Multiple Sclerosis

[bobsacamenoh]

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Just wondering what kind of training ODs get on MS. Can they recognize symptoms through regular exams? What exactly do they look for?

Thanks

 

[cpw]

Depends on the symptoms. ODs can definitely diagnose optic neuritis and the accompanying signs of MS.

You look for indistinct margins on the optic nerve, but depending on the location of the inflammation it may or may not show there. (it could be retrobulbar -- or on the nerve behind the eye)

Decrease in VA.
Pain on eye movement
Increase in symptoms with heat or exercise.
Change in color vision (or desaturation) between the two eyes. Check with plates or "red cap" test.

These are just the ones I remember off the top of my head.

The important thing to remember is that a diagnosis of neuritis does NOT mean the patient has MS. They have to go to a neurologist for an MRI of the brain to rule out plaques. If I remember correctly less than 50% of patients presenting with optic neuritis convert MS. But, you have to make sure the patient is aware it is a possibility.

So, to answer your question the short way... YES, ODs get some training in MS. 😉

 

[bobsacamenoh]

Thanks for the response, CPW!

I am still amazed at the different things that eye conditions may indicate. It's just another reason why a regular visit to the OD is an important part of maintaining one's health.

Is it common for most patients to skip the comprehensive eye exam and be in a rush to just get their glasses/contacts? Should the OD insist on the comprehensive exam? I have been to different optoms several times over the last few years and not once was I dilated - they never offered and I was one of those patients in a rush 😉

Depends on the symptoms. ODs can definitely diagnose optic neuritis and the accompanying signs of MS.

You look for indistinct margins on the optic nerve, but depending on the location of the inflammation it may or may not show there. (it could be retrobulbar -- or on the nerve behind the eye)

Decrease in VA.
Pain on eye movement
Increase in symptoms with heat or exercise.
Change in color vision (or desaturation) between the two eyes. Check with plates or "red cap" test.

These are just the ones I remember off the top of my head.

The important thing to remember is that a diagnosis of neuritis does NOT mean the patient has MS. They have to go to a neurologist for an MRI of the brain to rule out plaques. If I remember correctly less than 50% of patients presenting with optic neuritis convert MS. But, you have to make sure the patient is aware it is a possibility.

So, to answer your question the short way... YES, ODs get some training in MS. 😉