Saturday, December 8, 2012

What is the best way to treat Optic Neurology/Neuropathy that persists with Chronic Pain?

Q. My friend has suffered with this condition for years, and has gone to about all Specialists she can go to. She had a Radial Keropathy (RK) done years ago, before Laser Surgery became a big thing. She suffers so much, and I hate seeing her in this much pain. She in NOT diabetic. She needs help. She does use eye drops for the dry eye she has so much problems from. PLEASE HELP! I've asked this question before- I need some help with this situation, and I am BOUND and DETERMINED to get this resolved for her. Thanks for any logical and helpful input. It is truly appreciated.

A. The reason you are having problems with your question is that you are providing problem data.

The RK may be a cause. I'm sure that those radial lines are causing a lot of glare, those types of symptoms. It may have caused irregular healing of the cornea and she scrapes her eye every time she blinks. I'm not sure a transplant would be indicated. I'd have her see a cornea specialist to determine whether there's anything that she can do.

The optic neuropathy problem is totally different. She's probably young. Young people usually do not get optic neuropathies all by themselves. These inflammations are usually associated with systemic problems such as Multiple Sclerosis, etc. I'd not drop that on her but have her seen by a neuroophthalmologist.

If she has questions, have her contact me or address her issues in this forum. There are some very sharp people who look at these questions that may be able to direct her better.


Is it worth getting laser eye surgery?
Q. my eyesight is quite bad and was thinking about getting laser eye surgery. However it is quite expensive and i am worried about the risks of it.

I am only 18, is it too soon?
Which treatment is the best to have?

A. Overall it's worth it! Probably too soon for you though. You're still going to have some minor body changes though your early 20s. I waited until my mid-20s. If your prescription has been stable for a few years though you should be good. You doctor will be able to advise.

If you go to a reputable surgeon the risks are minimal, but always there. You will have to read the disclaimer packet, or at least sign off that you read it, of everything that is likely to go wrong.

As to "what treatment" that depends on your eyesight and your doctor. If your sight is really that bad your only option may be RK, if I recall correctly. I believe that is the most "aggressive" treatment.

As to what to expect. On the way home, If you eye-numbing drops wear out before your pill pain-killers kick in it is going to feel like someone put out cigarettes in both of your eyes. It happened to me, and I will label it as "extreme discomfort" just under "true pain." Hopefully the valium will still be in your system and you won't care as much as you normally would. (This is the only thing I wished I was warned about that I was not) The first week or two of post operation care is a pain in the butt. Lots of eye drops, but better than getting an infection. You will probably need to keep a bottle of re-wetting drops on-hand for about 5-7 months after the surgery. My doc put me on Restasis for two weeks before my surgery to really get the tear production going into overdrive. I think this helped quite a bit with getting over the dry-eye factor after the surgery.


Bad vision, what are my options for eye surgery?
Q. I have -10 grade in both eyes. I heard about Lasik and PRK. Am I a candidate for these surgery? What are my other options?

A. Sounds like youve done some research. First, your options may depend on your age. A safe age for refractive surgery would be 21 and over.

Surgery options include:
LASIK/LASEK
PRK
RK
Phakic IOLs
Pseudophakic IOLs

If youre doing okay with contacts and/or glasses, sometimes thats the best way to go - any surgery has risks

The only way to know if youre a candidate for any of the surgeries is to see an opthalmologist and be screened to see what would be best for your eyes.


How do I become a member of the Secret Service?
Q. Do I need to go to college? I want to join the Navy to become a Navy SEAL, but I only want to be there for 10 years the maximum, and then join the Secret Service, to be like a Secret Agent, and protect important people, or places. Another question is, do Navy SEALs and the Secret Service work shoulder to shoulder?

A. From the Secret Service web site:

To be considered for Special Agent positions you must:

- Be a U.S. Citizen

- Be between 21 and 37 years of age at time of appointment

- Have (1) a bachelor's degree from an accredited college or university; or (2) three years of work experience in the criminal investigative or law enforcement fields that require knowledge and application of laws relating to criminal violations; or (3) an equivalent combination of education and related experience

- Have uncorrected vision no worse than 20/60 binocular; correctable to 20/20 in each eye (NOTE: Lasik, ALK, RK and PRK corrective eye surgeries are acceptable eyes surgeries for special agent applicants provided specific visual tests are passed. The following are the waiting periods before visual tests are conducted after the surgery: Lasik surgery�three months; PRK�six months; and ALK and RK�one year.)

- Be in excellent health and physical condition

- Pass a written examination

- Qualify for a Top Secret clearance and undergo a complete background investigation, to include in-depth interviews, drug screening, medical and polygraph examinations

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