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Old 04-30-2008, 05:01 PM   #1
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Opthamologist vs. NeuroOpthamologist

Hi there. I recieved a question inside another post asking if its smarter to go see a Neuro-opthamologist rather than a regular Opthamologist for MS. That question came up inside another post and I didnt want to hijack it, so I thought Id start another thread and let everyone contribute their thoughts.

My thoughts are that its not really necessary to go that route- to a Neuro-Opthamologist unless you are having eye issues related to MS; usually Optical Neuritis is what they treat, but every eye condition related to neurological diseases is treated and diagnosed by these guys...I started seeing a Neuro-Op because my Opthamologist could see inflamation of the optic nerve, but wasnt certain how to treat it. Knowing I have MS he was even more afraid to make recommendations so he referred me to a Neuro-op at the University Hosptial in the city. This referral led to one of the longest and most comprehnsive eye exams Ive ever had. Now I have been experiencing loss of vision in one eye for over 2 years, my prescription has changed to the point that in 2 years Ive gone from having regular glasses and wearing contacts 12 hours a day to having bifocals and not being able to wear contacts for more than 2 hours at a time...my ON caused me to have both flashes and halos for some time as well as major color blindness, which fortunately went away with the IV SoluMedrol which I was given. The Neuro-Op was able to determine the reason for this (ON) and treatment course...we went with IVSM because it was critical for me to get back my vision immediately (I drive in sales for a living). Thank goodness it worked. I have suffered with ON a few times in the past 2 years, however after that one initial bad time, it has resolved on its own since then.

I also want to add that if I hadnt had the extreme pain and loss of vision which led to the ON dx, I probably would have simply stayed with the regular Opthamologist as I feel he is qualified to handle most diseases of the eye- but this particular referral turned out to be a good thing for me.

So, an Opthamologist, or a Neuro-Opthamologist? Anyone have any input ?

Nikki
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Old 04-30-2008, 05:14 PM   #2
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Re: Opthamologist vs. NeuroOpthamologist

Thanks, MSNik, I was the one that asked the question. I went from basic reading glasses to progressive lenses within a year's time and now a year later, I'm finding I cannot read anything without my glasses on. I have not been since my diagnosis, so I think I will go ahead and make the appt. and tell him about my MS and see if he thinks anything is changing due to this. I have been very pleased with him in the past and he is easy to talk to. I may tell them when I make my appointment to see if they have any other suggestions. Again, thanks.

 
Old 04-30-2008, 05:30 PM   #3
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Re: Opthamologist vs. NeuroOpthamologist

Hey MS for LIfe, I knew it was you, but didnt want to throw your name out there- but since YOU did...

I feel for you, Ive had the same vision problems over the past 2 years...people say its old age (im 40) but its not. This started when I had my first bout of ON and right after my initial MS dx..I hate the fact that I can no longer see out of my contacts, or that Ive had to get new glasses 4 times in the past 2 years..my prescription keeps changing!

I do think youre okay with a regular Opthamologist for now..but it cannot hurt to express your concerns and ask if he thinks its worth having a Neuro-Opth appt...I found it to be incredibly comprehensive- really really in depth study of my eyes- and so thorough. But, it was also expensive, no one would take my insurance so this one I have to pay out of pocket. But if you ever have ON, youll do anything- trust me, to stop the pain and get your vision back at all.

Let us know what the opthamologist says...good luck. and Hugs!
Nikki
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Old 04-30-2008, 09:56 PM   #4
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Re: Opthamologist vs. NeuroOpthamologist

I agree with Nikki on this---an opthamologist is a great start,when the ON

rears its uglyness then its time for the neuro-optho.

I have had 4 bouts of ON in about 9 months,I still have not regained my color

perception and the left eye,left peripheral vision has not returned.

My lens have changed so much in the last 2 years.I can not read anything

without my glasses,if someone took my bifocals I'd be in big trouble.

I do not beleive its old age,its bilateral ON and its leaving its toll.

Never leave the eyes unattended,the first sign of ON get to a DR.

 
Old 04-30-2008, 11:42 PM   #5
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Re: Opthamologist vs. NeuroOpthamologist

I am in the middle on this.

If you are having eye problems that you believe at the outset seems like it well might be neurological in nature, go to a neuro-ophthalmologist. However, it is also true that a GOOD regular ophthalmologist is not a bad place to START if someone is unsure. But if the brain is involved or suspected to be, I would certainly go to a neuro-op. have seem WAY too many people who get stuck with ophthalmologists who feel equipped to handle things they really aren't. Cases of ON going undxed and more. My regular ophthalmologist immediately referred me to a neuro-op -- that's exactly what she should have done. For me personally, because I HAVE had eye issues related to MS, my neuro-ophthalmologist now acts as my regular eye doctor. When I go see her next year for my regular annual check-up, she will also take another picture using OCT.

Just want to clarify that Optic Neuritis is not the only neurological condition of the eye.

 
Old 05-01-2008, 12:26 AM   #6
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Re: Opthamologist vs. NeuroOpthamologist

ooopps.... sorry wrong post..

 
Old 05-01-2008, 04:56 AM   #7
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Re: Opthamologist vs. NeuroOpthamologist

Hey duttin! Welcome back! Im glad to see you in the posts! Are youre eyes still giving you issues? Are you feeling any better? Is EVERYTHING coming along better for you?

I kind of was thinking of you when I threw this out to everyone..I know you have alot to add when it comes to eye issues...and anyway, its great to hear/see you back.

Nikki
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Old 05-01-2008, 07:07 AM   #8
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Re: Opthamologist vs. NeuroOpthamologist

Wow, great responses. I was going to ask if possibly the neuro-opthamologist would be covered by health insurance or not, but MSNik makes it sound like it would not. I guess I should research a little. We do have great medical, but I did not pick up the vision coverage this year. I will call this morning for an appointment with my regular opthamologist and let you guys know how it goes.

 
Old 05-01-2008, 07:18 AM   #9
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Re: Opthamologist vs. NeuroOpthamologist

Re: insurance, the doctor would be listed under neurologists, not vision. A neuro-ophthalmologist is a neurologist who specializes in conditions of the eye. They have degress in both neurology and ophthalmology. That said, you may have to do a little research. My neuro-op is listed on my insurance solely as a neurologist -- in general, my listings don't give specialties. Your regular ophthalmologist or neurologist should be able to give you a referral.

Good luck!

Quote:
Originally Posted by MS for life View Post
Wow, great responses. I was going to ask if possibly the neuro-opthamologist would be covered by health insurance or not, but MSNik makes it sound like it would not. I guess I should research a little. We do have great medical, but I did not pick up the vision coverage this year. I will call this morning for an appointment with my regular opthamologist and let you guys know how it goes.

 
Old 05-01-2008, 08:25 AM   #10
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Re: Opthamologist vs. NeuroOpthamologist

Bearygood could be right- its going to totally depend on the insurance plan. Because a Neuro-Op IS an MD, and not an 'eye' doctor or OD, you should find it under Neurology- but my insurance company isnt that impressive. They have them listed under Opthamology (same with Retina specialists and things like that) but they only have one covered Neuro-Op in the entire plan and I couldnt get into see him for almost a year! I figured at the time that anything I had to do, including paying for it- was helpful, so my regular eye doc got me an appt to see the one Ive continued to see for the past two years.
Its a crapshoot, finding insurance coverage- you might get lucky- definately check it out~!
Nikki
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Old 05-01-2008, 04:25 PM   #11
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Re: Opthamologist vs. NeuroOpthamologist

I'm lucky for my insurance, a neuro-optho is covered under one of my medical insurance as medical and also under my optical insurance.

When it comes to any eye problems,an optrician,opthamologist or a neuro-opthomologist,the eyes should never be left unchecked.

Whom ever you can get into first, GO!,then follow up with an opthamologist or a neuro-optho

 
Old 05-02-2008, 10:53 AM   #12
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Re: Opthamologist vs. NeuroOpthamologist

im going to see a neuroophthamologist next week... dont exactly know why... but we'll see what he says..... i think my eyes are fine but my ms specialist said I had some "pallor to the optic nerve"... we'll see.... I've never had any REAL vision problems, so I'm interested to see what they find out........

 
Old 05-02-2008, 12:50 PM   #13
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Re: Opthamologist vs. NeuroOpthamologist

Quote:
Originally Posted by tarapags1107 View Post
im going to see a neuroophthamologist next week... dont exactly know why... but we'll see what he says..... i think my eyes are fine but my ms specialist said I had some "pallor to the optic nerve"... we'll see.... I've never had any REAL vision problems, so I'm interested to see what they find out........
Pallor to the optic nerve would certainly be reason to see a neuro-ophthalmologist. It's great that your doctor suggested this. As long as you're there, see if they have OCT (optical coherence tomography) capabilities. It's a good opportunity to get a baseline picture of the eye. Good luck and keep us posted!

 
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