AboutMitchell Axelrod Expertise I'm happy to answer questions about eye exam findings and procedures, glasses and contact lens types/prescriptions/problems. I can also answer questions about general eye conditions/diseases.
I do not answer questions concerning surgical techniques/procedures.
Please state your age or within a small range when asking questions, as it is often important.
Experience Optometrist 19 yrs.
Education/Credentials Doctor of Optometry, cum laude; Residency in Ocular Disease
Question QUESTION: when eyes are dialated can you see the nerves behind the eye and if they are damaged or just what is going on in the eyeball it self.
ANSWER: Hi Julie,
Even without dilating the pupil, you can (only) see the end or 'head' of the optic nerve where it plugs into the back of the eyeball. It is this nerve that carries the visual info to the brain. You cannot see behind the eyeball, only into it as if looking inside a ping pong ball. Some eye diseases, like glaucoma, damage the optic nerve and the head of it starts to look sickly. Other nerves that supply the muscles that move the eye around or nerves that allow for sensing pain, itch, etc. cannot be seen. Thanks for asking, if you have other questions about this let me know.
Mitch Axelrod,OD
---------- FOLLOW-UP ----------
QUESTION: my daughter had brain surgery to remove a petuitary tumor.
her eye sight faded 2 weeks after the surgery.
a doctor dialated her eyes and stated the nerves from the brain to her eye are damaged and will not heal.
this is the only test he did. From what i am understanding above there is no way he saw this.
what test would show these nerves and thier status.
thank you for your help
Answer Hi Julie,
I am very sorry to know this. Yes you can only see the head of the optic nerve when you look inside the eye. If what you see is a damaged, swollen, or pale optic nerve head then you know the rest of the nerve that you can't see is also effected. The surgeon may know that the optic nerve was damaged during the brain surgery and is now seeing the result of this at the optic nerve head. Without knowing more about what he saw, it's hard to tell you more about what happened. I can't tell from your note the time span between the surgery and the doctor's comment about the optic nerve. If the surgery was much longer ago than two weeks, it would be possible to see atrophy which means the optic nerve is failing to function and stay healthy. Atrophy is not a good sign. But if the surgery was two weeks ago, it's too soon to seen 'atrophy' which takes longer to happen so he might see swelling. If it is swelling, then there may still be hope if they can reduce the swelling. You certainly can ask exactly what he saw to tell you there is permanent damage. If there is swelling it is important to act quickly. These things I am describing are common knowledge among eye doctors and neurologists, so I would be surprised if there was swelling and he wasn't doing anything about it. Sadly it is not uncommon to nick the optic nerve during such delicate and complicated surgery like pituitary tumor removal, and it may have happened in your daughter's case. I have several patients who also lost some vision because of similar surgery that tell me over time they seem to have gained some vision back. So do not feel hopeless but make sure you know what happened, and have additional opinions if you need to. If your daughter has poor vision there are doctors that specialize in helping 'low vision' patients make the most of what they have. Please write back if you have any more questions.
Regards,
Mitch Axelrod,OD
