Update: December 2018

Diseases of the optic nerve differ significantly from pathologies of the eye itself (iritis, etc.). In these conditions, the formation and transmission of impulses to the brain is disrupted. Their symptoms can occur in people who have never had problems with color vision or visual acuity. Distinctive feature is also the rapid development and completion acute period. Most often, the visual pathway is affected by an inflammatory process – neuritis.

To understand the symptoms and principles of diagnosis, it is necessary to know the basic anatomy of the eyeball and optic nerve.

Structure of the eye and optic nerve

In order for a person to see something, the light that is reflected from all objects in the surrounding world must reach the receptors of the optic nerve (cones and rods). However, before this, it passes through several structures of the eye. Let's list them, starting with the most superficial:

All these structures are mainly powered by choroid, which is located directly behind the retina. Diseases of the parts of the eye that conduct light develop quite slowly and lead to loss of vision only in late stages. Neuritis occurs much faster and primarily impairs visual function.

To promptly suspect inflammation optic nerve, you should know the most common causes that can lead to this condition

Causes

Optic neuritis can occur only in the presence of another infectious pathology. Therefore, when diagnosing, it is important to look for the presence of the following concomitant (or recent past) diseases in the patient:

• Any inflammatory processes in the eye:

• Injuries to the bones of the orbit or their infection (and periostitis);
• Inflammation of the air sinuses (frontitis, sphenoiditis, etc.);
• Tonsillitis;
• Various chronic infections caused by specific microbes: neurosyphilis, typhus and others;
• Infections of the membranes and tissues of the brain (encephalitis, encephalomyelitis, any and arachnoiditis);
• Inflammatory processes in the oral cavity (caries, periodontitis, etc.), which can also spread along the facial tissue to the optic nerve.

It is very typical for the disease to develop a few days (4-7) after suffering from an acute respiratory viral infection. Therefore, if any symptoms appear optic neuritis, you should consult a doctor.

Symptoms

The first signs of the disease develop unexpectedly and can manifest themselves in different ways - from decreased/loss of vision to pain in the orbital area. Depending on the affected part of the visual pathway and the clinical picture, two forms of neuritis are distinguished:

1. Retrobulbar– the optic tract is affected after exiting the eyeball.
2. Intrabulbar– the inflammatory process has developed in the initial segment of the nerve, which is located within the eye;

It should be noted that symptoms of optic neuritis often occur on only one side.

Symptoms of intrabulbar neuritis

The disease always begins acutely - the first signs appear within 1-2 days and can progress quickly. The greater the damage to the optic nerve, the more more severe symptoms. As a rule, with the intrabulbar form, the following changes can be detected in visual function:

1. The presence of livestock is the most characteristic feature neuritis, in which the patient develops blind spots in the field of vision (mainly in the center). For example, a patient can see with one eye all objects in the environment, with the exception of those that are directly in front of him;
2. Decreased acuity (myopia)– observed in every second patient. More often, myopia is slightly expressed - vision decreases by 0.5-2 diopters. However, if the entire thickness of the nerve is damaged, the eye completely loses vision. Blindness may be reversible or irreversible, depending on the timing of treatment and the aggressiveness of the infection;
3. Twilight vision impairment- eyes healthy person begin to distinguish objects in the dark after 40-60 seconds. In the presence of neuritis, on the affected side, vision adaptation takes at least 3 minutes;
4. Changing color perception– the patient may lose the ability to see some colors. Also, when the nerve is irritated, blurry colored spots may appear in the field of vision.

Intrabulbar neuritis, on average, lasts from 3 to 6 weeks. Its outcome may vary from full recovery functions of the eye to one-sided blindness. The likelihood of an unfavorable outcome can be reduced with adequate and timely therapy.

Symptoms of the retrobulbar form

This neuritis is somewhat less common than the intrabulbar form. Since the nerve lies freely in the cranial cavity (not counting the surrounding tissue), the infection can spread in two directions: along outer surface(peripherally) and internally (axially). The most unfavorable case is when the entire diameter of the optic nerve is affected.

Depending on the location of the infection, the symptoms of the disease will differ:

Type of retrobulbar neuritis	Where is the infection located?	Characteristic symptoms
Axial	At the center of the optic nerve	Severe decrease in visual acuity (by 3-6 diopters). One-sided blindness often occurs; Blind spots (scotomas) in the center of the visual field.
Peripheral	On the outer nerve fibers	Pain in the orbital area, which intensifies when turning the eyes to the sides. Often dull in nature, somewhat reduced after taking NSAIDs (Ketorola, etc.). Completely removed by glucocorticosteroid hormones (Dexamethasone, Hydrocortisone, etc.); Reduction of visual fields from the periphery - “lateral” vision disappears; Visual acuity, as a rule, is completely preserved.
Transversal (transverse)	The inflammatory process develops throughout the entire thickness of the nerve trunk	Combines signs of axial and peripheral types.

Due to the characteristic symptoms, a diagnosis of optic neuritis can be assumed. However, to confirm it it is necessary additional diagnostics, which will clarify the presence of infection and its location.

Diagnostics

Laboratory diagnostic methods are not of fundamental importance in eye diseases. IN clinical analysis blood (CBC), the number of WBC/leukocytes may be increased - more than 9 * 10 9 / liter. It is also possible to accelerate ESR by more than 15 mm/sec. However, these changes only indicate the presence of inflammation and do not indicate its location and cause. Urine, stool and venous blood, as a rule, remain normal.

The most informative are special ophthalmological methods that make it possible to diagnose intrabulbar neuritis in early dates. These include:

• Ophthalmoscopy is a method that does not require special equipment. The examination is performed in a dark room, where the doctor examines the patient's fundus through the pupil using a magnifying lens. Thanks to the method, it is possible to study the initial part of the optic nerve - the optic tract. With neuritis, it will be swollen, hyperemic (reddened), and pinpoint hemorrhages are possible;
• Fluorescein angiography - this method allows you to clarify whether the optic disc is completely or partially affected. During the examination, the patient is injected with a special substance into a vein, which will “illuminate” the vessels in the fundus of the eye, after which the doctor evaluates them using a special device (fundus camera). Angiography is used only in large/private clinics, since the method is quite expensive. The average price is about 3,000 rubles.

The above methods are not informative for retrobulbar neuritis, since it is not the optic disc that is affected, but the section of the nerve after it exits the eye. Changes in the disc are observed only by the 5th week. The diagnosis is made based on complaints and excluding other eye diseases.

How to distinguish toxic neuropathy from neuritis

These two diseases are very similar in symptoms, but differ in treatment tactics and prognosis. To assign effective therapy, should be put correct diagnosis, as soon as possible. To do this, you need to analyze the following nuances:

• Cause of the disease– viruses or microbes always play a major role in the development of neuritis. Toxic neuropathy most often appears due to exposure to methyl alcohol or large amounts of 40-proof alcohol (more than 1.5 liters). Also to possible reasons relate:
  • Poisoning with heavy metals or their salts (lead, antimony, mercury);
  • Overdose/individual intolerance to certain drugs: NSAIDs (Aspirin, Ibuprofen, Ketorolac, etc.), synthetic antibiotics (Sulfadimethoxine, Sulfacetemide) and cardiac glycosides (Digoxin, Strophanthin);
  • Poisoning by vapors of phenol-formaldehyde resins (contained in regular cigarettes and smoking mixtures).
• Eye damage - if neuritis is characterized by a process in one eye, then toxins damage the nerves on both sides;
• Reaction of the pupils - with toxic damage, the muscle located in the iris stops working. Therefore, the pupil in such patients remains dilated, even in bright light;
• Condition of the fundus of the eye and optic nerve– as a rule, ophthalmoscopy does not reveal any abnormalities. Thinning and destruction of the nerve occurs after exiting the eye;
• Effect of treatment– if a diagnosis of neuritis has been made and therapy has been started, it will not have any effect on visual function.

Using the above signs, toxic neuropathy can be identified. Main principle its treatment is the elimination of the damaging factor (alcohol, metal, medicine) and its removal from the body. After this, the work of the nerve and its blood circulation are stimulated with the help of drugs such as Neuromidin, Trental, etc.

In most cases, vision changes become irreversible and the effect of treatment is to improve the general condition.

Treatment

First of all, the cause of the disease – an infection of the optic nerve – should be eliminated. Therapy depends on the microorganism that caused the disease. If it's a virus, an appointment is needed antiviral drugs(Amiksin is recommended), if a microbe is present, an antibiotic is used. Unfortunately, in most cases it is impossible to detect the cause of neuritis. Therefore, all patients are prescribed antibacterial drug, which acts on a large number of different microorganisms. As a rule, this is a combined penicillin (Amoxiclav) or a cephalosporin (Ceftriaxone).

Besides, standard scheme Treatment of optic neuritis includes:

Drug group	Why is it prescribed?	How is it used?	The most common representatives
Glucocorticosteroids	Used to reduce inflammatory reactions: swelling of the nerve/optic disc and damaging processes.	If the patient has retrobulbar neuritis, local injection of hormones is possible - using a special syringe into the tissue behind the eye. In the intrabulbar form, general glucocorticosteroids are predominantly used.	Dexamethasone; Hydrocortisone; Methylprednisol.
Detoxification drugs		Used as intravenous infusions (droppers)	Reopoliglyukin.
Vitamins	Improves metabolism in nerve tissue. Slightly stimulate the transmission of nerve impulses.	In the hospital they are usually used in the form intramuscular injections. On outpatient stage You can use tablet forms.	RR ( a nicotinic acid); B 1 (thiamine); B 6 (pyridoxine); Neurobion is a combination drug.
Medicines that improve microcirculation	Improves nutrition of nervous tissue	They are used mainly after an acute period of illness with a pronounced decrease in visual functions.	Nicergoline; Actovegin.

Also, therapy can be supplemented with drugs that improve impulse transmission along the nerves. These include: Neuromidin, Nivalin, etc. It should be noted that only a neurologist can decide on the need for such treatment.

Besides drug treatment Physiotherapy may be prescribed. The need for it may arise if there is severe visual impairment after an illness. The most common methods are magnetic and electrotherapy, eyes.

Prevention

Since nerve damage occurs only in the presence of other diseases, the only measure to prevent neuritis is timely treatment infections. Special attention should be given eye diseases, which often spread through the surrounding tissues to the nerve trunk or optic disc.

Optic neuritis can lead to irreversible loss of eye function or one-sided blindness. Prevent these conditions with high probability, you can contact your doctor in a timely manner if you suspect characteristic symptoms. IN medical institution, an additional examination will be carried out, which will make it possible to make a final diagnosis. After this, it is assigned complex treatment from several groups of drugs for 4-6 weeks and, if necessary, physiotherapeutic procedures.

(optic neuritis) - damage to the optic nerve inflammatory in nature. Also to this disease include nerve damage in demyelinating diseases. Within the framework of optical neuritis, intra- and retrobulbar neuritis are distinguished, which differ significantly in the ophthalmoscopic picture. General symptoms are: decreased vision and the appearance of scotomas; In some forms, pain in the eye is possible. Ophthalmoscopy plays a primary role in diagnosis. Treatment is based on a combination of anti-edematous, anti-inflammatory, desensitizing, antibacterial or antiviral, immunocorrective, detoxification and metabolic therapy.

ICD-10

H46

General information

The optic nerve (n. opticus) consists of processes (axons) of retinal neurons. The latter perceive the image and transmit information about it in the form of nerve impulses traveling along axons to the cerebral visual centers. Each optic nerve consists of more than 1 million axons. It begins with the optic disc, located on the retina and accessible to ophthalmological examination. The part n located inside the orbit. opticus is called intrabulbar (intraorbital). After leaving the orbit, the optic nerve passes into the cranial cavity, this part is called retrobulbar. In the area of ​​the sella turcica, the optic nerves cross (chiasma), where they partially exchange their fibers. The optic nerves end in the visual centers of the midbrain and diencephalon.

Throughout its entire length, the optic nerve is enveloped in membranes that are closely connected with nearby structures of the orbit and brain, as well as with the cerebral membranes. This determines frequent occurrence Optic neuritis in inflammatory diseases of the orbit, brain and its membranes.

Etiology and pathogenesis of optic neuritis

Among the factors that provoke optic neuritis, the most common are inflammatory processes orbit (periostitis, phlegmon), eyeball (iridocyclitis, retinitis, keratitis, panophthalmitis) and brain (arachnoiditis, meningitis, encephalitis); infectious processes in the nasopharynx (ethmoiditis, sinusitis, frontal sinusitis, chronic tonsillitis, tonsillitis, pharyngitis). The development of optic neuritis can lead to common infections: tuberculosis, malaria, typhus, brucellosis, ARVI, diphtheria, gonorrhea, etc. Other causes include alcoholism, head injury, complicated pregnancy, systemic diseases(gout, collagenosis), blood diseases, diabetes mellitus, autoimmune disorders. Often, optic neuritis manifests itself in multiple sclerosis.

Emergency treatment when optic neuritis occurs due to poisoning methyl alcohol consists of urgent gastric lavage and giving the patient 30% orally ethyl alcohol(vodka). The latter acts as an antidote, displacing methyl alcohol from the body. A single dose is 100g and is administered every 2-3 hours.

If signs of optic nerve atrophy are detected, antispasmodics and drugs to improve microcirculation (nicergoline, pentoxifylline, nicotinamide, nicotinic acid) are additionally recommended. The outcome of both intra- and retrobulbar forms of optic neuritis depends on the type and severity of the lesion. It varies from complete restoration of visual function to the development of atrophy and amaurosis.

ICD-10 code

Optic neuritis

What is Optic Neuritis -

Inflammatory optic nerve disease, accompanied by a decrease in visual functions. A distinction is made between optic neuritis and retrobulbar neuritis. In the first case, the optic nerve head is also involved in the inflammatory process. With retrobulbar neuritis, the inflammatory process is localized mainly behind the eyeball. In this case, the axial bundle of nerve fibers is affected.

What provokes / Causes of Optic Neuritis:

Call:

• inflammatory diseases of the brain and its membranes (meningitis, encephalitis),
• general acute and chronic infections(flu, sore throat, erysipelas, typhus, smallpox, malaria, syphilis, tuberculosis, brucellosis, etc.),
• are common non-communicable diseases(blood diseases, diabetes, gout, nephritis, etc.),
• focal infections (tonsillitis, sinusitis, otitis media, etc.),
• pathological pregnancy,
• alcohol intoxication,
• inflammatory processes in inner shells eyes and socket,
• injury,
• multiple sclerosis.

Pathogenesis (what happens?) During Optic Neuritis:

Inflammatory changes manifest themselves in pinpoint infiltration and cell proliferation. From soft meninges the process passes into the layer of nerve fibers. When inflammation is localized in the optic nerve trunk, it is interstitial in nature. Edema and tissue infiltration occur with the participation of leukocytes, lymphocytes and plasma cells with the further development of neovascularization and connective tissue. Nerve fibers are affected secondarily and may subsequently atrophy. Deterioration in visual function is caused by degeneration of nerve fibers in the area of ​​inflammation. After the process subsides, the functions of some nerve fibers can be restored, which explains the improvement in visual acuity.

Symptoms of Optic Neuritis:

Clinical picture depends on the severity of the inflammatory process. With mild inflammation, the optic disc is moderately hyperemic, its boundaries are unclear, the arteries and veins are somewhat dilated. A more pronounced inflammatory process is accompanied by a sharp hyperemia of the disc, its borders merge with the surrounding retina. White spots appear in the peripapillary zone of the retina and multiple hemorrhages. Usually the disc does not proliferate with neuritis. The exception is cases of neuritis with edema. Characteristic of neuritis early disorder visual functions, expressed in decreased visual acuity and changes in the field of vision. The degree of decrease in visual acuity depends on inflammatory changes in the papillomacular bundle. There is usually a narrowing of the visual field, which may be concentric or more significant in one area. Central and paracentral scotomas appear. Narrowing of the peripheral boundaries of the visual field can be combined with scotomas. Also characteristic is a sharp narrowing of the field of vision to red, and sometimes complete absence color perception. As neuritis transitions to atrophy, the disc turns pale, the arteries narrow, exudate and hemorrhages resolve.

Neuritis of various etiologies may occur with characteristic clinical symptoms. The edematous form of inflammation of the optic nerve is characteristic of relapses neurosyphilis. IN early period In secondary syphilis, neuritis occurs either with mild changes in the disc in the form of hyperemia and blurred boundaries, or in the form of severe papillitis with a sharp decrease in visual functions. A very rare form is papulous neuritis, in which the disc is covered by a massive prominence in vitreous grayish-white exudate.

Tuberculous neuritis manifest themselves in the form of a solitary tubercle of the optic nerve head or ordinary neuritis. The solitary tubercle is a grayish-white tumor-like formation located on the surface of the disc and spreading to the surrounding retina.

Optic neuritis in acute infectious diseases has approximately the same clinical picture.

At retrobulbar neuritis At the onset of the disease, the fundus of the eye can sometimes be normal. More often there is slight hyperemia of the optic nerve head, its boundaries are unclear. These changes can be more pronounced, as with neuritis. IN in rare cases the picture resembles a congestive optic disc. In this case, the disc is enlarged in diameter, its boundaries are not defined, the veins are dilated and tortuous. Retrobulbar neuritis most often develops in one eye. The second eye may become sore some time after the first. Simultaneous disease of both eyes is rare.

By clinical course differentiate acute and chronic retrobulbar neuritis. In the first case, a sharp decrease in visual acuity occurs quickly (within 2-3 days); in the chronic course of the process, visual acuity decreases gradually. Acute retrobulbar neuritis is characterized by pain behind the eyeball and when the eye is pressed into the orbit. Visual acuity after its initial decrease begins to recover after a few days. Only in rare cases does this not happen and the eye remains practically blind.

Usually, with retrobulbar neuritis, a central absolute scotoma is determined in the field of view White color and other colors. At the onset of the disease, scotoma has big sizes, in the future, if visual acuity increases, it decreases, becomes relative and, with a favorable course of the disease, may disappear. In some cases, the central scotoma turns into a paracentral annular scotoma. The disease leads to descending atrophy of the optic disc, most often in the form of temporal blanching of half of the disc due to damage to the papillomacular bundle. If there are changes in the disc, atrophy may be secondary.

Some features during the course have retrobulbar neuritis of toxic origin. One of the most common reasons these neuritis is poisoning with methyl alcohol or liquids containing methyl alcohol. Against the background of general poisoning phenomena (unconscious or coma in severe cases of poisoning, nausea, in milder cases vomiting) after 1-2 days a sharp decrease in visual acuity in both eyes develops, sometimes to the point of complete blindness; At the same time, dilation of the pupils is observed, their reaction to light is weakened or absent. The fundus is normal or marked mild hyperemia optic disc.

In rare cases, a picture of ischemic neuritis is observed - the disc is pale, its borders are blurred, the arteries are sharply narrowed. The further course of the process may be different. During the first month after poisoning, vision may improve. Following this, significant deterioration of vision occurs again, up to blindness. Decreased visual acuity is caused by the development of optic nerve atrophy.

Alcohol and tobacco intoxication causes damage to the papillomacular bundle. Occurs when chronic alcoholism or when smoking strong types of tobacco containing large amounts of nicotine. It is observed more often in men over 30 years of age. The disease occurs as a chronic retrobulbar neuritis, the fundus of the eye is often normal. Mild hyperemia of the optic disc is much less common. A relative central scotoma appears in the field of view with normal peripheral boundaries. It often has the shape of a horizontal oval running from the point of fixation to the blind spot. It is characteristic that when complete refusal from drinking alcohol or smoking, there is an increase in visual acuity and a decrease in scotoma. However, pallor of the temporal half of the optic disc persists.

Retrobulbar neuritis in diabetes mellitus It has chronic course and usually occurs in men. The defeat is almost always bilateral. Visual acuity decreases slowly. Central absolute or relative scotomas appear with normal peripheral boundaries of the visual field. The optic discs are initially normal, but subsequently develop temporal pallor.

Diagnosis of Optic Neuritis:

In typical cases, diagnosis is not difficult. It is more difficult to diagnose mild neuritis without decreased visual function and neuritis with edema. In these cases, it is necessary to differentiate from pseudoneuritis and congestive disc. Pseudoneuritis is characterized by normal visual functions and no changes during follow-up. IN initial stage A congestive disc differs from neuritis by the preservation of visual functions and the presence of partial or complete marginal edema of the optic disc.

The appearance of even single small hemorrhages or exudative foci in the disc tissue or surrounding retina confirms the diagnosis of neuritis. The most accurate way to differentiate these conditions is with fundus fluorescein angiography. It also provides reference data for distinguishing neuritis from a congestive disc. Monitoring the course of the disease is also important. For symptoms indicating an increase intracranial pressure, confirmed spinal tap, the diagnosis leans in favor of a stagnant disc. Most difficult differential diagnosis neuritis from edema and complicated congestive disc, since in both cases visual functions quickly change. Here too, increased intracranial pressure can confirm the diagnosis of stagnant disc.

Retrobulbar neuritis, occurring with inflammatory changes in the optic nerve, is differentiated from neuritis itself on the basis of a discrepancy between the intensity of changes in the disc and visual acuity. A sharp decrease in visual acuity, central scotoma with slight changes in the optic nerve head indicate retrobulbar neuritis.

Treatment of Optic Neuritis:

Urgent hospitalization required. Until the etiology of optic neuritis is clarified, treatment is aimed at suppressing the infection and inflammatory reaction, dehydration, desensitization, improvement of metabolism in the tissues of the central nervous system, immunocorrection.

Antibiotics are prescribed for 5-7 days wide range actions parenterally (do not prescribe drugs that have an ototoxic effect - streptomycin, neomycin, kanamycin, gentamicin - due to their similar action to the optic nerve). Corticosteroids are used in the form of retrobulbar injections of dexamethasone solution 0.4%, 1 ml daily, for a course of 10-15 injections, as well as oral prednisolone, starting at 0.005 g 4 to 6 times a day for 5 days with a gradual dose reduction. Orally Diacarb (acetazolamide) 0.25 g 2-3 times a day (3 days on, 2 days off, at the same time take Panangin 2 tablets 3 times a day), glycerin 1-1.5 g/kg body weight, intramuscular solution of magnesium sulfate 25% 10 ml, intravenous solution of glucose 40%, solution of hexamethylenetetramine 40%, intranasally into the middle nasal passage - tampons with a solution of adrenaline 0.1% daily for 20 minutes (under blood pressure control).

Orally B vitamins, piracetam (nootropil) up to 12 g/day, solcoseryl (Actovegin) intramuscularly, 10 mg (>/2 tablets) of dibazole 2 times a day are prescribed orally for 2-3 months. After clarifying the etiology of optic neuritis, treatment is carried out aimed at eliminating the cause of the disease ( specific treatment tuberculosis, antiviral and immunocorrective therapy of herpes, surgery sinusitis, etc.). The same treatment, with the exception of the prescription of antibiotics, is carried out for bilateral toxic retrobulbar neuropathy resulting from poisoning with methyl alcohol or its derivatives.

Emergency treatment in such cases includes detoxification measures - ingestion of a 30% ethyl alcohol solution in a single dose of 90-100 ml, followed by repeating a half dose every 2 hours (can be administered through a tube or a 5% solution intravenously); use of 4% sodium bicarbonate (baking soda) solution for gastric lavage and other routine measures to help with acute poisoning. The duration of the disease is about 4 weeks; there is no direct relationship between the severity of ophthalmoscopic changes in the optic nerve head and visual impairment.

Papillitis usually occurs acutely, the process is often one-sided. Retrobulbar optic neuritis can be acute, unilateral, or chronic bilateral, with one eye first becoming ill, and after a few weeks or months the other (a typical course against the background of optochiasmal leptomeningitis). Pallor of the temporal half of the disc becomes noticeable in the 3rd week of the disease. The outcome of optic neuritis can be complete recovery and restoration of visual functions, but more often there is partial (possibly complete) atrophy of the optic nerve.

Which doctors should you contact if you have Optic Neuritis:

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Other diseases from the group Diseases of the eye and its adnexa:

Orbital abscess

Adenoviral conjunctivitis

Albinism

Amblyopia is binocular

Amblyopia hysterical

Amblyopia obscuration

Retinal angiomatosis

Optic nerve development abnormalities

Accommodative asthenopia

Muscular asthenopia

Optic atrophy

Afakia

Blepharitis

Blepharochalasis

Myopia

Bourneville disease

Sjögren's disease

Internal stye

Inflammatory diseases of the choroid (uveitis)

Eversion of the lower eyelid, ectropion

Hemianopsia

Hemophthalmos

Herpes eyes

Herpetic eye lesions (herpetic keratitis)

Herpetic conjunctivitis

Heterophoria

Hypertension, eye manifestations

Hypofunction of the lacrimal glands

Glaucoma

Glaucomocyclic crises

Optic nerve glioma

Dacryoadenitis

Dacryocystitis

Retinal pigmentary degeneration

A sharp decrease in vision is a reason to visit not only an ophthalmologist, but also a neurology specialist.

Eye diseases are usually accompanied by a gradual loss of the ability to see.

Therefore, when suffering from optic neuritis, symptoms and treatment should be taken very seriously.

Rapid deterioration of vision may indicate concomitant neurological pathology, in particular, optic neuritis - inflammation leading to changes in the structure of the nervous tissue.

Neuritis can appear at any age, but is more often detected in people under 50 years of age. A common feature considered to be rapidly developing vision loss.

The following symptoms of optic neuritis are considered characteristic:

• Sensation of a “grid” before the eyes
• Yellowish tint of protein
• Impaired color vision
• Blind Spots
• Decreased vision experienced in hot weather
• Pain in the eyes
• Twilight vision disorder
• Changes in field of view

Types of optic neuritis

Depending on which part of the optic nerve is inflamed, the following types neuritis:

• Papillitis– damage to the intraocular segment of the optic nerve. It stands out as a special variety. With ophthalmoscopy, this area is clearly visible, unlike other parts.

The disease progresses rapidly. Observed sharp deterioration vision, changes in visual fields and color perception. Main symptom– decreased vision from the blind spot stage to loss of the ability to see. On examination, swelling and infiltrates in the retinal area and dilated vessels are observed.

• At retrobulbar neuritis inflammatory processes develop in other parts of the nerve.

On examination, obvious violations are often not observed. Patients complain of dull ache when moving the eyeball, loss of areas of the visual field.

Additional information about this type of disease is contained in the video:

The identification of these types based on topographical criteria is conditional, since inflammation can also affect neighboring parts of the optic nerve. There are different forms of neuritis according to the depth of location of the inflammatory focus:

• Perineuritis- inflammation that affects the optic nerve sheath.
• Axial neuritis– inflammation of the macular area.
• Total form– inflammation of all layers.

Causes of neuritis

The mechanism of development of this disease is not entirely clear to modern scientists. Provoking factors include the following:

• Infectious diseases (influenza, measles, meningitis, encephalitis)
• Systemic diseases ( diabetes, multiple sclerosis, blood diseases, kidney diseases)
• Inflammatory diseases eye
• Chronic course of sinusitis, periodontitis
• Excessive use of alcohol and tobacco
• Nutrient deficiencies
• Poisoning harmful substances(lead, methanol)
• Tumor metastases
• Insect bites

Diagnostics

Diagnosis is difficult when it is necessary to distinguish neuritis occurring in mild form, without severe visual impairment, from other eye diseases. One of the signs of neuritis is pain syndrome when moving eyeballs. Diagnostics is carried out using the following methods:

1. Ophthalmoscopy

2. Pupil tests for light reaction

3. Perimetry

4. EFI eyes

6. Brain MRI

Optic neuritis. Treatment

Treatment is usually carried out inpatiently. Until the causes of the disease are clarified, the following drugs are prescribed:

• Antibiotics to suppress infection
• Dehydration aids
• Detoxification drugs
• Anti-inflammatory drugs
• Vitamin therapy
• Preparations to improve microcirculation
• Remedies for reducing hypersensitivity

After clarifying the origin of the disease, a course of treatment is carried out aimed at eliminating the cause of the disease. In some cases, decompression of the optic nerve sheath is indicated - opening it up in order to reduce pressure in the nerve.

Optic neuritis. Treatment with traditional methods

The use of traditional medicine is possible with the consent of the attending physician. Self-medication is unacceptable: optic neuritis can result in complete and irreversible loss of vision. Facilities plant origin good as additional measures.

1. You will need one tablespoon dried nettle per glass of water. Bring to a boil, leave for an hour, then drink a little before meals.

2. Squeeze the juice from fresh leaves aloe, add boiled water in a ratio of one part to five. Use as lotions.

3. Pine cones have a healing effect. They improve the condition of blood vessels and stop the destruction of brain cells.

To prepare the syrup you will need a glass of green cones. Grind them, pour 2-3 liters of water. Add 4-5 tablespoons of fragrant rue, chopped lemon and sugar in the amount of 200-250 g. Keep on fire for about 30 minutes, then filter. Drink one spoon of syrup three times a day before meals.

4. Fresh milk contains a variety of nutrients: vitamins, amino acids, microelements, fatty acid. ethnoscience Recommends the use of fresh natural milk for neuritis.

5. Raspberries have anti-inflammatory and antipyretic properties. Pour 200-250 g of berries with a liter of water, bring to a boil and leave for two hours. Then you need to strain and take three times a day.

Prevention

Preventive measures are aimed at maintaining healthy condition body:

• Prevent and promptly treat ENT diseases, caries
• Give up bad habits
• Contact a neurologist if you have alarming symptoms
• Avoid hazardous situations

Optic neuritis may resolve on its own within a week or a few days.

However, there is a risk of death of optic nerve fibers, and, as a result, deterioration or loss of visual function. Therefore, at the first signs of decreased vision, you should immediately contact a specialist.