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    Suggest treatment for blurred vision and joint pain

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Posted on Wed, 12 Jul 2017 in Headache and Migraines
Question: Episodes of blurred vision, joint pain. Also episodes of foggy head, like it is encased in lead.
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Answered by Dr. Dariush Saghafi 1 hour later
Brief Answer:
Referral to Rheumatologist

Detailed Answer:
Good evening.

I've reviewed your questions/concerns and the fact that you were started but then, stopped from Lexapro due to side effects.

The one would best be able to tell you why they wanted to send you to a rheumatologist for your symptoms would be the referring doctor but if I were to take a guess then, I might say they were concerned for some type of vasculitic disease or process or arthritic though blurred vision doesn't quite go with the latter too well. Vasculitis is an inflammation or swelling of arteries in some part of the body. In this case since your symptoms are blurred vision and feeling heavy and foggy in the head then, the inflammation would be implied to be in the head which would include things such as Temporal Arteritis, perhaps optic neuritis, optic neuropathy, cerebritis or CNS Lupus......these are the things that come to mind.

When you throw in joint pain then, some other things work their way into the differential but essentially just about all those things could be ruled out with a few simple blood tests including a CBC with differential, ESR, CRP, Rheumatoid Factor, and Lupus anticoagulant.

However, I'm not sure I would think right away along those lines without doing more of a workup of the symptoms to see first if you may not be suffering from some type of headache syndrome given the anxiety, agitation, and blurred vision you are reporting with this heavy feeling in the head....could be one way to describe a mild to moderate stress cephalalgia or headache. I definitely don't believe you have Temporal arteritis since you are very young for that diagnosis and lupus is not as likely since you're gender is masculine and Lupus is mostly found in females.

Also, you could be having eye troubles primarily.

Therefore, from my perspective and before working you up fully from a rheumatological perspective I would probably send you to an ophthalmologist to do a very good evaluation of your eyes. I'd make sure there is no evidence of increased pressure inside the eyeball (glaucoma), swelling of the eye itself (uveitis), and check your visual acuties to make sure you're not reduced in your vision suddenly or for no good reason. Once that's ruled out then, I might look at your symptoms from a neurological point of view to see if you might not be suffering from some type of headache syndrome like migraines or very bad tension type headaches.

Finally, if all those workups yield nothing THEN, I'd send you on to the rheumatologist.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Cheers out to Elkhorn.....isn't that considered to be the RV capital of the world? I also recall going either to Elkhorn or close by to the Rugby fields to watch my son compete with his university team a couple of years ago....boy the weather was horrible that weekend...it was winter and bone chilling. They actually canceled the 2nd day of the tournament because it reached 9 below zero and the fields were just covered in ice and they were worried about concussions and other bone breaking injuries...not to mention the frostbite!

Tally Ho!

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2474 Questions

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