Tilted optic nerves and failed visual fields test ? Scared

[Lkakpk]

So , I suffer chronic migraine and see a neurologist . Year ago on a eye exam was spotted my optic nerves look tilted and full so referred . Was decided it’s normal for me . Fast forward year later and had an extremely bad headache for two weeks with blurred vision . Seen neuro who thinks it’s a chronic migraine episode but arranged mri to be safe . Vision went worse so seen eye doctor who again commented on my discs . After tests vision was confirmed as fine and discs look same as scan done last year . BUT I failed visual field in left eye ( patchy area ) I repeated it but again only a bit better ( borderline normal ) doc didn’t seem concerned but I am worried as it’s on my left eye and apparantly disc is more tilted and crowded on that side . Should I be worried ? Got a fear of idiopathic intercranial hypertension but been told highly unlikely as discs would look worse and I don’t fit generic overweight female patient as apparently most with this are overweight . Should I push for a lumbar puncture ? My neuro is convinced it’s migraine but I’m a worrier

If your field is borderline you could ask for a Goldman visual field. It isn't automated so any areas you miss can be rechecked by the person administering the test.

Also, is the doc who isn't concerned a neuro doc or ophthalmologist. If an ophthalmologist is happy with your discs then I would be satisfied. If not, maybe get an appointment with one for their opinion.

Is your colour vision ok? Do colours look normal?

Also, you would be best off seeing a neuro-opthalmologist if possible. They are experts in ocular migraines and IIH

Hi , thanks for getting back . So I have seen both. Neuro and a opthamologist . Neuro basically ruled out iih . Said I don’t fit criteria and he would expect my discs to look worse . In his opinion my discs look normal . Opthamoligist says my discs are tilted ( left more than right ) and crowded and again says unlikely swollen and probably normally for me after repeat scan . Colour vision is fine not an issue atall . Had ongoing cloudy /blurry vision since it started two weeks ago ( the headache ) but vision came out fine on exam apart from the visual field . Just concerned with my headaches being so bad and it being more than typical chronic migraine .

If I was you and still worried, I would request a second opinion from a different opthalmologist (consultant) rather than push for a LP. Good luck

@Budapestdreams thanks so much I will do

I'd expect you to have a visual field defect if you have severely tilted discs.

If your fundus photographs look the same as the ones taken last year, it's very unlikely to be raised intercranial hypertension. You tend to get characteristic changes to the blood vessels too.

I don't have exactly the same issues you have but I am visually impaired in my left eye due to posterior vitreous detatchment and cataracts and I have some visual field loss as well. The cataracts and PVD have got worse over time but the visual field loss has stayed the same, which leads the consultant to believe it has probably always been there. I'm short sighted anyway but only have severe vision loss in my left eye. I also have something called drusen in both eyes and have a particularly small optic nerve in my left eye as well but apparently that's genetic. I am currently still able to drive (according to my consultant) but been waiting for months for the dvla to update my licence. I was very worried when all this first started happening a couple of years ago but at the moment it seems relatively stable so I'm hoping it stays that way. If you're concerned they should allow you to see a different consultant to get a second opinion. I really empathise as sight loss is so incredibly worrying. Good luck with getting some answers x

@underneaththeash thanks for replying . No vessel changes . Just concerns me with the headache being so bad and I’ve had pulsation tinititus too but apparently you can get that with chronic migraine too .

Thanks so much x

@SkinPaperThin thanks so much x

@underneaththeash the visual field fail was on left eye ( eye with more of an optic nerve tilt ) so that kind of sits With what you say . Doctor didn’t seem too worried about visual field fail and seemed to dismiss it .