by eyeglasses or surgery. Talk to your ophthalmologist regarding other forms of treatment.
My husband suffered trauma to his eye last September when it was hit with a piece of wood in the lower outside quadrant. The tear damaged extended to the edge of the iris, but the wood hit with a great deal of force. He immediately had surgery at our local eye center to repair the tears. He had little vision in the eye. His retina detached in late October and the surgeon put in a scleral buckle. A large cataract has developed. His eye does not drain probably due to the buckle and he has developed glaucoma. During this time the doctors have felt he would get good usuable vision back after removal of the cataract and installation of a new lens. They are hoping the retina is in good condition since they have not been able to check it due to the large cataract. They are hoping to perform surgery soon but have now told him that due to damaged “xaneoles” which hold the lens on, his vision may not be that good.
It is difficult to find any information since this is a trauma case.
My husband feels confident in these doctors. I question that how do we know that we shouldn’t fly to a state of the art facility for this surgery. What would the differences be? How do we know his doctor is highly qualified in this area, especially because his (the doctors) confidence level in the outcome has dropped.
Are there any other resources for trauma damage you could refer us to?
Dear Mspitz,
It is not unusual for an eye to have all of these complications after a traumatic accident. Even with the best of surgeons this scenario is likely to occur. I cannot comment on the skill of your current doctor but if you are concerned, a second opinion is always a good option. At least you will be reassured that you have done everything possible to save the vision in that eye. Good luck.
I have a hole in one macular. Is there any hope that one day it could be cured? Perhaps with stem cells?
TIA
A macular hole is a small break in the macula, the part of the retina that provides clear central vision. Macular degeneration and a macular hole are not the same condition although they both occur most often in people over age 60 and result in blurred, distorted vision.
In most cases, the cause of a macular hole is due to the aging of the vitreous, or gel, in the eye. The vitreous contains fibers that are attached to the retina. As we age, the vitreous shrinks and pulls away from the retina. This is normal and usually causes no adverse effects other than an increase in floaters in the vision. However, in some cases the vitreous can tear the retina as it pulls away causing a macular hole.
Some macular holes can seal themselves and do not require treatment. However, surgery is often needed to improve vision. The vitreous is removed in a procedure called a vitrectomy to prevent further pulling on the retina and is replace by a gas bubble or silicone oil. The bubble or oil acts as an internal, temporary bandage that holds the edge of the hole in place while the macula heals. Following surgery, the patient must remain in a face down position for several days to weeks. This allows the bubble or oil to press against the macula to help it heal. The improvement in vision varies from patient to patient and is more successful in patients who have had a macular hole for less than 6 months. Most people with bilateral macular holes respond well to low vision aids and glasses.
Currently there is research being conducted on other treatments for the repair of a macular hole. The use of stem cells is being used in several research projects for various eye diseases; however, it is not at present, an acceptable treatment for a macular hole.
My friend’s son is 5 years old, his VA is OD: DS +1.00 1.0 OS: DS +5.00 0.2
He is eccentric fixation, OS Exotropia -10 deg.
The problem is that he has gone through vision therapy for over a year, but the OS VA has not even a bit improvement, they have visited several famous eye doctors and tried computerized vt, Haidinger’s brush treatment, and some other exercises. Hope we can get good advise from you, thanks.
Dear GZFLY,
Without knowing the exact cause of the childs exotropia or eye turn, it is difficult to know if this childs vision is expected to approach to near normal with vision therapy or if the eye doctor justs expects a slight improvment in visual acuity. If the child simply has an eye turn, without other pathology, the vision should improve to near normal with vision therapy as long as the child follows the eye patching (or other technique) of the right eye that forces him to use his left eye. A child will not do well with vision therapy if they do not follow this patching or if they constantly look under or over the patch with their good eye.
The child may also have a pathology such as optic atropy that caused the decreased visual acuity and then the eye turn. In this case vision therapy may or may not help the visual acuity in that eye.
The child’s mother should ask the eye doctor the following questions:
1. What is the cause of the eye turn? Is ocular pathology a posibility?
2. Why hasn’t my childs vision improved through vision therapy?
3. What else can be done to improve the visual acuity?
where can i find some information about teoris of low vision mobility? i need tree teoris for my exam. tanck you.
Dear Patricia,
I am trying to understand your question and believe you are asking about theories of mobility instruction. You may find the answer at the American Optometric Association Library. They can be reached at (800) 365-2219 X 4117 or at ilamo@AOA.org.
Dr. Noon,
I have had poor vision all my life. I’ve been wearing hard lenses for 34 years and am currently 39. I had a detached retina 7 years ago and can’t see the big E in that eye. I was diagnosed with myoptic degeneration in my good eye 20/70 with correction. It’s getting harder to do things such as reading, computer work etc. I think I was in shock and didn’t ask the right questions. What is Myoptic degeneration? What’s the prognosis? I know that there isn’t any treatment. I’m trying to use reading glasses, magnifiers etc. I get tons of headaches and the eye strain becomes very painful. Anything I can do to make the transition a little easier and what should I expect? Any info would be greatly appreciated. Thanks,
Eileen
Dear Eileen,
Myopia or nearsightedness is a condition where light focuses in front of the retina of the eye causing blurred vision. For most myopic people, myopia is corrected with glasses or contact lenses. Myopia results from the eye being either to long or from the curvature of the cornea being too curved or a combination of both. (See anatomy of the eye under the ?Information on Eye Conditions? tab on this website).
In degenerative myopic, the cause is generally due to the excessive length of the eye. As the eye grows and lengthens it becomes extremely nearsighted. This excessive growth of the eye causes stretching and thinning of the retina and other tissues in the back of the eye leading to damage to these tissues. If the retina tears, a retinal detachment is likely to occur. While the nearsightedness of an eye with degenerative myopia can be corrected with either glasses or contacts, the vision will still not be clear because of the damage that occurred to the retina. This damage cannot be reversed and is often progressive as the eye continues to grow and stretch. There have been recent studies showing that a procedure called Scleral Buckling may help decrease further stretching of the retina in adults. You should be under the care of a retinal specialist who can discuss this procedure or any other procedure that may be beneficial to you.
Eileen, even though ?regular glasses? or contact lenses cannot fully correct your vision, special low vision glasses and other magnification products will be helpful and will allow you to continue to read and do the other activities that you wish to pursue. Seek out the care of an eye doctor that specializes in Low Vision Rehabilitation. He or she will prescribe special glasses and other low vision aids that will help maximize your remaining vision. An eye doctor who does not practice low vision rehabilitation will not prescribe these glasses for you. A doctor who specializes in Low Vision Rehabilitation does not take the place of your retinal specialist. Either ask your retinal specialist for a referral to an eye doctor who specializes in low vision rehabilitation or call your state?s optometric association for a referral.
Dear Dr.Noon:
I have an anamalous optic in the right eye. It has been discribed an d photgraphed as a hole in the back of the eye. The photo had a light shining through. I can see from the eye but not very good. What treatments are available from low vision . Would glasses help?
Dear Carol,
Most people need low vision rehabilitation if they have uncorrectable blurred vision in both eyes. If you have blurred vision in both eyes, then you should definitely see a low vision specialist. If you have good correctable vision in your left eye, then you probably do not need to see a low vision specialist.
Low vision glasses will help you use the remaining vision in your right eye by magnifying the image that you see. However, if your left eye can see without needing magnification, you will not be able to use both eyes together when your right eye is using glasses with magnification. Because the brain cannot process similar images in different sizes the result will be double vision. In this case it is best to get a detailed image of what you are looking at with your left eye only.
Two of my sons have red-green color blindness. Is there any special help they can get from our school system? Their ages are 5 & 7 yr. Thanks, Debbie
Dear Debbie,
The normal retina contains two types of photoreceptor cells, rods and cones. The rod cells help with night vision and the cone receptors help distinguish colors. Color blindness or color deficiency is defined as the inability to perceive the differences between some or all colors. As with your sons, a color deficiency is usually genetic but it may also occur because of optic nerve or brain disease. There are many types of color blindness with the most common being a red-green hereditary (genetic) photoreceptor disorders.
There is no treatment to cure inherited color deficiencies; however, certain types of tinted lenses may help an individual distinguish colors more easily. Your son’s eye doctor will be able to determine if your child responds to different tints.
Although people with this color deficiency may not perceive colors correctly, they will have 20/20 vision and full visual fields. Therefore, the color deficiency should not interfere with the ability to learn in school. Your child’s teacher should be aware of the color deficiency so that he or she may help with projects that require color discrimination. As your child ages, the color deficiency may affect vocational choices such as an electrician who has to identify the different color of wires. I know of no other help that is provided in the school system and do not believe that your sons will need further help.
I developed optic neuritis in my left eye last august. (and got diagnosed with MS in january) I’ve had at least 3 doctors (a neuro-opthalmologist, a regular opthalmologist, and a neurolgist) all tell me that my eye would return to normal vision within 4 months. So, needless to say, I’m a bit miffed that my vision in that eye is still blurry. (I did have ginormous blind spots covering 2/3rds of the vision for about a month)
My regular family doctor is the only one who told me that he thought I’d probably be stuck with poor vision in my left eye for life…and I tend to believe him more than the other three.
Is there anything that I can do to help the optic nerve heal? I know with MS, sometimes they can give you an IV steroid, but now that it’s at least 6 months since the initial optic neuritis, I’m wondering if it would be too late to take steroids, or is it still possible that steroids would work for me?
Thanks…
Erin
Erin,
Any time that your vision changes it is important to contact your eye doctor. A decrease in vision may indicate that you are beginning another episode of optic neuritis. If so, there is a good chance that your vision will return after this episode.
Thanks… I made an appointment with my eye doctor, but cant get in to see him until early June. (argh!) But, I’m seeing my neurologist in a couple of days. If he thinks I’ve started another round of optic neuritis, maybe he can get me in to see another opthalmologist quickly.
Wouldnt I have pain on eye movement like I did in august when I first developed ON??? Or is optic neuritis sometimes painless?
Dear Erin,
Optic neuritis is an inflammatory disease of the optic nerve often associated with Multiple Sclerosis. After an episode of optic neuritis, the prognosis for recovery of vision is often good, although most people have some remaining damage to visual function. Unfortunately, after 6 months, you most likely will not see a large improvement in the vision of the effected eye.
Two studies, the Optic Neuritis Treatment Trial and the follow-up study, the Longitudinal Optic Neuritis Study have tried to determine treatment guidelines for optic neuritis. The studies compared the effects of the use of oral prednisone, intravenous prednisone and a placebo in the treatment of optic neuritis. The results of the study so far show that treatment with oral prednisone in standard doses should be avoided, but treatment with intravenous methylprednisolone should be considered, particularly if a brain MRI demonstrates multiple abnormalities consistent with multiple sclerosis or if a patient needs to recover vision rapidly. The decision as to whether to prescribe this treatment must be made on an individual patient basis. Prescribing no treatment for acute optic neuritis also is a viable option. The longitudinal portion of this study is ongoing. Additional information regarding the studies can be found in medical libraries or on the internet.
I’ve noticed in the past few weeks that whatever improvement I had seems to be regressing. (things are getting more blurry) I’m calling my opthalmologist tomorrow to see if I can get in to see him sometime within the next week or so.
It’s just disturbing that I seemed to be having improvement, and now it seems to be getting worse. Today I was looking at myself in a mirror. I was probably 2 1/2 feet from the mirror and could barely tell it was me in the mirror just looking thru the bad eye. I can barely read printed text in a book with just that eye now, and it was just weeks ago that I could still read fairly clearly with that eye. It’s really quite disturbing to sit and watch your vision go. Hopefully the vision in my right eye will be ok. It’s just that now I’m paranoid that something will happen to my good eye. I dont think I’d make a very good blind person.
Erin
hi doctor,
I recently went to a Laser eye doctor over the weekend and was advised that I would not be a good candidate to get the surgery due to the fact that I only have one good eye. And he was surprised that my regular optometrist never declared my right eye as “Legally Blind.” If this is the case-who can I talk to about this. Can I get help or assistance such as Disability or something.
Dear Lani,
Fortunately for you, you are not legally blind by definition as you have one eye that is able to see clearly with eye glasses. The term legal blindess, implies poor, uncorrectable visual acuity in both eyes. Therefore, you are not entitled to disability benefits. I also agree that you should not risk the vision that you have in your good eye by having Lasik surgery.
In the United States, where normal vision is considered to be 20/20, legal blindness is defined as visual acuity with best correction in the better eye worse than or equal to 20/200 or a visual field extent of less than 20 degrees in diameter. Most states use these standards to provide rehabilitation services and benefits to people who are visually impaired. Some of these benefits and services include an IRS income tax exemption, free telephone directory assistance, free Talking Book Library Services through the National Library Service and Vocational and Independent Living Services through individual state programs. Please note the term Legal Blindness does not mean that a legally blind person is blind or has no usable vision. Most people defined as legally blind have usable vision and can perform most daily tasks with the use of special glasses or low vision aids.
I have been looking for a second opinion from a professional regarding my daughter. She is 6 years old and she was born with a small pale optic nerve with strabismus. We tried patching upon the advice of another doctor when she was very young with no results. She is blind in the left eye and does not even see light through this eye. It makes me upset that the doctor insisted upon patching when she has no vision to work with and no chance of recovering vision. This was very frightening for her. We changed to another opthamologist when she was three. He was suprised that the other doctor did not even suggest an MRI for the cause of the blindness.
An MRI was done after we switched doctors. There was nothing to report and we still do not have an answer as to why her nerve does not work.
Our doctor told us she must wear glasses for the rest of her life to protect her eye even though her vision in her good eye is 20/20 and she requires no prescription. He also suggested surgery when she is a little older to straighten the effected eye for cosmetic reasons.
I was wondering if you have any opinion as to why she would be born with a damaged optic nerve? She was a full term healthy baby. Also, are the glasses absolutly necessary or a little over cautious? Do you feel the course of treatment we are receiving is what you would suggest?
I have had some bad advice from doctors and I just want to feel secure my daughter is receiving the right treatment. Thank you so much for your time and response.
Amanda in Ontario Canada
Amanda,
There are many reasons for congenital optic nerve developmental abnormalities. Injury to the optic nerve during development may be due to a toxin such as alcohol, related to an infectious agent, due to lack of oxygen or due to injury. There may also be a genetic component. It is often difficult to determine the exact cause of optic neuropathy in a child unless there is a clear hereditary component. This is most likely the reason you have not been told the exact reason for the lack of visual acuity in your daughters left eye.
Since your daughter is only seeing out of one eye, she needs to protect this eye with a pair of glasses that have polycarbonate lenses. If she is involved in a high risk sport such as baseball she should wear protective sport eye wear. Since your daughter only sees out of one eye, she sites all objects such as balls when playing with this eye. If she is to get hit in an eye when playing, this will most likely be the eye that is hit.
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