Inflammation of the optic nerve (optic neuritis, opticoencephalitis) is a serious ophthalmic pathology, a disease characterized by the development of inflammation of the optic nerve. In this case, demyelination occurs, a decrease in the fat layer in the structure of nerve fibers that provide signal transmission to the central nervous system. Inflammation of the nerve of the eye is most often combined with other diseases, pathologies of a neurological nature. In patients diagnosed with opticoencephalitis, a sharp decrease in visual function is noted in combination with severe pain symptoms that increase with eye movement.
There is currently no cure for this disease. The goal of therapy is to improve the general and local conditions associated with relapses and long-term treatment. The exact guidelines for action are described by the authors of the article. If left untreated, it can cause significant morbidity in any major organ in the body. In the last decade, the prevalence has increased significantly. With his systemic communication, any structure of the eye can be affected at any stage of the disease, remaining the only sign of infection.
There are no pathognomonic signs of ocular syphilis. Frequent manifestations include interstitial keratitis, uveitis, chorioretinitis, retinitis, retinal vasculitis, and cranial and optic neuropathies. Therefore, it is clinically difficult to diagnose syphilis based on eyepiece results alone. Case Report A 37-year-old female patient was presented at our clinic with acute, severe, painless visual loss in her right eye. Apart from mild anemia, he reported no systemic complaints or illnesses. Ophthalmic examination showed visual acuity of 0, 1 and impaired color vision in the right eye and 0 with normal color perception in the left eye.
The reasons for the development of opticoencephalitis
The optic nerve consists of one billion sensitive processes (axons) of a structure such as the retina of the eye, which transmit information, signals to the brain about the perceived image through electrical impulses. The final processing of the data obtained takes place in the occipital region of the brain.
Intraocular pressure was 13 mm Hg. And 15 mm Hg. Respectively. Anomalies were noted in the anterior segments. In indirect ophthalmoscopy, we noted symmetrical papillary edema in both eyes, as well as a slight retinal edema in the macular region. To rule out intracranial hypertension, a computed tomography of the skull and a neurological examination were organized. Screening blood tests and all inflammatory parameters were unremarkable. The nonspecific syphilitic serum test result was also negative.
The sheaths, as well as the space under the sheath of the optic nerve, are inextricably linked with the brain, central nervous system. For this reason, in inflammatory diseases of the brain, intracranial pressure may increase, pathological processes affect the optic nerve.
Inflammation of the nerve of the eye in medical practice is diagnosed in people aged 18 to 50 years. In the elderly, children of younger age groups, optic neuritis is extremely rare.
Systemic corticosteroids have been administered. Nuclear magnetic resonance imaging of the skull and orbits and other blood tests including blood protein, C-reactive protein, autoimmune screening tests were nagative. Based on these data, a diagnosis of bilateral syphilitic neuroretinitis was made. During a more detailed medical history, the patient denied having any skin or mucous lesions that could have been primary syphilitic changes. He had a rash on his palms and soles, but it disappeared without any treatment.
Since ocular syphilis tends to be associated with neurosyphilis, its cerebrospinal fluid was also examined and did not show any changes. The patient was treated with intramuscular injections of penicillin 4 million. Papillary edema was markedly reduced on the tenth day. After 6 months of follow-up, visual acuity returned to 0 in both eyes. Full-scopic changes are completely eliminated, as well as pathological staining in fluorescein angiography. Discussion Ocular syphilis can present various clinical forms, the most common of which are interstitial keratitis, uveitis, chorioretinitis, retinitis, retinal vasculitis, and cranial and optic neuropathies.
Depending on the localization of inflammatory processes, ophthalmic pathology is classified into retrobulbar and intrabulbar neuritis. With a retrobulbar form of inflammation, which can be acute, chronic, pathological processes are localized outside the eyeball. The sensory bundle of nerve fibers is damaged. At first, the inflammation covers one eye, but if timely effective treatment is not prescribed, the pathology passes to the second, healthy eye. With intrabulbar optic neuritis, the inflammatory process affects the optic nerve head.
Among patients with syphilis, about 5% develop chorioretinitis, and 50% of them are observed with bilateral lesions. Gass described the typical appearance of acute syphilitic chorioretinitis as large, lacrimal, yellowish lesions in the macula or midfloor periphery. Differential diagnosis of neuroretinitis includes cat scratch disease, toxoplasmosis, ocular Lyme borreliosis, sarcoidosis, acute epitheliopathy of background epitopyopathy, and pigment spot epitheliopathy. Large, repressive structures and triggers of neurological symptoms.
The main reasons that provoked opticoencephalitis are due to endo- and exo-factors of different nature... Inflammation of the optic nerve can develop against the background of chronic viral, bacteriological, colds (respiratory) infections, and local diseases.
Optic neuritis is accompanied by neurological pathologies, chronic infections that contribute to the development of destructive processes in the nerve fibers responsible for the conduction of impulses. Optic neuritis is diagnosed with multiple sclerosis. Pathology can also be a characteristic harbinger of this neurological disease of the central nervous system.
And the optic disc. The changes seen in the back of the eye are divided into 4 periods. Initially, only dilated vessels are observed. Over time, the light of their light becomes clear. Vasculitis, hemorrhage and hemorrhage, with time slowing down and degeneration of the optic nerve.
Optic neuropathy. The typical image of the optic nerve on fundus examination is accompanied by progressive nerve damage, characteristic defects in the visual field, and the typical evolution of these changes. The optic nerve is also normal - so the ophthalmologist said. Neurology also found nothing.
The main causes of opticoencephalitis:
- inflammation of the lining of the brain;
- alcoholic, drug intoxication;
- acute, chronic bacterial diseases (herpes, gonorrhea, brucellosis, tuberculosis, syphilis);
- focal, local ascending, descending infections (sinusitis, rhinitis, tonsillitis);
- non-infectious diseases (gout, erysipelas, blood pathologies);
- mechanical trauma, damage to the deep structures of the eye;
- difficult pregnancy;
- inflammation of the inner lining of the eye,
- decreased twilight vision;
- organic lesions of various parts of the central nervous system;
- chronic dysfunction of internal organs.
People with symptoms of brain damage are at risk. Ophthalmic pathology is diagnosed with inflammatory processes in the oral cavity, serious dental diseases (caries, periodontitis). The development of optic neuritis is facilitated by autoimmune diseases (optic neuromyelitis), prolonged use of certain medications, and radiation exposure.
Cardiac neurosis ?! Is this one of you? - p. 45
Starting and magnetic resonance
Eye problems, numbness, weakness, mild headache - page 2. Symptoms still persist, which is worse. Instantaneous, passing paralysis of the arms and legs. Exploring the look at what. What you see immediately describes, and you score straight away.I have 20 years and big problems!
The base of the eye is altered in people with atrial fibrillation, prolonged overexposure, inflammation in the eye apparatus, and others. You passed out, but did you feel left hand, that is, you saw it, moved your fingers. have you seen the right leg? Atrophy of the optic nerve refers to the gradual process of the disappearance of fiber-optic fibers and their replacement by connective tissue, in which the light received by the retina is transformed into an electric motor, which passes into the posterior lobe of the brain with various disorders, narrowing of the visual field and loss of visual acuity are observed.
If treatment is not prescribed in a timely manner, inflammation quickly passes to other, deeper structures of the eye, which, in turn, can become the main reason for the weakening of visual function, leading to complete blindness. 
Symptoms
Symptoms, the intensity of their manifestation depends on the age, general physiological state of patients, immunity, localization. Symptoms diagnosed with inflammation of the nerve of the eye:
Atrophy can be caused by a large number of diseases of the eye itself, as well as of the nervous, cardiovascular and other systems. Optic atrophy can be the result of eye damage, poisoning, or a hereditary disease. There are several types of optic atrophy: congenital atrophy, acquired optic atrophy. Congenital atrophy is a group of genetically determined diseases in which vision is impaired from birth. Acquired optic nerve damage atrophy develops in retinal cells or fiber nerve fibers.
- sharp pain syndrome in the orbital region, aggravated by eye movement;
- headaches, severe migraine;
- decreased visual acuity;
- change in color perception;
- "Blind" White spot, blurred spots in the visibility zone;
- narrowing the angle of peripheral vision;
- dilated pupil, photophobia;
- change in twilight vision;
- high fever, chills, nausea, vomiting, loss of consciousness.
A decrease in the optical function of the eye, the symptoms of neuritis intensify after excessive physical exertion, overwork, disturbances in sleep and rest, taking a hot bath, visiting a bath, a sauna.
The reasons may be: glaucoma, myopia, inflammation, toxic damage, trauma, poor blood circulation in the vessels of the optic nerve, metabolism, compression of tumors from optical fibers, - explain the specialists of the Institute of Eye Microsurgery.
Innovative methods of treatment Treatment is a rather difficult process for doctors, since in some cases it is quite difficult to restore dead fibers of the optic nerve, in some cases it is impossible. Moreover, there are many reasons for optic nerve atrophy, so the diagnosis can take a long time. For this, doctors' specialists from the Technical and Scientific Institute "Eye Microsurgery", Academ. Feodorov uses direct stimulation of the optic nerve using alternative magnetic, electric and laser fields.
As a rule, inflammation in the early stages develops in one eye, but if treatment is neglected, after six to seven days it is possible that the inflammatory process will spread to the healthy eye.
Symptoms of inflammation of the nerve of the eye are manifested in the form of small point infiltrations, proliferation of cell structures. Inflammation can be of varying severity, spread from the pia mater to the nerve fibers, and affect the optic nerve trunk. If the inflammation is localized in the trunk of the nerve, the pathological process becomes interstitial, which leads to the formation of edema, infiltration of the surrounding tissues.
The sooner the diagnosis is made, the better the treatment results. Treatment of the disease can be carried out in several directions: conservative treatment, physiotherapy, electrical stimulation, magnetic stimulation, surgery. Conservative treatment includes symptomatic treatment, including: vasodilators; medicines that improve blood flow to the optic nerve; anticoagulants; drugs that improve metabolic processes in the nervous tissue; drugs, the effect of which is to stimulate metabolism and absorption of pathological processes, improve the inflammatory process and improve the functioning of the nervous system.
A metabolic disorder in the cellular structures of fibers transmitting nerve impulses, if treatment is not prescribed on time, will lead to their atrophy in the areas of inflammation. With the retrobulbar form, in the initial stages, there is a sharp decrease in vision, unpleasant sensations, discomfort when the sick eye moves.
Diagnostics
To establish an accurate diagnosis when the first symptoms appear, it is necessary to undergo an examination by an ophthalmologist. Treatment of opticoencephalitis can be prescribed after a comprehensive diagnosis, determination of the form, stage of the disease, the reasons that provoked the development of inflammation in the optic nerve.
This treatment is individual for each patient, depending on the complexity of the disease, the age of the patient and the reasons leading to the disease, and is carried out in parallel with magnetostimulation, electrical stimulation, physiotherapy, etc., the specialist adds.
Magnetic stimulation improves blood circulation, activates metabolic processes, and accelerates healing. Electrostimulation is carried out by inserting an electrode with a special needle behind eyeball, the optic nerve, and the other attaches to the skin. Physiotherapy uses electrophoresis, magnetic stimulation of the retina and optic nerve with ultrasound.
Patients are prescribed special tests to check their color perception. Ophthalmoscopy is mandatory, which allows you to determine changes in various structures of the eye using a directed light beam. If necessary, additionally appoint MRI, fluorescent angiography. 
With the help of conservative and timely treatment, the atrophy process can be stopped, and vision can be improved. Full recovery of vital function will not occur, and if treatment is started later, the more difficult it is to avoid negative consequences, while in later cases, partial or complete development of blindness occurs. If progressive optic atrophy remains untreated, it can develop blindness, experts conclude.
A simple eye exam can save your life. From Brain Tumors to Lung Cancers, learn about the diseases that are in your eyes! One of the first signs of type 2 diabetes may be slight bleeding on the retina, which is a symptom of diabetic retinopathy. If left untreated, this condition can lead to blindness, but it can be controlled under control. If detected early, diabetic retinopathy can also be treated with lifestyle changes such as eating healthy foods or losing extra pounds.
Healing techniques
Treatment of optic neuritis should take place under the full supervision of a physician. The treatment regimen is prescribed to patients after a comprehensive diagnosis. When appointed in a timely manner, effective treatment the prognosis is favorable. Pathological symptoms, optical functions of the eye will be fully restored. With an advanced form of the disease, one-sided blindness is possible.
This could be a sign of multiple sclerosis, a degenerative disease that affects the nervous system. Inflammation of the optic nerve is present in about 75% of sclerosis cases. However, inflammation of the nerve does not automatically indicate the presence of a disease; it may just be a simple infection. While some patients complain of nerve irritation, others have no symptoms and the disease is only detected by ophthalmologic control.
Weakening of blood vessels and narrowing of arteries can indicate hypertension. Many studies have shown that there is a link between cardiovascular disease and blood vessel problems in the retina. Approximately 25% of people with rheumatoid arthritis complain that they have another symptom, also present in the eye, inflammation of the irritation or different coloration of the iris. Rheumatoid arthritis is a disease that affects the joints of the hands and feet.
Inflammation of the optic nerve, the treatment of this ailment is carried out in a hospital. Taking into account the root cause that provoked the development of ophthalmic pathology, in addition to the main therapeutic methods, treatment is aimed at stopping the symptoms of secondary diseases. It is important to stop the spread of the pathological process in time, eliminate the symptoms of inflammation, overcome the infection, restore metabolism in nerve fibers in all structures of the diseased eye.
An eye, brain tumor, breast cancer, or lung cancer can also be found that have already spread. Some types of retinal bleeding can indicate tumors because they alter the patient's field of vision. And malignant melanomas can have symptoms that can be detected by ophthalmologists.
For many people, the disease causes pain that persists for months or even years after the eruption has healed. As a result chickenpox almost all viruses are destroyed, with the exception of a few that remain hidden in sensitive sites for many years. With age or as a result of illness, the immune system loses its ability to control the virus, which can then be reactivated. In this case, an inflammatory reaction occurs in the lymph nodes and nerves, causing the appearance of vesicles in the form of bouquets of skin.
Neuritis is treated with antibiotics:
- Streptomycin;
- Penicillin;
- Gentamicin.
Steroid, non-steroidal, hormonal, anti-inflammatory drugs, immunomodulators are also used to increase the body's defenses. Antibacterials may be prescribed to eliminate the infection. medications a broad spectrum of action.
To relieve puffiness, reduce inflammatory reactions, glucocorticosteroids are prescribed. Local treatment involves the use of ointments, tablets, injections. Additionally, detoxification therapy is carried out, complex vitamin and mineral supplements are prescribed. The duration of the treatment course is from two to six weeks. Treatment, pharmacological drugs, duration complex therapy is prescribed by the attending ophthalmologist.
Treatment of neuritis by surgery, decompression of the optic nerve sheath, which is aimed at normalizing intracranial pressure, relieving inflammatory edema, eliminating the main symptoms, is prescribed in severe cases.
Timely prescribed treatment of the retrobulbar, intrabulbar form of optic neuritis guarantees a complete restoration of the optical functions of the eye. In this case, relapses should not be ruled out.
Given the rapid progression of inflammation in the optic nerve, at the first symptoms, you should immediately contact a medical center, an ophthalmologist for diagnostics.
Opticoencephalitis is an inflammation of the optic nerve, accompanied by a significant decrease in visual functions, an uneven narrowing of the visual field and the formation of cattle. The causes of the disease can be different. Not timely treatment of inflammation of the optic nerve in just a few weeks, and, in some cases, even in a few days, it can lead the patient to complete blindness.
Causes of inflammation of the optic nerve
Inflammation of the optic nerve can be caused by the following reasons:
general infections (for example, syphilis, tonsillitis, flu, typhus, brucellosis, tuberculosis) as causes of inflammation of the optic nerve;
intoxications often cause inflammation of the optic nerve (including those resulting from excessive addiction to alcohol);
general non-communicable diseases (diabetes, blood diseases, nephritis, gout);
pathological pregnancy;
inflammation of the inner membranes of the eyes and orbit;
various injuries as causes of inflammation;
multiple sclerosis;
focal infections (eg, tonsillitis, sinusitis, otitis media);
inflammatory diseases of the brain as a cause of inflammation of the optic nerve.
Treatment of inflammation of the optic nerve
Difficulties arising in the course of therapy, the need for electrophoresis, magnetophoresis and phonophoresis, as well as topical application medicines in the form of injections, necessitate the placement of a patient diagnosed with inflammation of the optic nerve in a specialized hospital. As a rule, the treatment of inflammation of the optic nerve is carried out by two specialists at once: an ophthalmologist and a neuropathologist. This contributes to the correct assessment of the degree of neglect of the disease and its severity, timely diagnosis and treatment of complications and concomitant diseases, rapid and accurate determination of the clinical prognosis, as well as the most optimal choice of therapy regimen.
First of all, the treatment of inflammation of the optic nerve is based on the use of antibiotics and corticosteroids. In addition, several years ago, an operation was developed, the meaning of which is to stop the inflammatory process developing in it in the shortest possible time, while the death of the optic nerve has not yet occurred. During this operation, a special drug is injected into the eye, stimulating a significant growth of lymphatic vessels, which, in turn, can dissolve the edema that accompanies inflammation of the optic nerve. At the same time, a substance is injected into the patient's eye, which accelerates the development of blood vessels that feed the optic nerve. The earlier the inflammation of the optic nerve is surgically treated, the higher the chance of a favorable treatment.
How does the inflammation of the optic nerve manifest itself?
The clinical picture of the disease depends on the severity of the inflammation. With mild inflammatory process the optic disc is moderately swollen, its borders are indistinct, the arteries and veins in the eye are slightly dilated.
More severe inflammation of the optic nerve is characterized by a sharp swelling of the optic nerve head. With this diagnosis, the patient often complains of white spots with vision. Multiple hemorrhages are also possible. In patients with inflammation of varying severity, the quality of vision deteriorates, usually against the background of a narrowing of the visual field and a decrease in color sensitivity.
According to the clinical course, it is customary to distinguish between acute and chronic inflammation of the optic nerve. In the acute form of the disease, the quality of vision deteriorates extremely sharply - within 2-3 days. Chronic inflammation is characterized by a gradual decrease in visual acuity and the absence of pain behind the eyeball.