Visual perturbance while jogging

Theophilus Samuels theophilus.samuels at btinternet.com
Wed Aug 8 10:26:50 EST 2001


> Uhthoff's symptom of visual loss with exercise is most frequently
associated
> with optic neuritis. The symptom carries a major risk for recurrence of
> optic neuritis and development and possible diagnosis in many cases often
> leading to multiple sclerosis.

I do not recall the history given in the beginning of this thread, but, I am
almost certain that there was no mention of ocular pain. In MS, visual
disturbances most commonly present as an acute optic neuritis in which
unilateral visual failure often occurs in association with ocular pain.

Optic neuritis usually begins as a blurring of the visual field and the
patient's symptoms may vary from a slight loss of brightness to complete
loss of light perception. The pain may be in the orbital or supraorbital
regions and may worsen with movement. On examination, the patient may also
have a reduced visual acuity, Marcus-Gunn pupil (relative afferent pupillary
defect), focal area of visual loss (scotoma) or enlargment of the blind
spot, and papillitis (inflammation of the optic disc). Fundoscopy may reveal
pallor of the optic disc (optic atrophy) which often follows bouts of optic
neuritis.

Uhthoff's phenomenon occurs in some patients where their motor, sensory or
indeed visual symptoms are temporarily made much worse after a hot bath or
exercise, i.e. factors raising the body temperature. Uhthoff's symptom on
the other hand, refers to transient visual blurring that occurs with
exercise or heat exposure and is usually confined to one eye. There is no
Uhthoff's syndrome per se.

The one main symptom of optic neuritis that occurs in almost every case is
dyschromatopsia or reduced colour vision. It is also known as macular
desaturation, and the colour most often affected is red. Without going into
too much detail, this is easily tested for by comparing the colour of a red
hat-pin between each eye and noticing any differences in the vividness
perceived.

Visual sensations or phosphenes can also occur in optic neuritis; these are
best observed in a dimly lit room (sometimes those with a chronic condition
of optic neuritis may admit to seeing 'better' in dimly lit rooms).

There is about a 50% chance of converting to MS within 15 years if optic
neuritis is present. However, it should be noted that the conversion rates
from many different studies vary greatly (ranging from 30 to 70% or higher).

Finally, there are many causes for optic neuritis which include viral
infections, autoimmune diseases and genetic diseases (such as Leber's optic
neuropathy, a disorder of the mitochondrial genome - very rare). And not
forgetting the physician's favourite cause of idiopathic (i.e. unknown
cause).

T.L.S.

'When Hermann Minkowski unified space and time, Einstein then decided to
warp it'

PS. The individual in question should see both an ophthalmologist and a
neurologist.

Jayne Dough <two_mules at nospam.mindspring.com> wrote in message
news:9kqojv$612$1 at slb2.atl.mindspring.net...
> >
> > when jogging, and especially when the weather is hot, I experience some
> > mysterious eye trouble. <<
>
> Uhthoff's Syndrome: At the turn of the last century, Wilhelm Uhthoff was a
> renowned clinical neuro-ophthalmologist and probably the first clinician
> whose entire career was devoted to this discipline. His achievements are
> among those that mark the commencement of contemporary
neuro-ophthalmology.
> Uhthoff's symptom of visual loss with exercise is most frequently
associated
> with optic neuritis. The symptom carries a major risk for recurrence of
> optic neuritis and development and possible diagnosis in many cases often
> leading to multiple sclerosis. A metabolic by product of exercise
increases
> in body temperature or causes a reversible conduction block in
demyelinated
> optic nerves and results in temporary loss of vision.
>
>
>





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