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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