normal or to be concerned.

[hello07]

48 yr old female good health no meds came in for a CL's check up. wasn't seeing well with her cl's especially at night. refraction changed in the right eye only by -.50D increase. Anterior segment normal. IOP's normal. No APD. EOM's normal. Optic nerve cupping symmetrical and macula intact. My only concern is that the right optic nerve showed some mild pallor temporally. Left optic nerve looked pink and healthy. I asked her if she is in good health or any medical problems again at end of exam and she said no. Anything possibly going on? Have her do a VF's?
Any input is appreciated. Can this be normal? or any past inflammations? MS ?

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[qwopty99]

the poor vision at night could conceivably be explained by the over-plus of her old Rx. (though the next question, why is she more minus, does come up).

despite the normal APD, if u think the mild pallor might be real, then a VF isn't a bad idea. if it came back clear, that would give some relief.

when was her last eye exam? was it by u?

 

[Tippytoe]

48 yr old female good health no meds came in for a CL's check up. wasn't seeing well with her cl's especially at night. refraction changed in the right eye only by -.50D increase. Anterior segment normal. IOP's normal. No APD. EOM's normal. Optic nerve cupping symmetrical and macula intact. My only concern is that the right optic nerve showed some mild pallor temporally. Left optic nerve looked pink and healthy. I asked her if she is in good health or any medical problems again at end of exam and she said no. Anything possibly going on? Have her do a VF's?
Any input is appreciated. Can this be normal? or any past inflammations? MS ?

You can't be serious, right? Tell us your joking.

If not, please go turn in your OD degree and demand whatever school you went to to give you your money back.

 

[hello07]

qwopty99, good question whether the pallor is real or not. VF's is the way to go. Her last eye exam was 2 years ago by ophthalmology and I saw her 1 1/2 year ago again for CL's. I don't recall seeing that pallor then. Records don't indicate anything of that nature. she was -1.75 and now she is -2.25. she was -2.25 from the MD Rx 3-4 years ago and on her last visit I gave her -1.75 she saw clearer. Now, it went back to -2.25.
Am I overlooking at this or do I send her for so many tests that will most likely turn up negative?

Tippytoe I am serious. I am sorry I embarassed you for being your colleague. Perhaps, I am not as astute as you are. Maybe I should have asked Can there be any optic pallor with no underlying causes? No pathology?

I'm sure we have all seen some slight temporal pallor in one optic nerve than the other where it happened to be nothing wrong with the person.
I wish I could turn in my OD degree but it's too late.

 

[gochi]

qwopty99, good question whether the pallor is real or not. VF's is the way to go. Her last eye exam was 2 years ago by ophthalmology and I saw her 1 1/2 year ago again for CL's. I don't recall seeing that pallor then. Records don't indicate anything of that nature. she was -1.75 and now she is -2.25. she was -2.25 from the MD Rx 3-4 years ago and on her last visit I gave her -1.75 she saw clearer. Now, it went back to -2.25.
Am I overlooking at this or do I send her for so many tests that will most likely turn up negative?

Tippytoe I am serious. I am sorry I embarassed you for being your colleague. Perhaps, I am not as astute as you are. Maybe I should have asked Can there be any optic pallor with no underlying causes? No pathology?

I'm sure we have all seen some slight temporal pallor in one optic nerve than the other where it happened to be nothing wrong with the person.
I wish I could turn in my OD degree but it's too late.

I'm a pre-optometry student and just just extremely curious as to why you are wishing to "turn in you're OD degree"?

 

[JeffChou]

I'm a pre-optometry student and just just extremely curious as to why you are wishing to "turn in you're OD degree"?

She was being sarcastic. Read all posts in sequence.

 

[drbizzaro]

48 yr old female good health no meds came in for a CL's check up. wasn't seeing well with her cl's especially at night. refraction changed in the right eye only by -.50D increase. Anterior segment normal. IOP's normal. No APD. EOM's normal. Optic nerve cupping symmetrical and macula intact. My only concern is that the right optic nerve showed some mild pallor temporally. Left optic nerve looked pink and healthy. I asked her if she is in good health or any medical problems again at end of exam and she said no. Anything possibly going on? Have her do a VF's?
Any input is appreciated. Can this be normal? or any past inflammations? MS ?

the answer lies in her inability to see well esp. at night -> a CL prob, and most likely not ON related

 

[362.04]

1. photostress test
2. threshold visual field test 24-2, SITA-SAP, III, white
3. photograph
4. Repeat in 1month.
5. No intervention needed at this time.

 

[hello07]

Thanks everyone for your input. I hope I didn't mess up with this one but my gut feeling is with what you all said- RX change, ON fine- no intervention needed.

 

[362.04]

Thanks everyone for your input. I hope I didn't mess up with this one but my gut feeling is with what you all said- RX change, ON fine- no intervention needed.

Correction. Need to recheck in 1month.

 

[cpw]

closed for seeking medical advice. (no curbside consults --- without having all the information it's impossible for other docs to give you an accurate diagnosis)