Dear Vipresh
I have received your mail. I am sorry that I am late in
replying. I have studied the case history and all the investigations inserted in the mail
regarding the eye condition of your
uncle (Mamaji ) . Based on those findings, it appears to me that your uncle may
be suffering from “Optic neuritis”, a
neuro-ophthalmic condition, rather than Glaucoma. MRI findings and
visually evoked potential (VEP ) indicate optic neuritis. Though his Humphrey auto
perimetry report is not classical of
optic neuritis, the field may change during the course of the disease. I am not
sure about the optic disc changes which are very essential to diagnose a case
of glaucoma. In this situation , further
tests like OCT and Heidelberg retinal tomography by an ophthalmologist
are needed to thoroughly evaluate the
optic disc of the eyes. Optic neuritis
may be due to different causes
which the Neuro-ophthalmologist will
evaluate and give treatment according to the course of the
disease. There is a rare possibility of a condition called meningioma of
the optic nerve sheath of right eye, a rare
benign tumour which should be excluded by critical evaluation of the MRI. I don’t know whether he has regained some amount of his vision now. I suggest
him to attend the glaucoma facility of Dr R. P Centre of Ophthalmic Science,
AIIMS, New Delhi if possible.
Thanking you for refer ring to me and wish your uncle to recover
soon.
Dr P.K.Goswami
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