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Which is it, Glaucoma or Optic Neuritis?

Submitted by hayamorgen on Wed, 06/19/2013 - 2:21pm

I'm a 50yr old female who had been diagnosed with Glaucoma 2 yrs ago (by Dr. Anne Coleman, Jules Stein Eye Institute,UCLA) and more recently with Optic Neuritis (by Dr. Alfredo Sadun, Doheney Eye Center USC).

Some background about myself: I've always had high IOPs (22-28) since my 20s, and low blood pressure (90/60) which had been known to dip even lower perdiocally. About a year ago I was 'diagnosed' with Chronic Lyme (I was bitten in NC when I was 26 yrs old and got the bulls eye rash; I was treated with antibiotics at the time). I put diagnosed in quotations because my Western blot test was inconclusive, but I have markers of immune system deficiencies as well as persistently elevated inflammation markers (TGF-b1, C4A).

I had a short episode of Graves (hyperthyroid) disease which had resoved after a very brief 2 months treatment. So it seems my immune system is 'confused': over active against normal body cells but underactive against the systemic infection. My symptoms are: High IOPs (untreated 18-26); vision loss in the left eye characterized by blind spots in the center lower left portion of the VF, loss of contrast, graying or dimming of vision, general loss of acuity, marked color desaturation. There's some cupping and RNFL thining. VF tests show limited loss. Brain & orbits MRI showed no lesions and optic nerve palor. Lumbar puncture showed Oligoclonal bands of unspecified origin.

I have been on IOP lowering drugs for a while and they are effective in lowering pressure to about 12-14. However, I feel my vision is continueing to worsen. Other tests have ruled out Lupus, MS, & Devic's disease.

At this point I'm confused about whether I have Glaucoma, Optic Neuritis or possibly both. I am searching for a third opinion by an expert who is not too biased by his specialty (i.e. Glaucoma or Neuro), who can evaluate me and give his assessment as to diagnosis and further treatment. I am willing to travel to see such an expert in the Western US. I would greatly appreciate any advice from members of this community with respect to who to go see. I also appreciate any clues into possible exaplanations of my vision loss.

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