What Happens If Your Optic Nerve Becomes Inflamed? | Knock Knock Eye
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- Опубликовано: 15 май 2024
- This week on Knock Knock Eye, Will rants about how and why he ends up being sent every ophthalmology magazine under the sun each week before getting into the main topic, Optic Neuritis, which is the inflammation of the optic nerve.
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My kid had optic neuritis (from what turned out to be MOG antibody disease) and we credit their good outcome almost entirely to the tired and long-suffering ophthalmology resident who, at midnight, spotted optic neuritis from among the weeks of numerous baffling symptoms and got us over to the pediatric neuro-ophthalmologist who set things right.
We never got that resident's name and never saw him again and so never had a chance to thank the guy who probably saved our kid's vision, mobility, and maybe even life.
Anyway, keep up the good work.
Hi Dr G. I have some insight on your opening rant. I work in the medical devices field. Many medical licenses are accessible via state licensing boards so that is one source for how marketers reach you, and also for legitimate subscriptions you have bought, your name is sold on mass mailing lists to other publishers. My job is to review those non-peer-reviewed articles for our marketing department and make sure the doctors that we contract with to promote our products are not promoting off-label uses and that they are staying within our supported claims. So they are certainly always marketing pieces, trying to promote some product or educational opportunities, but they should still be legitimate, market-cleared devices or sound educational events, if the regulatory team for the manufacturer has done their job.
Thank you for covering this Will 😁
Optic Neuritis talk starts 11:07
I took part in a research study tracking vision progress in patients with MS and a history of optic neuritis. Once a year for 6 years I would go and get an MRI, then do 4 hours of various eye tests. It was exhausting but super interesting. Seeing the difference between my eyes in the trace waves was fascinating!
I’m a dog trainer with an online training school and I also get magazines and stuff I never signed up for and always clean up house every so often.
My best advice
None, I’ve given up lmao 😂
I had optic neuritis a few years before being diagnosed with MS. I am eternally grateful that it was in my "bad" eye (which is not actually an eye issue but a brain problem). For me the worst bit was that I lost the colour red entirely, just as I was trying to play cricket for the season (which uses a red ball). I'm now bummed that I never thought to see how a pendulum looked 🤣
Will, you know very well that the problem cataract robots solves is how to make an obscene amount of money for the person who will sell it to the hospital.
In a better world the cataracts robots would be about being able to perform basically free cataract surgeries safely in extremely impoverished areas, the governments being able to buy the robots and all the tools and substances necessary, and then can just have a hospital van touring the country for the basic healthcare. But that would be in a better world, not hyper-capitalist hellscapes.
One common source for anyone who has a state license is the state database. Not because the state sells the information, but because it's part of the open records laws in most states - the publishers can get name and address from the database, and it's a targeted audience for the advertising sales that support the publication.
Basically, they make their money on the advertising; the "information articles" are a lure to get you to open the magazine for the ads
Got the same thing on the veterinary side. Once upon a time, I was able to get free subscriptions for mainstream magazines for the waiting room
Also the NPI registry is regularly scraped (just look at how many ad-ridden websites show the exact same records as NPPES), and that will have both your physical office and mailing address listed. They also might get the information from CMS records, or directories maintained by health plans. All of them are public.
Basically, unless the US majorly overhauls privacy rights (which they won't because nearly all if not all politicians sit comfortably in the pockets of big business), there isn't going to be any recourse in this case.
I have had optic neuritis multiple times-- never had anyone check for Pulfrich phenomenon, lol. It was always straightforward optic neuritis, and I was diagnosed with M.S. based on MRI after the 2nd occurrence. I always noticed graying of my vision with exercise (mowing the grass)--it made me feel like Frodo in LOTR, beginning to fade. Blue objects would appear neon blue in the affected eye, which was a quick check for me if I suspected a recurrence coming on.
There was a 5-year interval between the 1st and second occurrences. The second was accompanied by additional M.S. symptoms.
Dang, now I'm wishing I got blue wavelength hypersensitivity, because that actually sounds awesome. Here, I thought I was acutely developing cataracts in my early forties, as I just had a bunch of blurring in the center of my vision. I dismissed the other, non-optical, M.S. symptoms due to other autoimmune disorders, so I waited a bit long to get into the ophthalmologist and start the ball rolling on my M.S. diagnosis.
Anyways, here's hoping we can all get fixed up permanently before any symptoms recur or progress.
Anything online could be tracking you and selling that information.
Google and Facebook, for example, will track and record your movements, behaviour, and watch time and sell that information to advertisers.
If you have a smartphone or laptop, then you're being tracked and recorded.
Great episode! I had optic neuritis a little over 2 years ago, which eventually led to my MS diagnosis. Such a scary, crazy thing to have happen, seemingly out of nowhere. I received 3 days of IV steroids and my vision returned fully and quickly.
Thanks for this one doc. I developed optic neuritis from MS early last year. I just thought I was acutely developing cataracts at an early age, but my opthalmologist was pretty quick to get me in to an MRI and a neurologist to diagnose the MS.
It was actually soon after that episode where your then-stolen content started appearing in my RUclips feed, and you've always been both entertaining and informative since.
Yes. You do.
I haven't been an engineering professor for over 20 years. I no longer work in the field at all. But I still get the trade journals. Decades later.
To translate to ophthalmology; let's say that it results in an advertiser selling one more slit lamp. That pays for a lot of magazines.
I’m an ophthalmic tech and I love the junk journals; gives me a good starting point for further reading and discussions with the MD. See if any of your office staff are interested before you recycle ◡̈
I would so go to Dr. G's journal club
I'm in an accounting firm and we get random accounting, bookkeeping and HR junk mail all the time!!!
Random crap sent to my email and office….every…single….day. Happens with nearly every profession that is publicly searchable.
I had a headache that turned into a migraine (not the worst) then I started getting a lurching or shock feeling in my head. Thought it was my ears but finally sused out that it was my eyes while I was fishing. Had eye pain as well as that lurching/shock feeling the whole time. Auto resolved. It was "fun". Well timed article.
Yes, this happens in other professions, such as engineering. These "free" magazines are paid for by the copious ads.
How about a differential diagnosis for Optic Neuritis and Anterior Ischemic Optic Neuropathy?
I get Optic Neuritis about every 6 months (have MS, under treatment), given steroids just so it doesnt last forever but the upside is I get to see a picture of my optic nerve, which is cool. The damage isnt cool but the geek in me loves seeing scans/photos/xrays lol and it allows me to see, (for the moment lol) the cause of the vision problems😛
My fiance had optic neuritis in 2012 while we were in med school. It relapsed in 2016. In 2019 she got autoimmune encephalitis, and it caused irreversible brain injury. And I failed to save her....
_big hugs_ I'm so sorry. Try not to blame yourself. I understand that feeling all too well.
Fascinating topic! Thank you.
I have been wondering about the effect of hypertension on eyes?
Preaching to the choir doc. I'm a Vascular surgeon and I get a s**t ton of "throw away" magazines each week.
Thank you
Thanks
9:38 The advertising magazines are a lot less expensive in the long run. Kind of like an infomercial.
That initial rant is begging for a sponsor lol, there are companies that go through all the data brokers and ask them to delete your data
It's your professional org. I never got any junk mail for my profession until I joined the professional org.
I thought for sure your beginning rant was going to lead to an Incogni Ad. 😂
As a non-medical person, interested in medical things, thank you for the knowledge.
Haha, I know this one! It happened to me back in 2020. The weirdest part was I lost certain colors in my better eye; my worse eye basically went vague, blurry shapes and blocky colors. I don't know if the crazy high dose of steroids I took helped or it just healed on it's own, but I'm back to my pre-Optic Neuritis eyesight (after about a year). It lead to my MS diagnosis, though, which threw me for a loop, never expected that one (like many others in the comments, it seems!). But, four years later, that relapse plus a small one my neurologist didn't even think was one until the MRI results showed it was, and none since. I just say 2020 had one final middle finger for me, lol.
Yes, the unsolicited periodicals are ubiquitous. I worked in manufacturing for a while, and even though the machines we built were metal, we would get Plastics News, Rubber Innovations, Petrochemical stuff, and Waste Today (I actually read that one for the recycling articles). Now that I’m in trucking (last mile delivery), we get nonsense like Shipping News, Maritime Engineering Monthly, and Structural Engineering Insights.
A lot of these periodicals are owned by the same parent companies, so when you get on one list, you get on all their lists. I tried unsubscribing concertedly for about 6 months (lots of phone calls), and it would help temporarily before we got back on a list again. Now I just get rid of them as soon as they are delivered. I used to cry for all the trees killed in senseless mass marketing, but now I am a hardened shell and have no more tears in me. Do you recommend any eye drops that can resolve chronic disillusionment and restore compassion?
Maybe a silly question but is there much of a difference between optic neuritis and papilledema? I've had paps in both eyes before and it was explained to me, in fairly simple terms, like you've explained this.
Good Rx will find, and mail you under a rock. They mail me often 😢
Can you do a video on papilledema?
I’ve been seeing a new eye vision correction called EVO ICL. Can you please address this in a video?
Can confirm that lawyers get those, too. (Source: I'm a legal secretary/paralegal.)
We want more pants patients!
Ok, Doc. I'll admit it. I found your work address and sent you a First Descents t-shirt a couple years ago. Hope it wasn't wasted. It can be recycled at Goodwill.
Your office address is probably pretty easy to find. You are kind of high profile 😂. I'm a nurse and my work address is public information. You allude to working in Portland so that narrows the search down. Also since I have a certification and am part of a union I get magazines affiliated with those entities. Voter records/registrations are also easy to find. Someone wouldn't even have to pay for anything to get that information. If you belong to organizations, boards, are board certified, that info is all easy to find ...
I know a doctor who gets the NEJM delivered every week but he never subscribed or paid for it. At least it’s a high impact peer reviewed journal…
Do IIH!
I had a brain aneurysm rupture and diagnosed with 6 total aneurysm ms. The rupture damaged the optic nerve so one eye is not good as it should be. Neuro ophthalmologist says it probably won’t get worse but not better. 😞
So my symptoms was an hemorrhagic stroke with head tingling and numbness in my hands. I didn’t go to the Er for two hours. I Thought it was just a bad headache! 😂 I spent almost 30 days in Neuro ICU!
How often do you actually see bitemporal hemianopia? As a med student I feel like it’s everywhere lol
7:53 , if someone has a scalpel near me, and they are operating on me, I want the human touch. I don’t want a robot digging around in any part of my body or any orifice just to be more precise. The human body is different for a lot of people. AI cannot make a snap decision as quickly as a trained human.
My mom had optic neuritis which what began the work to confirm her possible/ probable to be definite MS. She lost a significant amount of vision, but it turned out to be the result of an optic nerve tumor and subsequent radiation.
Robots doing cataract is actually a big deal. It gets cheaper over time and it can help countless people across the world who can't afford the surgery.
Which # Interleukin do you target for this type of inflammation ?
I am relieved to learn that I am doing good in the world by never treating optic neuritis with oral steroids. (Not a medical professional, but still.)
I can promise you I will never start oral steroids alone for any cases of optic neuritis. As a non-doctor I dont think they'd let me if I tried lol Also I do wonder what a Dr. G journal club would look like.
All the time due to licensure.
Want the knock knock music back. Also do Sarcoidosis and eye balls.Don't forget the 45 pounds a year of just junk mail ads no one reads. I get so sick of it.I've read driver license companies sell your stuff. It gets old.
I'm tired of all the faxes to Dear-Dr-Retired-And-Or-Left-My-Department-Thirty-Years-Ago, we'd like to sell you this new thing or poach you from your office we pay generous benefits....
25 surgeries in a half-day with a 96% success rate means every day of cataract surgeries is two failures. That sounds absolutely like room for improvement. Not saying robots are the answer, but you are far from “enough” when it comes to success rate.
Not to mention that operating rooms and surgeons just aren't cheap. Hospitals run on extremely highly trained labor, which is part of why advanced healthcare is expensive. I think the benefit here is supposed to be more about deskilling than speed. This particular journal is still probably very tech-industry grifty, but automating things has it's benefits.
Ugh, throw away ad journals. Family medicine gets a ton. For years. Have tried to unsubscribe, to no avail. Just breathe. Breathe.
I show up here to be delighted that optic neuritis made it into the rotation and what should I see first in the comments section but @ggould256 talking about our kid.
That said, I do wish NMO & MOG antibody disease had made it in! "It's weird and call your neuroophthalmologist" is correct here, but they have to be looped in _much_ sooner than the timeframes in this episode; disease onset is much faster; people are unlikely to recover well without treatment (30% fatality rate without treatment, and significant disability for many of the remaining); it *can* be treated in at least some cases entirely with steroids (at least in the acute phase); and the steroid doses given for optic neuritis in this ep are comically low for NMO & MOG.
They're extremely rare, but they're also conditions where with early detection you can sometimes make the heroic diving save (shout-out to Boston Children's).