Optic nerve and neuritis

Optic nerve and neuritis

Neuritis is a condition in which inflammation causes swelling and damage to the optic nerve. The optic nerve is a plexus of nerve fibers that transmit information from the organ of vision in the form of impulses to the cerebral visual center. If this connection is broken, vision falls.

Signs and symptoms of optic neuritis, in which you should consult an ophthalmologist:

  • Decreased visual functions;
  • Narrowing of peripheral vision;
  • The appearance of livestock (spots) in the field of view;
  • Decreased color perception, difficulty distinguishing red, green, blue shades;
  • Problems adapting to changes in lighting;
  • Pain and discomfort with eye movements.

Causes: what diseases can lead to the development of optic neuritis?

  • Diabetes;
  • Alcohol poisoning;
  • Autoimmune diseases (eg, systemic lupus erythematosus, Sj√∂gren ‘s syndrome );
  • Inflammation of the brain (encephalitis, meningitis);
  • Chronic infections in the acute phase (Lyme disease, tuberculosis, syphilis, influenza);
  • Ophthalmic inflammatory and non-inflammatory diseases (glaucoma, iridocyclitis, keratitis, retinitis, uveitis);
  • Diseases of the upper respiratory tract (sinusitis, chronic tonsillitis, pharyngitis, tonsillitis);
  • Demyelinating diseases (multiple sclerosis).

Types of optic neuritis

Depending on the localization of the inflammatory process, two types of optic neuritis are distinguished: intrabulbar and retrobulbar. Depending on whether the lesion is unilateral or not, there are:

  • Mononeuritis;
  • Polyneuritis.

In order to understand the difference, let’s look at the structure of the optic nerve. It consists of the following parts:

  • Intraocular ( intrabulbar ) – the optic disc, in which the optical fibers of the retina and blood vessels converge;
  • Orbital (retrobulbar), that is, located behind the eye;
  • intratubular ;
  • Intracranial ( intracranial ), passing into the optic chiasm of both eyes.

Neuritis classification:

  • Intraocular neuritis, or papillitis – stagnation (inflammation) of the optic nerve head. This form is characterized by an acute deterioration and a rapid drop in vision, as well as the occurrence of headaches and eye pain. If left untreated, there is a risk of developing nerve atrophy and complete loss of vision;
  • Retrobulbar neuritis is an inflammation of the area of the nerve located between the eyeball and the chiasm. It can occur in acute and chronic form. It is divided into axial (when the pathology captures the central bundle of fibers, peripheral (in the sheaths of the nerve with spread deep into structures, fluid formation) and transversal – affecting all layers.

Diagnosis and treatment of optic neuritis

If the pathology is not detected in time and measures are not taken, the consequences can be irreversible: inflammation will become chronic with frequent exacerbations, optic nerve atrophy and loss of vision may develop.

An unequivocal conclusion about the presence of signs of neuritis can only be made by a doctor after an ophthalmological examination and additional examinations.

First of all, the ophthalmologist or neurologist must make sure that the patient has no concomitant diseases, find out what medications he takes on an ongoing basis, and also carry out standard procedures:

  • Visometry – checking visual acuity according to the table;
  • Computer refractometry to assess refractive errors;
  • Fluorescent angiography of the fundus vessels to detect circulatory disorders, hemorrhages and exudation;
  • Test for eye mobility in different directions;
  • Perimetry – assessment of changes in peripheral vision;
  • Ocular tonometry – measurement of intraocular pressure (IOP);
  • Direct ophthalmoscopy.

The examination may additionally include an electrophysiological method (registration of visual evoked potentials, VEP), which allows using special stimuli to assess the performance of the organ of vision and understand how the brain perceives and reacts to images. To find out the cause of the development of neuritis, an MRI of the brain, taking blood cultures, and consulting a neurologist and rheumatologist are sometimes required.

Optic neuritis is treated with conservative methods, therapy is aimed primarily at stopping the infection and reducing swelling. Typically, if the cause of inflammation is a bacterial infection, treatment for neuritis involves the use of broad-spectrum antibiotics. To relieve swelling and inflammation, use glucocorticosteroids .

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