It includes the inflammatory and demyelinating disorders of the optic nerve.
Etiology :
Idiopathic
Hereditary : Leber's disease
Demyelinating disorders: multiple sclerosis, neuromyelitis optica
Parainfectious :
Mumps, measles, chicken pox, whooping cough and glandular fever
Infectious :
Acute ethmoiditis, syphilis,
Toxic :
Anatomical types :
Papillitis- involvement of optic disc
Neuroretinitis - combined involvement of optic disc and surrounding retina in the macular area
Retrobulbar neuritis - involvement of optic nerve behind the eye ball
Symptoms :
Visual loss - sudden , progressive and profound visual loss
Dark adaptation - lowered
Impairment of colour vision
Impairment of depth perception (Pulfrich's phenomenon)
Pain - mild dull eyeache
Movement phosphenes
Episodic transient obscuration of vision (Uhthoff's symptom)
Signs :
Reduced visual acuity
Impaired colour vision
Marcus Gunn pupil - RAPD
Contrast sensitivity
reduced
Visually evoked response reduced
Ophthalmoscopic features : disc become oedematous and physiological cup is obliterated
Visual field changes : central or centrocaecal scotoma
Treatment :
Corticosteroid therapy may shorten the period of visual loss.
Oral prednisolone therapy alone is contraindicated in the treatment of acute optic neuritis.
Brain MRI scan - If the brain shows lesions supportive of multiple sclerosis, immediate intravenous methyl prednisolone (1 gm daily) for 3 days followed by oral prednisolone (1mg/kg/day) for 11 days.
Indications of intravenous methyl prednisolone in patient with normal MRI :
Visual loss in both eyes
When Only good eye is affected.
When slow progressive visual loss continue to occur.
ReplyDeleteMy husband was diagnosed with early onset Parkinson's disease at 57.his symptoms were shuffling of feet,slurred speech, low volume speech, degradation of hand writing, horrible driving skills, right arm held at 45 degree angle, things were tough for me, but now he finally free from the disease with the help of total cure ultimate health home, he now walks properly and all symptoms has reversed, he had trouble with balance especially at night, getting into the shower and exiting it is difficult,getting into bed is also another thing he finds impossible.we had to find a better solution for his condition which has really helped him a lot,the biggest helped we had was ultimatehealthhome they walked us through the proper steps,am highly recommended this ultimatehealthhome@gmail.com to anyone who needs help.