Optic neuritis is characterized by fast (for hours - several days) and often reversible loss of vision to one or both eyes.
Frequency. Women are more likely to fall ill from the age of 18 to 50 years.
Classification. Depending on the location of the pathological focus in the course of the optic nerve, there are: retrobulbar neuritis (the process is localized behind the eyeball in orbit) and intracranial.
Optic neuritis - causes
Along with unknown (idiopathic) variants, neuritis of the optic nerve is found in multiple sclerosis, viral infections (measles, chicken pox, shingles, mumps, mononucleosis), other infections of the nervous system (syphilis, tuberculosis, cryptococcosis, sarcoidosis), including fungal infections.
Symptoms of optic neuritis
Within a few hours or days, a decrease in visual acuity develops on one or both eyes, the perception of light intensity and color vision decreases, central and paracentral scotomes are possible. There is a pain in the area of the orbit and the brow, intensifying with the movement of the eye. The direct reaction of the pupil to light is weakened, and the friendly photoreaction somewhat widens (the pupil of Marcus Hunn).
Optic neuritis - Diagnosis
Diagnosis of typical cases is not difficult, it is somewhat more difficult to determine easily occurring neuritis. In these cases, it becomes necessary to differentiate them from a pseudo-inertia or a stagnant disc.
The diagnosis of neuritis is confirmed by single small hemorrhages or exudative foci in the tissue of the disc or the surrounding retina. The most accurate picture is given by fluorescence angiography of the fundus. The fall in visual acuity and central scotoma with minor disc changes unambiguously indicate the development of retrobulbar neuritis. It is important and monitoring the course of the disease.
Optic neuritis - Types of the disease
There are 2 main forms of the disease:
- mononeuritis, in which only one peripheral nerve is affected (facial, ocular, ray, etc.);
- Polyneuritis, characterized by inflammation of several nerves simultaneously.
Depending on the variety of the nerve involved in the pathological process, neuritis of the facial, auditory, ulnar, glossopharyngeal, oculomotor, tibia, sciatic, femoral, diaphragmatic and other nerves is distinguished.
Optic neuritis - Patient's actions
Consultations of an ophthalmologist, a neurologist, a neurologist are recommended.
Treatment of optic neuritis
Antibiotics, antiviral drugs that improve microcirculation (nicotinic acid, pentoxifylline), topical administration of hydrocortisone, prednisolone 1 mg / kg / day. for 2 weeks, then reduced for 1-2 weeks. Pulseraphy methylprednisolone is often performed: 30 mg / kg intravenously for 30 min every 6 h (total 12 doses), followed by a switch to oral prednisolone at 1-2 weeks. Complex therapy with vitamin B (milgamma and others) is carried out.
Current and forecast. The visual function usually begins to recover through 2-3 weeks. from the debut of the disease and a few months later returns to normal.
Optic neuritis - Complications
In 75% of women and 34% of men with optic neuritis in history, multiple sclerosis develops in the long-term period.
Prevention of optic neuritis
Prevention of neuritis of the optic nerve, which would reliably prevent the development of this disease, is currently absent. However, it is recommended to adhere to the following rules:
- timely treatment of foci of chronic infection in the ENT organs;
- in a timely manner, consult a neurologist when any complaints occur;
- immediately contact the ophthalmologist with the slightest reduction in visual acuity or other eye symptoms;
- avoid traumatic damage to the eyeball, etc.