Thank you for your replies. A bit of background behind the questions …
Several years ago, I had problems with my eyesight that seemed to go beyond normal ageing. My left eye has been poor since childhood, but my right eye was always very good. However, within the space of a month or so, I lost most of my ability to focus, my acuity dropped from an easy 6/4 to a difficult 6/6 (pinhole-corrected and missing some of the letters), my colour perception deteriorated and (most obviously) my dark adaption went from owl-like to bat-like (the road disappeared when I drove into forest-dappled sections, I couldn’t see in anything less than brightly-illuminated streets and most of the stars became invisible to me). I had an Amsler Grid test and noted that the centre appeared distorted and the grid was brown rather than black. About a fortnight after first examination by an opthalmologist, the consultant noted that the optic disk of the affected eye seemed paler than the other eye. Although, no photographs were taken, I got the impression that the pallor became more noticeable as my vision got worse.
A couple of things struck me as odd: the first was that the opthalmo-neurologist who followed up on the consultant’s observation didn’t believe that my eyesight had ever been 6/4 and thought my struggling 6/6 was pretty good (whereas to me it was like Registered Blind!!!). The other statement he made was that the pallor had probably always been there, as many opthalmologists/general practictioners/opticians would have probably just thought it was natural variation and not commented (despite it being “quite noticeable” by this stage). I queried this, as I was pretty certain that my previous RAF medical examinations went into some detail on the differences between my right and left eyes. I also stated that I was pretty sure my eyesight was better than 6/6. He re-itererated his previous statement and again rejected my ever having 6/4 vision in the right eye.
I obtained a copy of my RAF medical records, which confirmed that my right-eye had always been 6/4, with Colour Perception 2 (CP2) which meant very good colour vision (only aircrew and some specialist trades were tested for CP1). Furthermore, although other differences between the two eyes were noted, there was no mention of the optic disks being different. However, one thing did surprise me was that, a few years prior, I had seen an opthalmologist after experiencing some visual difficulties and could only manage 6/9 for a short time. I’d also had infrequent episodes of weakness and other MS-like symptoms (eg, fatigue and L’Hermitte’s sign), all of which I’d completely forgotten about. I sent the relevant records to the neuro- opthalmogist but got not response.
Subsequently, I was referred to my local neurology department and after a few months I had an MRI. The MRI showed nothing of concern but did note that I had more “focal white spots” than would be expected for my age. Amongst other things, the neurologist ruled out MS and my changes in vision were written off as “just one of those things, but nothing to worry about”.
By the time of the MRI (the NHS sometimes rivalling glaciers for rapidity) my vision had improved markedly - most of the stars were visible again and my acuity had improved to 6/5; I’ve never recovered accomodation, though, and my vision isn’t as sharp (even corrected) as it used to be. Interestingly, despite my supposedly always having a difference in optic disk brightness between the two eyes, no recent examination (including retinal photographs) have detected any difference at all.
Recently I’ve been having problems, primarily with fatigue, pain, weakness and instability. I’ve also had occasional bouts of eye-pain (including one episode of not being able to see things clearly (I felt like I was having to look round things to see them)) and facial pain. Initially, these were suspected to be due to neck and back problems. However, although recent MRIs confirm I do have spondylosis, it doesn’t appear to be clinically significant. Consequently, my GP intends to refer me to a neurologist for further investigation. My wife, who has a bit of relevant training, suggested that I might want to chat with my GP about whether MS might be back on the list of possibilities.
So, if previous patterns hold, given that I am likely to be examined by the neurologist when I’m improving, I’d like to know how regressing-remitting MS shows up in tests during remission.