Multiple sclerosis is a chronic disease associated with plaques of demyelination that affects the brain, spinal cord, and optic nerves.Exact cause is still not known, however risk factors include
age (20 to 40 years), gender (females more affected), smoking, genetic factors, Vitamin D and B12 deficiency and probably role of viruses.
Neurophysician is in a better position to treat it, however, ophthalmologist should be included in the managing team.
As an ophthalmologist, I would definitely work with a neuro-physician to co-manage these patients. I would especially be most comfortable with the neuro-physician giving the ONTT IV methylprednisolone treatment with monitoring and also for them to perform the risk stratification/prognostication for future MS.
Most of these disorders that have a significant field overlap should be treated multidisciplinary. The leader physician of the team most of the times comes from the most prominent clinical manifestation of the multiornanic - systemic disease
Both neuro-physician and ophthalmologist are needed it to manage MS. Follow u with neuro ophthalmologist is recommended to see if there is any changes in visual acuity and visual field based on the treatment that given by neuro- physician.
Why is disease management put first? Isn't this the main obstacle that prevents making any decisive progress in the field?
What about monitoring the course of Rucker's periphlebitis retinae and that of the vein-centered cerebral lesion developments together? to possibly find out what actuates the given process dynamics?
In cooperating with neuro-ophthalmologists and neuro-radiologists, 'neuro-physicians' can be expected to learn a lot about the process dynamics of multiple sclerosis in physical terms.
What a good question.
Did you know that optic neuritis is one of the main complications of the Astraznika Corona vaccine?
According to my studies in this field, the treatment of this disorder requires three specialists: ophthalmologist, neurologist and exercise physiologist But due to the involvement and swelling of the optic nerve, the main job is done by a neurologist.
The diagnosis is made by an ophthalmologist and sports exercises such as yoga and tai chi are required by a exercise physiologist during the recovery period.
Believe it or not, dear All:
Pondering Alexander Bruce's few lines introducing James Walker Dawson's 123 pages on "The histology of disseminated sclerosis" (Trans Roy Soc Edinb 1916;50:517-740) may answer your questions :)
Optic neuritis can be initial symptom of multiple sclerosis. So after patients are treated for acute demyelinating ON, they should be followed up by a neurologist closely for MS conversion and therefore long-term treatment decisions.
Ref:-
Article Optic neuritis as an early sign of multiple sclerosis
Farah Akhtar is "can be" reasonable, justifiable an indication for immune-mediating or immune-suppressive drug treatments?
Optic neuritis following Covid-2 vaccinations is no better explainable as an ON preceding new neurological disorders attributed to MS for many years, up to decades? As inexplicable as ON-like visual affections seen in IIH or normotensive hydrocephalus?
What's the reasoning buttressing your recommendation?
I completely agree with you
But we must keep in mind that updating science is a priority, and that the corona virus and vaccination are the first topic of discussion these days.
For this reason, we should not ignore the role of vaccination in the development of optic neuritis just because it is new, and the use of studies in the treatment of this complication due to MS, including Plasmapheresis, corticosteroid injections and cognitive exercises along with medication is very effective. It will be and will not have side effects.
Why not consider updating the 'leader physicians'? Who have been that busy in updating ON treatments in line with the first research topics of their respective times that not even the question of given and absent ON associations with Rucker's periphlebitis retinae was reflected upon.
Is handling, managing a condition really the best way to diagnose - see through, find out - what's going on?
Optic Neuritis due to Multiple Sclerosis requires multidisciplinary approach in treatment between an ophthalmologist and neuro physician.
Why not widen the two-disciplinary to a multi-disciplinary approach? Including experts in vascular and venous nervous affections, Pir Salim Mahar? Admit a broader diagnostic as much as a therapeutic scope?
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