Double vision--help get us out of referral cycle

[Anonymous]

Older teen reporting double vision. Can read only if book is at a very specific angle otherwise the letters double vertically.

Went to ophthalmologist a year ago, said he couldn't correct better than 20/30 (which sounded good enough to me for a -6) and referred us to a neuro-opthalmologist without giving us the prescription. Teen got sick with virus and threw up in waiting room, end of that appointment. Got second appointment with another neuro as could see sooner. Said everything was fine and new correction was to -8 but she couldn't be sure, maybe teen hadn't had enough sleep and she was over-correcting. Suggested teen see optometrist, no specific suggestion and never made it to one.

Things dragged on and overuse of contacts (teen had lost glasses from two years earlier) led to a corneal ulceration, first in one eye and then in second. Saw different opthalmologist in same practice as initial doctor. Got the 20/30 prescription finally to get glasses while eyes healing. Referred to yet another neuro-opthalmologist. Six week wait, appointment end of April.

It's been over a year since this started, teen is muddling along in reading, but this needs to get fixed and we need an up to date prescription. Am really afraid we'll go to the neuro only to be bounced back somewhere else and still not have a new prescription.

Any suggestions? Am a bit leery of handing this over to an optometrist but if there is someone good who someone has used for a double vision problem I'd definitely consider it. At least we might get a prescription.

[Anonymous]

I have a few different eye issues that have involved seeing multiple sub-specialists along the way. The one detail that seems relevant is that I've often gotten the refraction and prescription update from an optometrist. I've definitely gotten the best help for contracts from optometrists. I follow with a general ophthalmologist with referrals to optometrists or sub-specialists as needed. You might not get everything taken care of in one visit with one person - particularly the prescription and a neuro-ophth eval. I go to Northern Virginia Ophthalmology and have been happy with the care from multiple docs and optometrists (and referrals out of their group.) I can understand wanting quick resolution (a year is forever with wonky vision!) but starting over might be the fastest way to get there.

[Anonymous]

Don't skip the neuro. Double vision was one of the earliest symptoms of my mom's ms. Although my mom only had it for a couple of weeks, and then her vision was normal again.

[Anonymous]

I had double vision as a teen. It was a side effect from medication I was on that caused increased cranial pressure on the brain. A person with double vision should see a neurologist!

[Anonymous]

Double vision can be caused by pressure on the optic nerve. See a neurologist asap.

[Anonymous]

Anonymous wrote:Double vision can be caused by pressure on the optic nerve. See a neurologist asap.

OM! Did you not see OP's references to neuro appointments? You clearly read her post. WTF????

[Anonymous]

I know someone who had double vision subsequent to a concussion and she found that vision therapy was the only thing that helped.

[Anonymous]

Have you tried a pediatric optometrist and a pediatric ophthalmologist?

[Anonymous]

Please follow up until you get this fixed. It sounds like little things are getting in the way of a diagnosis. Your kid throws up in the waiting you - you get another appt and go to it! Stop putting this off!

[Anonymous]

Were there any tests done to determine if there is cranial pressure? I think that would be important and perhaps a neurologist should be consulted.

[Anonymous]

Thanks for all the responses. Looks like there are no shortcuts here and we'll have to wait to see the neuro-ophthalmologist. This one seems to be a neuro who does eye things, while last was an ophthalmologist who does neuro things. Perhaps the better route.

To PP who mentioned concussion, I am now wondering if this may have had something to do with this. Teen had a mild concussion about a month before this started.

[Anonymous]

Double vision would scare the crap out of me (as an adult), and a corneal ulcer is a big deal. I am sort of shocked at how laissez faire you seem to be and that this has been going on for a YEAR. Eye stuff can be terrifying and permanent.

If this were my child, I would be scheduling appointments with another neuro-ophthalmologist (not the original unhelpful one) as soon as possible. What about the Wilmer Eye Institute at Johns Hopkins? http://www.hopkinsmedicine.org/wilmer/services/neuro_ophthalmology.html Ranked one of the top eye hospitals in the country.

[Anonymous]

Anonymous wrote:Thanks for all the responses. Looks like there are no shortcuts here and we'll have to wait to see the neuro-ophthalmologist. This one seems to be a neuro who does eye things, while last was an ophthalmologist who does neuro things. Perhaps the better route.

To PP who mentioned concussion, I am now wondering if this may have had something to do with this. Teen had a mild concussion about a month before this started.

Were there any scans done? I bet this is the cause of the double vision.

[Anonymous]

Yes--teen had usual CT scan to ensure no bleeding in the brain after the concussion.

The Wilmer Institute sounds like a good option--will see how it goes with the new neuro-ophthalmologist and if it looks like anouther dead end, will definitely consider them. The neuro-ophthalmologist we were referred to is a Dr. David Katz in Rockville.

[Anonymous]

I saw multiple neuro-opthamalogists last year due to an unusual problem. Definitely go to Wilmer. They have incredible specialists, probably someone with real ped/teen expertise in addition to functional specialization. It's where everyone in DC goes when they have a really serious eye issue. (People tell you this stuff when you have a scary-looking eye problem.) Be forewarned: appointment times take a while, and you will probably have to go to Baltimore (they do occasionally have a neuro-opthamologist in the Bethesda office.) Fwiw, I cried a little and the nice people on the appointment line got me in sooner. The guy I saw was Dr. Mcculley (spelling?)

Alternatively, I also saw a very nice and professional neuro-opthamologist at GW. I don't remember her name, but it's a rare speciality so you can probably find her if you look in the GW system. By the time I got in to see her, my issue was beginning to resolve, but she was comprehensive and very helpful.

Fwiw, I really didn't like Katz; his diagnosis differed radically from what the radiologist who read my MRI/MRAs advised. When I told Katz that I wanted to get another opinion, he called and berated me. When I tried to justify my decision by saying that I wanted to go with an in-network option (which Wilmer was), he asked why I didn't think my eyesight was worth his $300 fee. It was insane - I've never, ever had anything like that happen. His diagnosis turned out to be correct (thankfully, the radiologist overread the films) but his manner was so freaky that I would caution against him.