Ophthalmology & Optometry/pseudotumors on optic nerves

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Question
I am a 33 year old female that had an eye exam
in July to renew my contact lens prescription. At
that time, the doctor informed me that I have
pseudotumors on both of my optic nerves and
was informed that I should see a neurologist
immediately. However, I do not have insurance
and could not afford a specialist, so instead I
went to a general physician who ordered an
MRI. I was able to get a grant through a charity
hospital and have an MRI done. I did not have
any blood clots or anything else that could have
caused the problem. However, I still have not
been able to see a neurologist to have them
write me a prescription, which is what I was told
I would need to fix the problem. I have terrible
headaches all the time and my eyes hurt and
my regular physician told me that I shouldn't
get my heart rate up, as it could cause the
pseudotumors to rupture. So, now, I am at a
stand still afraid to do anything. How likely is it
that something will happen to my eye sight if
this is left untreated? Will it eventually go away
on it's own? Also, I almost forgot to mention
that about a month ago, I had a headache that
was particularly bad, way worse than my normal
migraines and I was screaming in pain and
couldn't turn my head. My husband took me to
the ER and they did a spinal tap. They told me
my pressure was slightly too high, registering at
26 after they pulled off some fluid. I have no
idea what that means, but when they pulled
some fluid off, I had a relief of symptoms for a
little over 3 weeks. The headaches are back and
getting steadily worse. What does all this mean?
I apologize for this being so lengthy, I am just
confused. Thank you in advance.

Answer
Premenopausal women between ages 18-40 who are overweight ( obese) are most often prone to develop pseudo tumor cerebri or benign intracranial hypertension  .  The MRI is necessary to rule
Out brain tumor, clots.  aneurysms , bleeding within the skull.  When the intracranial pressure builds up , the optic nerve becomes edemetous and vision can
Become obscured, blurred, with greyouts and loss of peripheral vision and , if left untreated, can lead to permanent loss of
Vision.  Certain medications have been associated with
Pseudo tumor  such as accutane , tetracyclines, steroid withdrawal etc
The treatment is to Lose weight , administer drugs like Diamox, Lasix, steroids. And possibly surgery if there's no resolution .  Recent research at Johns Hopkins showed that a stent placed at the base of the skull into a major brain sinus
Vein, will relieve the intracranial pressure and reverse symptoms .  You need to be under the care of your primary care physician and s neurologist.   Hope this helps. Goods luck   
Dr Berger  

Ophthalmology & Optometry

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DR. KENNETH BERGER

Expertise

Any and all questions with regard to ocular ailments, eye diseases as cataracts, glaucoma, macular degeneration, diabetic retinopathy, etc , eye and visual sympomatology, eyeglasses, contact lenses, low or subnormal vision, pediatric vision conditions,and special and unique ailments will be discussed.

Experience

36 years of clinical experience in opticianry and therapeutic optometry. Still in private practice with special interests in vision conditions, diagnosing and treating ocular ailments, prescibing treatment plans which include medicine, eyeglasses, and contact lenses primarily. Although surgery is not within the realm of my area of expertise, I co-manage many pre and post -op surgical cases which include Lasik and PRK procedures.

Organizations
New Jersey Society of Optometric Physicians American Optometric Association

Education/Credentials
B.A.,1968, Hunter College of the City University of New York B.S.,1970, Pennsylvania College of Optometry O.D.,1973, Pennsylvania College of Optometry Therapeutic Pharmaceutical Administration Certification, New Jersey 1992

Awards and Honors
Clinical Efficiency Award, 1973, Pennsylvaania College of Optometry

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