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Neuritis Optik
Oleh :
Optic neuritis
Optic neuritis is an inflammation of the optic
nerve
of either one or both eyes,, it either:
i. papillitis: if it restricted to the optic nerve
head.
ii. Retrobulbar: if the inflammation in the back
of the eye.
Usually unilateral
typically affecting young adults 18 45
yrs
More common in female
Incidence 1-5 per 100,000 per year
Etiology
A. Idiopathic or May be due to :
B. Autoimmune disorder : the immune
system attack the myelin sheath of the
optic nerve, which become swolled &
inflamed, like what happen in :
i.
Multiple sclerosis
Bacterial
ii. Viral
Etiology
D. Ischemic : the optic nerve is infarcted due to occlusion
or decrease perfusion of posterior ciliary vessels, it
either:
Temporal arteritis
Types
Acute
Papillitis
Chronic
retrobulbar
Alcohol
ambylopia
Tobacco
ambylopia
Symptoms
In papillitis
optic dis
k
swelling
In retrobu
lbar < no
abnormal
changes
pat h y
o
r
u
e
n
sc
emic
h
c
s
i
e d di
l
l
In
o
w
le s
-> pa
ity
v
i
t
e
ens
s
t
s
ra
Cont
test
Visual acuity
test
Visual acuity is
markedly reduced
up to no perception
of light
Color vision
test :
impaired
st : RAPD
e
t
n
o
i
t
c
dont
light rea
e
y
r
y
e
a
ll
i
d
p
e
t
u
c
P
f the affe
o
l
i
p
u
p
The
t
irect ligh
d
o
t
t
c
a
re
direct
in
e
h
t
o
t
but react
To diagnose
multiple sclerosis
-> abnormalities
in white matter
Treatments
It usually resolve spontaneously but
treating with steroids speed up vision
recovery.
Prevention
Prognosis
Complications
Symptoms
Painless visual loss
Decrease color
vision
Etiology
Toxins ( tobacco , Lead, methanol, chloramphenicol, quinine) cause damage to
optic nerve & ganglion cells, aggravated by malnutrition, defecincies of protein,
vitamin B12, antioxidant)
Diagnosis
History of :
- exposure to toxins
- malnutrition
Visual field : paracentral
scotoma
Fundus : early no changes ,
late become pale
Treatment
Healthy life style
Stop exposure to toxic substances
Oral or parenteral vitamin B
Prognosis
Vision may improve if the cause is
treated or removed quickly.
Prevention
There are no scientifically validated preventive
measures for optic neuritis. Anecdotal evidence
suggests that maintaining a healthy lifestyle with
proper attention to good nutrition, exercise,
prevention of obesity, maintenance of emotional
health and adequate rest, together with
avoidance of toxins such as cigarettes, may
prevent many diseases. Regular annual eye
exams are critical to maintaining healthy vision.
Early treatment of vision problems can prevent
permanent optic nerve damage (atrophy).