Throughout life, a person inevitably encounters pathologies. which are inflammatory in nature. One of these diseases is optic neuritis. What is it, the causes and treatment methods will be considered below.
Definition
Optic neuritis is an inflammatory disease that is characterized by a sharp decrease in 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 its separate area. To a greater extent, young people are at risk, since pathology is much less common in old people and children.
Forms of the disease
Depending on the causes of the appearance of pathology, these forms of neuritis are distinguished:
- infectious - the development of the disease occurs as a result of an infectious lesion of the body;
- parainfection form is the result of improper vaccination or past viral diseases;
- demyelinating is characterized by a sharp lesion of one optic disc;
- 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 any poisoning, a classic example is eye damage with methyl alcohol;
- ischemic can develop as a result of a stroke.
Optic neuritis occurs as a result of a combination of some of the reasons that provoke inflammatory processes. Further treatment of the pathology depends on determining the form of the disease.
Types of Neuritis
The disease can occur in case of damage to the intracranial part of the nerve, the area where it leaves the eyeball, and the entrance to the skull. The defeat of the intracranial part of the optic nerve is called intracranial neuritis. Inflammation that occurs outside the skull can be divided into several varieties:
- Retrobulbar orbital - inflammation of the part of the optic nerve that is in the orbit.
- Axial retrobulbar - damage to the orbital part of the optic nerve.
- Cross retrobulbar - a lesion of the entire part of the optic nerve, which is located outside the cranium.
- Interstitial is an extensive nerve lesion that captures adjacent soft tissues.
All types of optic neuritis can be both acute and chronic. Symptoms in such cases will also be different.
Pseudo-neuritis
Sometimes, for several reasons, a person has an inborn pathology of the optic nerve nipple. In this case, false neuritis may develop. This condition is characterized by such manifestations:
- the nerve papilla is enlarged;
- its edges are fuzzy;
- color changed to grayish red.
Fortunately, pseudoneuritis does not affect visual acuity, but it requires attention from an ophthalmologist.
Causes of pathology
Most often, an experienced specialist can determine what was the impetus for the development of the disease, however, there are also cases with an unknown etiology. There are several main causes of optic neuritis:
- Viruses of chickenpox, herpes, encephalitis, mononucleosis, mumps.
- Pathogenic fungi that can live both on human skin and in the surrounding space.
- Bacterial infections. This is especially true for those that provoke inflammatory diseases of sites located near the optic nerve. For example, sinusitis, frontal sinusitis, pulpitis, otitis media, meningitis.
- Specific inflammatory processes, such as miliary tuberculosis, syphilis, cryptococcosis.
- Retrobulbar optic neuritis in multiple sclerosis may be one of the first manifestations of this disease.
- Idiopathic neuritis is a consequence of an unexplained pathogenic effect.
- Methyl poisoning, which causes eye damage.
- Mechanical injuries to the optic nerve.
- Allergic reactions.
- Alcohol or drug intoxication of the body.
In addition, symptoms of retrobulbar optic neuritis can develop in the last stages of diabetes mellitus in the absence of the necessary therapy to improve and maintain the condition.
Manifestations of the disease
Most often, symptoms of optic neuritis are manifested 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, a person experiences such symptoms:
- a feeling of 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;
- a decrease in the breadth of view, for example, the eye sees only in front of itself, lateral vision is significantly impaired;
- difficult adaptation to changing the brightness of lighting.
The inflammatory process is evidenced by an increase in body temperature, fever, as in colds, body aches and general poor health.
Diagnostics
According to the ICD, optic neuritis has the code H46. It has subspecies of the disease: retrobulbar neuritis and optical (papillitis). The type of disease and the degree of damage can be determined using the following diagnostic measures:
- 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 to examine the fundus. Also, using an ophthalmoscope, you can check the natural reactions of the eye to bright light. With neuritis, the pupil contracts noticeably less than a healthy eye.
- Using special devices, the response of the brain to light is recorded. The speed of the sent pulses is checked.
- Magnetic resonance imaging helps to determine the degree of nerve damage. In some cases, a contrast agent may be used that is administered to the patient in the optic nerve.
- Testing visual acuity using special tables with letters of different sizes.
- Gonioscopy, which is an examination of the eye with a gonioscope with curved lenses.
- Measurement of intraocular pressure.
- General blood analysis.
The clinical picture of optic nerve disc neuritis can look like this: the vessels of the eye are dilated, the optic nerve disc is hyperemic, has no clear boundaries and is connected to the retina of the eye, on which white spots appear.
Disease Therapy
Treatment of retrobulbar optic neuritis is aimed at eliminating the cause of the onset of the inflammatory process, as well as at restoring the functions of the eye. Moreover, 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, drugs of a wide spectrum of action are prescribed. Treatment of optic neuritis is carried out according to the following scheme:
- Antibacterial therapy based on such drugs as Amoxicillin, Amoxiclav, Ceftriaxone.
- The anti-inflammatory drug "Dexamethasone", which is injected directly into the fiber of the eye.
- Means for suppressing intoxication of the body due to the ongoing inflammatory process - "Reopoliglyukin", "Hemodez", which are administered intravenously.
- Vitamins of group B, PP.
- Blood circulation medications, such as Trental, Actovegin.
- Medications for restoring the conductivity of nerve impulses - "Neuromidin", "Nivalin."
- In the presence of edema, the drug "Diacarb" is used.
To restore vision, if necessary, laser correction or magnetotherapy is prescribed. With atrophy of the optic nerve, treatment with antispasmodics and drugs is prescribed to improve blood circulation.
If optic neuritis with rapid loss of vision has developed in the event of methyl alcohol poisoning, then the first thing to do is rinse the patient’s stomach and also introduce an antidote - ethyl alcohol. After that, such drugs as Nootropilum and B vitamins are prescribed intramuscularly.
Treatment with folk remedies
With this pathology, it is recommended to give preference to conservative therapy. However, in some cases, an ophthalmologist may allow the use of folk remedies as additional methods of combating the disease.
- Nettle infusion. A tablespoon of dried plant is infused in a glass of boiling water. Take a solution daily 2 tbsp. before each meal.
- Syrup of green cones. They must be poured with boiling water, add lemon and sugar, and then bring to a boil. The resulting syrup must be taken 1 tbsp. before each meal. The bumps help improve the condition of the vessels of the brain that also nourish the eyes.
In addition, it is recommended to use fresh cow's milk, as it contains useful vitamins and minerals, as well as saturated fatty acids. However, this is only suitable if the cow is in good condition and free from disease. In other cases, natural milk must be boiled before use.
Forecast
In most cases, if optic neuritis (according to ICD-10 code H46) was detected in time and the correct complex therapy was prescribed, then the prognosis is favorable. In this case, vision is fully restored within 2-3 months after the end of therapy.
However, this significantly increases the risk of 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, atrophy of the optic nerve may develop, which leads to loss of vision, or amaurosis, a chronic inflammation of the retina, which also leads to blindness.
Preventative measures
Any signs and symptoms of optic neuritis are unpleasant. Treatment is also costly and time consuming. In addition, there is the possibility of complications. In order to minimize the risks of pathology, you should follow these simple recommendations:
- Timely seek medical help for any diseases and inflammatory processes of the eyes.
- Eliminate the risks of injuries to the face and eyes.
- In case of contact with chemicals, it is recommended to use personal protective equipment, which includes a mask for the eyes and respiratory tract, as well as rubber gloves.
- Refuse the use of dubious alcohol-containing liquids, as they can be made on the basis of industrial alcohol - methanol, which is unsuitable for use and causes serious consequences.
- Timely treat colds.
- Engage in light sports to strengthen immunity.
- Stop smoking.
- Maintain a proper and balanced diet.
In addition, it is very important not to self-medicate without consulting an ophthalmologist, since there is a risk of irreversible loss of vision.
Conclusion
It is important to seek medical help in time for the first symptoms of the pathology, since there is a high risk of dying of the nerve fibers that are responsible for vision. If you immediately take therapeutic measures, then a condition such as optic neuritis does not pose a particular danger to eye health.