Hello doctor,My sister suffered intracranial hypertension six months back and she became blind a few weeks after. A lot was done (lumbar puncture, etc.) to bring back her vision but in vain. Recently she has had VP shunt surgery and there is another plan to do optic nerve sheath fenestration. I would like to ask you whether it is recommended to do optic nerve sheath fenestration a short time after VP shunt surgery was done. Secondly, I have attached the recent visual tests (VEP and optical coherence tomography) reports so that you can help me with interpretation.
Hi. I have seen the scans and the VEP (visual evoked potential) report you have sent (attachment removed to protect patient identity). In the OCT (optical coherence tomography) the optic nerve heads do seem bulged out. Was an MRI done? VP (ventriculoperitoneal) shunt surgery is done to make an alternate drainage path for the CSF (cerebrospinal fluid). An optic nerve sheath fenestration is done to relieve any pressure on the optic nerve due to the raised CSF. Your doctor must have seen some kind of a pressure build-up which could jeopardize the optic nerve further, hence he has planned the fenestration procedure. For more information consult an eye care ophthalmologist online -->