NANOSNET

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish

Normal optic nerve , visual fields and nystagmus in primary and all gazes

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish

Normal optic nerve , visual fields and nystagmus in primary and all gazes

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish

Normal optic nerve , visual fields and nystagmus in primary and all gazes

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish

Normal optic nerve , visual fields and nystagmus in primary and all gazes

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish

Normal optic nerve , visual fields and nystagmus in primary and all gazes

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish

Normal optic nerve , visual fields and nystagmus in primary and all gazes

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish

Normal optic nerve , visual fields and nystagmus in primary and all gazes

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish

Normal optic nerve , visual fields and nystagmus in primary and all gazes

Hello all

I have a 25 YO on long term medications for depression/ bipolar disease, most recently Lithium, lamotrigene and pregabalin, on Vyvanse for ADHD. He has many visual phenomena but is in academics and notes that he "cannot focus out of both eyes to continue to read on the computer or books". HJe has had to quit his position from this. Describes images overlap, feels his eyes move, and sees shadows to objects, colors are like "neon".

Labs for  lithium and LTG levels normal, no recent changes to med dosages. We got GAD 65, paraneoplastic serum panels negative, MR brain WWO normal. Trailed Klonopin with no benefit. Exam with high frequency nystagmus in primary and all gaze, likely accoiunting for visual distortion, least in downgaze, does not have an upbeat or dowbeat pattern that I can discern at the slit lamp.

1. While I think this is all likley from his multiple psych meds, is there a role in CSF testing? 
2. There was a remote use of Ketamine x 2 months approx 2-3 yrs ago, could that cause his visuo-perceptual issues?
3. Any other meds you might try?

Thank you,

Shruthi Harish