Discussions By Condition: I cannot get a diagnosis.

Tough Case, need help

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: Anonymous
  • December 12, 2008
  • 00:35 AM

Hello, my names Annette and i have this co-worker who needs your help. Her past medical history is a lot and makes finding a logical diagnosis harder.i naturally wanted to help so i got as much information from here as i could.so heres what i got...

She is a 25 year old female. Her senior year in high school she was involved in a major accident causing a horrible head injury to her right side of the head that required a craniotomy. she cannot smell or taste and is blind in her left eye due to a piece of her skull that severed her optic nerve.

about 6 weeks ago she woke up in the middle of the night not able to breath well, she said she felt as though it was in her chest like she was drowning. she went to doctor but by that time she felt better but just had a little cough and sent home. about three days later she started to feel as though she had a cold, a lot of sinus pressure, runny nose, coughing, etc.. symptoms finally subsided with little cough still present.

she wears contacts and one day her eyesight was blurry so not thinking much of it she went home and threw that set away.she started to feel her eye was swelling so she went to the doctor. they thought it might be a bacterial infection due to something on the contact lenses that might have scratched her cornea and prescribed her some eye drops. she was recommended to not wear her contacts, and she didn't, she just wore her glasses for the next 2 weeks. once her eye swelling started to get better she went to put in her new set and it was so severly painful she couldnt even get it in. she said as though her pain felt like "hot burning sand was shoved in her eye" with a pain level of 8. she mentioned once she put the eye rops in her eyesight cleared up for about 4 seconds then blurred again, she had some clear spots in her vision. now her eye is progressively getting worse. she started to get swelling of the actual eyeball itself making it discomforting to blink, blurry vision in her only good eye, red, irritated, cant focus on anything and now she doesn't even have the clear spots she used to have.she also mentioned she began to have super light sensitivity.she went back to doctor and he decided it is a viral infection since it is flaring again and prescribed her:

steroid drops called prednisolone acetate ophthalmic suspension USP thinking it might be keratitis. that steroid drop is not supposed to be used to treat it, but it reacts badly to keratitis, so prescribing her that was to see how her reaction is, and if reaction is bad they would have a diagnosis)but judging from how she looked at work today those eye drops that were supposed to help clarify their diagnoses only made it more difficult since there was no reaction.

they have also prescribed her:(in order)
1. ? L.... do not know the name, but just to help swelling.before eye got worse, and thought it was something simple.
2.eye quicks
3.? M.... a type of eye gel that you place directly on eye.do not know name.
4. systane eye drops (generic)
5. Steroid drops mentioned above.


i should also mention what makes this case difficult.
her left blind eye functions normally except she cannot see due to the severed optic nerve. her right eye's lacrimal was severed in the surgery she had after the accident her senior year making it impossible to cry or secrete any type of fluid.so its almost impossible to tell if what her symptoms are for both eyes or just one eye, or if she has something that causes puss since you cant tell, because her lacrimal is not working.

she also has continuous headaches after her accident, and is prone to pink eye.

its difficult to decipher what is caused by this new problem or what was already a sustained problem.and a lot of telling factors of what it might be are second guessed due to those preexisting conditions.

the doctors have suggested the following.
Keratitis
Herpes Zoster (shingles)
Ocular herpes

she doesn't exhibit and sores that would suggest herpes so i dunno about the herpes part.
i thought maybe:
map dot fingerprint dystrophy or Fuchs dystrophy. but those are just generic guesses from a helpless friend.

here are the last bits of things i gathered that might sound random but hey, I'm just trying to think outside the box.ha

1.she hasn't changed any makeup, lotions, detergents,or contact solution.
2.she has fake nails (maybe bacteria transfered from fingers to eye when placing contacts in?a weak immune system from fighting off previous cold wasn't able to fight of bacterial and then caused this progressively worse viral infection?)
3.no change in lifestyle whatsoever.

I'm not the best at explaining a lot of things so if you don't understand something please just ask because she needs help.

its a scary thing for such a young girl who is getting married this January to face the fear she might be completely blind before shes 26, or even able to start a family and look at her children's faces, so please if you have any information or need more information feel free to ask. here is my email address:
a_marie_723@yahoo.com

anything could be helpful.

Thank you so much for your time,

Annette

p.s. i haven't been able to visually look at her eye up close yet, but if i do i will mention any abnormalities i see that could possibly help with a diagnosis.

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