Wednesday, April 17, 2013

Dr P.K.Goswami

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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