any neurologists or ophthalmologists about? quick advice please

[timetosmile]

My fit and well mid 60's dad has developed what sounds like an isolated 6th nerve palsy with lateral diplopia and no other symptoms at all. He has no PMHx of note, not on any meds, just wears reading glasses.

Optician could find nothing wrong and after a visit to GP, his BP, glucose, TFTs ESR all normal apparently I am at the other end of the country

Who does he need to see (wants to go private) - neuro or ophth? or would you both do an MRI anyway so it doesn't matter too much?

bump for anyone around at lunchtime with minds wandering during the pathology meeting

Are you a medic? I'd try the doctors.net forum if you are there is usually someone helpful about

hi, defintly ophthalmology, they will organise further tests to find cause. The ophthalmologist may arrange orthoptic review for prisms to control the diplopia.

his Gp should have referred him urgently to ophthalmology.

Opthalmology may organise MRI, usual casue is diabetes, or increase in BP ( may be short lived increase, therefore undetectable at GP's) but if no casue found, v likely , then he shoudl have a 24 BP monitor.

apologies for bad spelling, fat fingers, small buttons

thanks florry, that's what the plan is, but then I had a wobble and started to think about all kinds of horrible degenerative things and SOLs....
is it quite common to have a (relatively) benign cause, then?

The most probable cause in his age group is a hypertensive episode putting pressure on the blood vessels near the nerve inside the brain. His gp will need to get tests done, routine stuff like BP, bloods, etc, may do an MRI depending on how easy it is to get them where you live.

Reassure him it's very likely to improve spontaneously over the next few weeks, but it can take 6-9 months to get maximum improvement in some cases.

Stick on prisms will work wonders temporarily.

Oh and SOLs would most likely have a very insidious onset, over a long period xx

thanks barley he's seeing ophth a 2 weeks, has had constant but mild Sx looking L laterally for 6-8weeks, no field defects, BP fine when measured at GPs....I'm hoping for an MRI just to put his (and worrying DMs) mind at rest!