Optic nerve disease symptoms and treatment. Causes and symptoms of eye nerve inflammation. Retrobulbar descending optic neuritis

Neuritis optic nerve- an inflammatory disease that affects the fibers of the optic nerve. Inflammation affects both the tissue and the nerve sheath. Usually this disease progresses against the background of neurological diseases, in which destruction of the fibers responsible for proper conduction is observed nerve impulses.

Because of inflammatory process mechanical fibers are compressed, as a result of which they cease to fully receive the necessary nutrients and die. In the place where the fiber died, it grows connective tissue, and the optic nerve gradually atrophies. If, when the first symptoms of the disease appear, it is not fully treated, then visual function will gradually decrease, up to complete blindness.

There are two types of optic neuritis:

• simple neuritis. In this case, the inflammation affects only the optic nerve head. On nearby tissues it is not distributed;
• retrobulbar optic neuritis. Inflammation affects nerve fibers located behind eyeball. Retrobulbar optic neuritis is diagnosed more often.

This type of neuritis usually affects one eye first, and after a week the inflammation spreads to the second. There are two variants of the course of the pathological process - acute and chronic. At acute version a person loses vision in a maximum of three days; with chronic vision, visual function is lost slowly.

Etiology

There are quite a few reasons that could provoke the progression of optic neuritis. It is worth noting that damage to the nerve disc is one of the signs of the presence of neurological pathologies in the body.

• inflammatory diseases affecting the brain;
• the presence of other ailments;
• infectious diseases with chronic course– , sore throat, etc.;
• complicated pregnancy;
• ailments non-infectious– blood pathologies, etc.;
• progression ;
• intoxication of the body narcotic substances, alcohol;
• inflammation inside the eye shell;
• eye injuries varying degrees gravity ( common reason development of the disease);
• the presence of benign and malignant neoplasms in the body.

Symptoms

The clinical picture changes as optic neuritis progresses. On early stage The disease shows only slight redness of the nerve disc, and its contours become less clear. Feeding him blood vessels increase in size. If the inflammation is not eliminated at this stage, pathological exudate will begin to be released, permeating the disc. As a result, its tissues will swell. The vitreous body becomes cloudy and the hyperemia of the disc itself increases. Later, plasmorrhages and hemorrhages appear on it and in the peripapillary sections.

Symptoms can appear either abruptly or gradually (it all depends on the course of the disease). It is worth noting that the first sign of optic neuritis is a decrease in visual acuity. Later the following symptoms appear:

• pain when moving the eyeball. As the pathology progresses pain syndrome can occur even in a state of complete rest;
• decreased perception of colors;
• headache;
• a person has twilight vision (a characteristic symptom);
• hyperthermia;
• range peripheral vision significantly reduced;
• a symptom such as nausea is not always observed;
• visual function decreases after taking a shower, visiting a sauna or bathhouse, etc.;
• There is a blind spot in the center of the visual field.

Diagnostic measures

When at least one of the specified symptoms, you should visit immediately medical institution to carry out diagnostics, confirm or refute the diagnosis, as well as establish the true cause that triggered the progression of the disease. A standard diagnostic plan includes the following:

• ophthalmological examination;
• reaction of the pupils to light (the pupil in the affected eye practically does not react to a light stimulus);
• examination of the disc in the fundus using an ophthalmoscope;
• electrophysiological study;
• Brain MRI.

Sometimes a consultation with specialized specialists is prescribed to accurately confirm the diagnosis and establish the real reason progression of the disease.

Treatment

Optic neuritis requires treatment in a hospital setting so that doctors can monitor the patient’s condition. The main method of treatment is medication. Its main goal is to eliminate the inflammatory process, as well as suppress the pathogenic activity of infectious agents. To treat optic neuritis, doctors prescribe:

• corticosteroids;
• anti-inflammatory drugs. Release form: drops, ointments, tablets. It is possible to prescribe injections;
• antibiotics. As a rule, preference is given to broad-spectrum drugs;
• medicines, which have a positive effect on blood microcirculation;
• prednisolone.

In difficult clinical situations they resort to surgical technique treatment. The surgeon performs decompression of the optic nerve sheath - opens its membranes, thereby reducing the pressure in the nerve caused by inflammatory edema. As a rule, in this case, the symptoms of the pathology disappear very quickly. The prognosis is positive.

Treatment of pathology folk remedies it is inappropriate to carry out, especially when acute form. The lack of adequate and timely therapy can cause not only a decrease in visual function, but also complete blindness. Therefore, any folk remedies for treating neuritis at home should be excluded.

It is worth noting that in the case of complete treatment of the disease, the prognosis is quite optimistic. Usually vision is gradually restored over the course of one month, but full recovery occurs only after a few months. After therapy, the patient should be periodically examined by his attending physician to eliminate the risk of relapse.

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Diseases with similar symptoms:

Retrobulbar neuritis is an inflammatory disease that develops as a result of damage nerve fibers eyeball. Characterized by a gradual decrease in visual function. Clinicians also believe this disease one of the first manifestations of multiple sclerosis. Retrobulbar neuritis usually “attacks” people from age category from 25 to 35 years.

Unfortunately, no person is immune from the development of inflammation in the eye. Any such illness causes inconvenience and anxiety. But what to do if vision in one eye suddenly disappears? Can it be returned? Which specialist treats the pathology? It's worth looking into in detail.

What kind of disease is this?

Neuritis called an inflammatory process that occurs acutely and damages nerve fibers.

Experts identify 2 main forms of the disease :

• Intrabulbar: inflammation is localized in the initial part of the nerve that does not extend beyond the eyeball.
• Retrobulbar: pathology affects the visual pathways outside the eye.

Causes

Optic neuritis can occur for the following reasons:

• Any eye inflammation: iridocyclitis, uveitis, chorioditis, etc.
• Receiving injuries to the bones of the orbit or their infection (osteomyelitis, periostitis);
• Diseases of the nasal sinuses (sinusitis, sinusitis);
• Development of specific infectious diseases: gonorrhea, neurosyphilis, diphtheria;
• Inflammatory processes in the brain (encephalitis, meningitis);
• Multiple sclerosis;
• Dental diseases (caries, periodontitis).

ICD-10 code

In the international classification of diseases, experts encrypt pathology as H46 " Optic neuritis."

Symptoms and signs

The disease manifests itself quickly and unexpectedly. The disease is characterized by unilateral damage, so most often patients complain of symptoms appearing in only 1 eye. Manifestations of the disease largely depend on the amount of damage: the more it is affected by inflammation, the brighter and stronger the symptoms.

Depending on what form of the disease has developed in the patient, its symptoms may appear in varying degrees: from the appearance of pain inside the eye to sudden loss of vision.

• Symptoms of the intrabulbar form

The first manifestations appear already on days 1-2, after which their rapid progression is noted. Patients notice the appearance of visual field defects, in which blind spots form in the center of the image. Moreover, patients' visual acuity decreases in the form of myopia or even blindness occurs in 1 eye. IN the latter case it can become irreversible: the prognosis depends on the start of therapy and the aggressive properties of the pathogen.

A person most often begins to notice deterioration of vision in the dark: it takes at least 40 seconds to get used to the absence of light and begin to distinguish objects, and about 3 minutes on the affected side. Color perception changes, causing patients to be unable to distinguish certain colors.

On average, intrabulbar neuritis lasts about 3-6 weeks.

• Symptoms of the retrobulbar form

Occurs much less frequently compared to the other form. Its main manifestation is considered to be loss of vision or its noticeable decrease. The disease is characterized by headaches, weakness, and increased body temperature.

In addition, central blind spots and decreased peripheral vision may occur. Patients often complain of pain “inside the eye,” in the eyebrow area.

On average, retrobulbar neuritis lasts about 5-6 weeks.

Diagnostics

Methods used to make a diagnosis:

• – is the main procedure of the ophthalmologist, which allows you to examine the fundus of the eye. With optic neuritis, the color of the disc is hyperemic, its swelling, as well as foci of hemorrhage, may be observed.
• FA (fluorescein angiography): used to clarify the damage to the optic disc: the degree of damage to the nerve by the inflammatory process is revealed. The patient is injected intravenously with a certain substance that “illuminates” the vessels in the retina. The ophthalmologist then uses a fundus camera to assess their condition.

For the retrobulbar form, these methods are not considered informative! The disc begins to change color only after 5 weeks. Therefore, the main diagnosis is the collection of complaints and the exclusion of similar diseases.

Treatment

The goal of therapy is to eliminate infectious agent. At viral infection specialist prescribes antiviral drugs(Amiksin), and for bacterial infections - antibiotics.

In a real situation, it is not possible to establish the cause of the disease, so the doctor prescribes to all patients suffering from optic neuritis, antibacterial agents wide range actions ( Penicillin group, Cephalosporins).

• Glucocorticosteroid drugs: . They excellently reduce inflammatory reactions and swelling of the optic disc. Most often, hormones are administered as a parabulbar injection (into the tissue of the eye).
• Detoxification agents: Reopoliglyukin, Hemodez. The specialist prescribes intravenous infusions.
• Vitamins of group B, PP. They are necessary for improvement metabolic process V nerve tissue. The medication is administered intramuscularly.
• Medicines to improve microcirculation– Actovegin, Trental. They help normalize the nutrition of nervous tissue and are necessary in case of significant visual impairment and the appearance of visual field defects.
• Medicines to restore nerve impulse transmission: Nivalin, Neuromidin.

Treatment is carried out by an ophthalmologist together with a neurologist. In addition, in case of significant impairment of visual acuity or visual field defect, physiotherapy is prescribed: electro- and magnetic therapy, laser stimulation of the eye.

Prevention

Inflammation in the optic nerve is a consequence of other diseases. Therefore, the only measure to prevent the pathological process is timely treatment infectious focus in the body.

Development deserves special attention eye diseases, the pathogen of which is capable of spreading through tissues to the optic nerve.

Forecast

In many ways, the outcome of the pathology depends on when the disease was identified by a specialist and anti-inflammatory therapy was started, as well as on the course of the disease. A quarter of patients experience a relapse of optic neuritis, and the pathology can be localized in any eye.

Most often, vision returns spontaneously after 2-3 months. Only in 3% of patients it did not recover completely and is less than 0.1.

Optic neuritis is a serious and dangerous disease, requiring long and timely treatment. The sooner the patient receives therapy, the greater his chances of regaining vision and getting rid of visual field defects.

Video:

(optic neuropathy) - partial or complete destruction of the nerve fibers that transmit visual stimuli from the retina to the brain. Optic nerve atrophy leads to decreased or complete loss of vision, narrowing of visual fields, impaired color vision, and pallor of the optic disc. The diagnosis of optic atrophy is made when identifying characteristic features diseases using ophthalmoscopy, perimetry, color testing, determination of visual acuity, craniography, CT and MRI of the brain, B-scanning ultrasound of the eye, angiography of retinal vessels, study of visual EP, etc. For optic nerve atrophy, treatment is aimed at eliminating the pathology that led to this complication.

ICD-10

H47.2

General information

Various diseases of the optic nerve in ophthalmology occur in 1-1.5% of cases; of these, 19 to 26% lead to complete atrophy of the optic nerve and incurable blindness. Pathomorphological changes in optic nerve atrophy are characterized by destruction of axons of retinal ganglion cells with their glial-connective tissue transformation, obliteration of the capillary network of the optic nerve and its thinning. Optic nerve atrophy can be a consequence of a large number of diseases that occur with inflammation, compression, swelling, damage to nerve fibers or damage to the blood vessels of the eye.

Causes of optic nerve atrophy

Factors leading to optic nerve atrophy may include eye diseases, central nervous system lesions, mechanical damage, intoxication, general, infectious, autoimmune diseases, etc.

The causes of damage and subsequent atrophy of the optic nerve are often various ophthalmopathologies: glaucoma, pigmentary dystrophy retina, occlusion of the central retinal artery, myopia, uveitis, retinitis, optic neuritis, etc. The danger of damage to the optic nerve may be associated with tumors and diseases of the orbit: meningioma and glioma of the optic nerve, neuroma, neurofibroma, primary cancer orbits, osteosarcoma, local orbital vasculitis, sarcoidosis, etc.

Among diseases of the central nervous system, the leading role is played by tumors of the pituitary gland and posterior cranial fossa, compression of the area of ​​the optic chiasm, purulent inflammatory diseases(brain abscess, encephalitis, meningitis), multiple sclerosis, traumatic brain injury and damage to the facial skeleton, accompanied by injury to the optic nerve.

Often optic nerve atrophy is preceded by hypertension, atherosclerosis, starvation, vitamin deficiency, intoxication (poisoning with alcohol substitutes, nicotine, chlorophos, medicinal substances), large simultaneous blood loss (usually with uterine and gastrointestinal bleeding), diabetes mellitus, anemia. Degenerative processes in the optic nerve can develop with antiphospholipid syndrome, systemic lupus erythematosus, Wegener's granulomatosis, Behcet's disease, Horton's disease.

Congenital atrophies optic nerve are found in acrocephaly (tower-shaped skull), micro- and macrocephaly, craniofacial dysostosis (Crouzon's disease), hereditary syndromes. In 20% of cases, the etiology of optic nerve atrophy remains unclear.

Classification

Optic nerve atrophy can be hereditary or non-hereditary (acquired). Hereditary forms of optic atrophy include autosomal dominant, autosomal recessive and mitochondrial. The autosomal dominant form may be severe and mild course, sometimes combined with congenital deafness. An autosomal recessive form of optic nerve atrophy occurs in patients with Wehr, Wolfram, Bourneville, Jensen, Rosenberg-Chattorian, and Kenny-Coffey syndromes. The mitochondrial form is observed when there is a mutation in mitochondrial DNA and accompanies Leber's disease.

Acquired optic nerve atrophy, depending on etiological factors, can be primary, secondary and glaucomatous in nature. Development mechanism primary atrophy associated with compression of peripheral neurons visual pathway; The optic disc is not changed, its boundaries remain clear. In the pathogenesis of secondary atrophy, swelling of the optic disc occurs, caused by a pathological process in the retina or the optic nerve itself. The replacement of nerve fibers by neuroglia is more pronounced; The optic disc increases in diameter and loses its clear boundaries. The development of glaucomatous optic nerve atrophy is caused by the collapse of the lamina cribrosa of the sclera against the background of increased intraocular pressure.

Based on the degree of color change of the optic nerve head, initial, partial (incomplete) and complete atrophy are distinguished. The initial degree of atrophy is characterized by slight blanching of the optic disc while maintaining the normal color of the optic nerve. At partial atrophy blanching of the disc is noted in one of the segments. Complete atrophy manifested by uniform pallor and thinning of the entire optic nerve head, narrowing of the vessels of the fundus.

Based on localization, ascending (if retinal cells are damaged) and descending (if optic nerve fibers are damaged) atrophy is distinguished; by localization - one-sided and two-sided; according to the degree of progression - stationary and progressive (determined during dynamic observation by an ophthalmologist).

Symptoms of optic atrophy

The main sign of optic nerve atrophy is a decrease in visual acuity that cannot be corrected with glasses and lenses. With progressive atrophy, a decrease in visual function develops over a period of several days to several months and may end complete blindness. In case of incomplete optic nerve atrophy pathological changes reach a certain point and do not develop further, and therefore vision is partially lost.

With optic nerve atrophy, disturbances in visual function can manifest themselves as concentric narrowing of the visual fields (disappearance of lateral vision), the development of “tunnel” vision, color vision disorder (mainly green-red, less often - blue-yellow part of the spectrum), the appearance dark spots(scotoma) in areas of the visual field. Typically, an afferent pupillary defect is detected on the affected side - a decrease in the pupillary reaction to light while maintaining a congenial pupillary reaction. Such changes can occur in one or both eyes.

Objective signs of optic nerve atrophy are revealed in the process ophthalmological examination.

Diagnostics

When examining patients with optic atrophy, it is necessary to determine the presence concomitant diseases, the fact of taking medications and contact with chemicals, Availability bad habits, as well as complaints indicating possible intracranial lesions.

During a physical examination, the ophthalmologist determines the absence or presence of exophthalmos, examines the mobility of the eyeballs, checks the reaction of the pupils to light, and the corneal reflex. Visual acuity testing, perimetry, and color vision testing are required.

Basic information about the presence and degree of optic nerve atrophy is obtained using ophthalmoscopy. Depending on the cause and form of optic neuropathy, the ophthalmoscopic picture will differ, but there are typical characteristics encountered with various types optic nerve atrophy. These include: pallor of the optic disc of varying degrees and prevalence, changes in its contours and color (from grayish to waxy), excavation of the disc surface, a decrease in the number on the disc small vessels(Kestenbaum's symptom), narrowing of the caliber of the retinal arteries, changes in the veins, etc. The condition of the optic disc is clarified using tomography (optical coherence, laser scanning).

With optic nerve atrophy caused by infectious pathology, laboratory tests are informative: ELISA and PCR diagnostics.

The differential diagnosis of optic atrophy should be made with peripheral cataracts and amblyopia.

Treatment of optic atrophy

Since optic atrophy in most cases is not independent disease, but serves as a consequence of others pathological processes, its treatment must begin with eliminating the cause. Neurosurgical surgery is indicated for patients with intracranial tumors, intracranial hypertension, cerebral aneurysms, etc.

Nonspecific conservative treatment optic nerve atrophy is aimed at preserving visual function as much as possible. In order to reduce inflammatory infiltration and swelling of the optic nerve, para- and retrobulbar injections of dexamethasone solution, intravenous infusions of glucose and calcium chloride solutions are performed, intramuscular injection diuretics (furosemide).

To improve blood circulation and trophism of the optic nerve, injections of pentoxifylline, xanthinol nicotinate, atropine (parabulbar and retrobulbar) are indicated; intravenous administration nicotinic acid, aminophylline; vitamin therapy (B2, B6, B12), injections of aloe extract or vitreous; taking cinnarizine, piracetam, riboxin, ATP, etc. In order to maintain low level to control intraocular pressure, pilocarpine is instilled and diuretics are prescribed.

blindness

To prevent optic nerve atrophy, timely treatment of ophthalmic, neurological, rheumatological, endocrine, infectious diseases; prevention of intoxication, timely blood transfusion in case of profuse bleeding. At the first signs of visual impairment, consultation with an ophthalmologist is necessary.

Optic neuritis, the treatment of which consists of complex application different groups medications, as a rule, is a consequence of the inflammatory process. Most people who experienced this disease for the first time, when timely application to the doctor they got rid of it quickly enough. Next, let's take a closer look at what optic neuritis is. Symptoms and therapeutic measures in pathology will also be described in the article.

General information

The optic nerve is a bundle of fibers. Its function is to transmit signals from the eye to the brain. Pain is one of the main signs indicating that a person has optic neuritis. The causes of the pathology are usually associated with various autoimmune diseases provoked by infections. In a number of patients, the inflammatory process of this localization may indicate the presence of multiple sclerosis, systemic disease. It is based on damage to neurons in the brain and spinal cord. Optic neuritis is usually unilateral. However, it is not uncommon for both eyes to be affected.

Clinical picture

How does optic neuritis manifest? The symptoms of the pathology are as follows:

When should you visit a specialist?

Optic neuritis is quite serious pathological condition. If you ignore a visit to the doctor, irreversible consequences may occur. You should contact a specialist in the following situations:

Provoking factors

Unfortunately, today the exact cause of neuritis has not been established. The most common opinion is that pathology appears when the immune system mistakenly begins to attack myelin. This substance coats the optic nerve. This attack results in myelin damage and inflammation. IN healthy condition this coating promotes faster transmission of impulses from the eyes to the brain to convey visual information. With the development of inflammation, obstacles arise in front of the signals. This, in turn, provokes deterioration visual perception. What exactly causes the immune system to attack myelin is unknown.

Classification

It can be performed ophthalmoscopically. In this case, the following categories are distinguished:

Retrobulbar optic neuritis: causes

To provoking factors other than those described above for general disease, include a descending infection against the background of lesions of the brain and its membranes. Over the past few years, experts have cited multiple sclerosis and demyelinating lesions of the nervous system as the most common causes of this form.

Clinical picture

There are three forms in which retrobulbar optic neuritis can manifest. The symptoms for each of them are as follows:

For all the forms described in acute course pathology, no changes in the fundus of the eye are noted. Only after 3-4 weeks is decoloration detected in the temporal half or throughout the entire disc - partial or total descending atrophy.

Diagnostics

The following methods are used to detect pathology:

• Routine inspection. During it, the ophthalmologist evaluates the ability to distinguish colors and visual acuity.
• Ophthalmoscopy. During the study, the organ of vision is exposed to bright light. This allows you to study the structure posterior section eyeball. The optic disc is examined using ophthalmoscopy.
• Light test. The specialist moves the light source in front of the patient's eyes, observing the reaction of the pupils. With neuritis, they narrow much more slowly than in a healthy state.

Therapeutic measures

Regardless of what category of pathology a person has - intra- or retrobulbar optic neuritis, treatment should have an etiopathogenetic focus in accordance with the identified factor that caused the inflammation. First of all, the following is recommended as therapy:

If a pathology is detected on late stage used to eliminate symptoms of atrophy in the optic nerve antispasmodics. They affect the intensity of microcirculation. These, in particular, include such medications as “Xanthinol”, “Nitsergoline”, “Sermion”, “Trental”, nicotinic acid. Laser and electrical stimulation of the organs of vision and magnetic therapy are considered feasible and quite effective.

Throughout life, a person inevitably encounters pathologies. who wear inflammatory nature. One such disease is optic neuritis. What it is, its causes and treatment methods will be discussed below.

Definition

Optic neuritis is an inflammatory disease characterized by sharp decline vision due to destruction of the optic nerve sheath. In most cases, the consequences of the inflammatory process are reversible, since not the entire nerve is affected, but a separate section of it. Young people are more at risk, since the pathology is much less common in the elderly and children.

Forms of the disease

Depending on the causes of the pathology, the following forms of neuritis are distinguished:

• infectious - the development of the disease occurs as a consequence infectious lesion body;
• parainfectious form is a consequence of improper vaccination or previous viral diseases;
• demyelinating is characterized by severe damage to one optic nerve head;
• autoimmune develops against the background of a malfunction in the body, when the immune system begins to react aggressively to other cells of the body;
• the toxic form manifests itself as a result of some kind of poisoning; a classic example is eye damage from consuming methyl alcohol;
• ischemic can develop as a result of a stroke.

Optic neuritis occurs as a consequence of a combination of certain causes that provoke inflammatory processes. Determining the form of the disease depends further treatment pathology.

Types of neuritis

The disease can occur when the intracranial part of the nerve, the area where it exits the eyeball and the entrance to the skull, is damaged. Damage to the intracranial part of the optic nerve is called intracranial neuritis. Inflammations that occur outside the skull can be divided into several types:

1. Retrobulbar orbital - inflammation of the part optic nerve, which is located in the eye socket.
2. Retrobulbar axial - damage to the postorbital part of the optic nerve.
3. Retrobulbar transverse - damage to the entire part of the optic nerve that is located outside the cranium.
4. Interstitial - extensive lesion nerve, which captures nearby soft tissues.

All types of optic neuritis can be either acute or chronic. The symptoms in such cases will also differ.

Pseudoneuritis

Sometimes, for a number of reasons, a person has congenital pathology nipple of the optic nerve. In this case, false neuritis may develop. This condition is characterized by the following manifestations:

• the nerve nipple is enlarged in size;
• its edges are indistinct;
• color changed to greyish-red.

Fortunately, pseudoneuritis does not affect visual acuity, but requires attention from an ophthalmologist.

Causes of pathology

More often experienced specialist can determine what was the impetus for the development of the disease, however, there are also cases with an unclear etiology. There are several main causes of optic neuritis:

1. Viruses of chickenpox, herpes, encephalitis, mononucleosis, mumps.
2. Pathogenic fungi, which can live both on human skin and in the surrounding space.
3. Bacterial infections. This is especially true for those that provoke inflammatory diseases of areas located near the optic nerve. For example, sinusitis, frontal sinusitis, pulpitis, otitis media, meningitis.
4. Specific inflammatory processes, such as syphilis, cryptococcosis.
5. Retrobulbar optic neuritis in multiple sclerosis may be one of the first manifestations of this disease.
6. Idiopathic neuritis is a consequence of an unclear pathogenic effects.
7. Poisoning methyl alcohol which causes eye damage.
8. Mechanical injuries in the area where the optic nerve is located.
9. Allergic reactions.
10. Alcohol or drug intoxication of the body.

In addition, symptoms of retrobulbar optic neuritis may develop late stages diabetes mellitus Without necessary therapy to improve and maintain the condition.

Manifestations of the disease

Most often, symptoms of optic neuritis appear rapidly, within a few hours. In rare cases, this process takes a day. One eye is affected; bilateral neuritis is extremely rare. In this case, the person experiences the following symptoms:

• feeling of a veil in front of the affected eye;
• a sharp and significant decrease in visual acuity;

• change in color perception;
• reaction to bright light;
• tearing of the affected eye;
• pain when moving the eyeball;
• decreased visual breadth, for example, the eye sees only in front of itself, peripheral vision deteriorates significantly;
• Difficulty adapting to changes in lighting brightness.

The inflammatory process is indicated by an increase in body temperature, fever, as in colds, body aches and general poor health.

Diagnostics

According to the ICD, optic neuritis has code H46. It has subtypes of the disease: retrobulbar neuritis and optical (papillitis). The type of disease and the extent of damage can be determined using the following: diagnostic measures:

• An ophthalmological examination by a doctor and finding out the symptoms that the patient is experiencing.
• Ophthalmoscopy, which is carried out using a beam of light aimed at the pupil. This is necessary for examining the fundus. You can also check with an ophthalmoscope natural reactions eyes to bright light. With neuritis, the pupil contracts noticeably less than in a healthy eye.

• Using special devices, the brain's reaction to light is recorded. The speed of the pulses sent is checked.
• Magnetic resonance imaging helps determine the extent of nerve damage. In some cases, a contrast agent may be used and injected into the patient's optic nerve.
• Checking visual acuity using special tables with letters of different sizes.
• Gonioscopy, which is an examination of the eye using a gonioscope with curved lenses.
• Measuring intraocular pressure.
• General analysis blood.

The clinical picture of optic disc neuritis may look like this: the vessels of the eye are dilated, the optic disc is hyperemic, has no clear boundaries and is connected to the retina, on which white spots appear.

Therapy for the disease

Treatment of retrobulbar optic neuritis is aimed at eliminating the cause of the inflammatory process, as well as restoring the functions of the eye. At the same time, during therapy, the patient is in the hospital for constant monitoring by doctors. Most often, it is not possible to find out the exact cause of neuritis. In this case, broad-spectrum drugs are prescribed. Treatment of optic neuritis proceeds according to the following scheme:

• Antibacterial therapy based on drugs such as Amoxicillin, Amoxiclav, Ceftriaxone.

• Anti-inflammatory drug "Dexamethasone", which is injected directly into the eye tissue.
• Means for suppressing intoxication of the body due to the ongoing inflammatory process - "Reopoliglyukin", "Hemodez", which are administered intravenously.
• Vitamins of group B, PP.
• Drugs to improve blood circulation, such as Trental, Actovegin.
• Medicines for restoring the conduction of nerve impulses - Neuromidin, Nivalin.
• If there is edema, the drug "Diacarb" is used.

To restore vision, if necessary, it is prescribed laser correction or magnetic therapy. For optic nerve atrophy, treatment with antispasmodics and drugs to improve blood circulation is prescribed.

If optic neuritis with rapid loss of vision has developed in case of methyl alcohol poisoning, then the first thing to do is to rinse the patient’s stomach and also administer an antidote - ethanol. After which medications such as Nootropil and B vitamins are prescribed intramuscularly.

Treatment with folk remedies

• Nettle infusion. A tablespoon of dried plant is infused in a glass of boiling water. The solution must be taken daily, 2 tbsp. before every meal.
• Syrup from green cones. Pour boiling water over them, add lemon and sugar, and then bring to a boil. The resulting syrup should be taken 1 tbsp. before every meal. The buds help improve the condition of the blood vessels in the brain, which also nourish the eyes.

In addition, it is recommended to use steam cow's milk, since it contains healthy vitamins and microelements, as well as fatty saturated acids. However, this is only suitable if the cow is in good condition and has no diseases. In other cases natural milk must be boiled before use.

Forecast

In most cases, if optic neuritis (ICD-10 code H46) was detected in a timely manner and the correct treatment was prescribed complex therapy, then the prognosis is favorable. Vision is completely restored within 2-3 months after the end of therapy.

However, this significantly increases the risk of disease multiple sclerosis, especially in women after 40 years. To prevent the onset of the disease, it is recommended to regularly visit a neurologist, especially if there is the slightest suspicion of the development of complications.

In rare cases, if treatment was not started in a timely manner, optic nerve atrophy may develop, which leads to vision loss, or amaurosis - chronic inflammation retina, which also leads to blindness.

Preventive measures

Any signs and symptoms of optic neuritis are unpleasant. Treatment is also expensive and time consuming. In addition, there is the possibility of complications developing. In order to minimize the risk of pathology, you should adhere to the following: simple recommendations:

In addition, it is very important not to self-medicate without consulting an ophthalmologist, as there is a risk of permanent vision loss.

Conclusion

It is important to apply for timely medical care at the first symptoms of pathology, since there is high risk death of nerve fibers that are responsible for vision. If you do it right away curative measures, then a condition such as optic neuritis does not pose a particular danger to eye health.