Optic nerve disease. Types of neuritis of the optic nerve. Causes, diagnosis and treatment. Treatment with folk remedies

Neuritis ophthalmic nerve- a disease characterized by an acute decrease in vision due to destruction of the sheath of the optic nerve. The condition in the vast majority of cases is reversible, responds well to treatment. Women of middle age suffer more often. It is extremely rare in children and the elderly.

This state requires especially close attention due to the fact that people who have had neuritis of the optic nerve have a high probability of developing multiple sclerosis in the long term.

A separate section of the nerve is more often affected, a total lesion is extremely rare. According to the causal site, a classification of neuritis is built.

Classification of optic neuritis

Neuritis of the optic nerve can develop with damage to its intracranial part or the area between its exit from eyeball and entrance to the cranial cavity.

With damage to the intracranial part, intracranial optic neuritis develops.

The pathology of the optic nerve area outside the cranial cavity (retrobulbar neuritis) is usually divided into several groups:

• Retrobulbar orbital - a pathological process in the area of ​​​​the optic nerve located inside the orbit.
• Retrobulbar axial - damage to the part of the nerve located immediately behind the eyeball.
• Transverse retrobulbar - damage to all fibers that make up the optic nerve
• Interstitial - involvement, in addition to the fibers of the optic nerve, of the surrounding glial cells and connective tissue.

Causes of optic neuritis

Very varied. Most often, these are infectious agents of various origins; there are also neuritis with an unexplained cause. Causes of optic neuritis can be divided into the following groups:

• Viral. Cause neuritis can any viruses tropic to nervous tissue. The most famous of them are: various herpes viruses, including chicken pox virus, herpes simplex, mononucleosis; encephalitis virus, mumps.
• Various pathogenic fungi.
• bacterial infections. In most cases, bacterial inflammation of nearby tissues pass into neuritis of the optic nerve - inflammation of the sinuses (sinusitis, frontal sinusitis), pulpitis, ear diseases, meninges(meningitis).
• Inflammation of the eye (uveitis, etc.)
• specific inflammation. There are a number of diseases accompanied by an inflammatory process special kind- granulomatous. It is neither bacterial nor viral inflammation. Perhaps as a generalized lesion with such infections (for example, sarcoidosis, miliary tuberculosis), and local foci of infection (syphilis, cryptococcosis).
• Neuritis of the optic nerve as a manifestation of multiple sclerosis. As mentioned above, most people who have had optic neuritis develop in the long term multiple sclerosis. Also, blurred vision can be the first symptom of this disease.
• Neuritis of the optic nerve of unknown etiology, or idiopathic. Cases have been registered when the cause of neuritis cannot be found out even after its successful treatment.

Symptoms

Clinical manifestations of optic neuritis develop suddenly, within a few hours, a maximum of a day. It affects more often one eye, but bilateral disease is also common. The disease is characterized by the following features:

• Feeling of a "grid" before the eyes in the first hours from the onset of the disease.
• Rapid and significant deterioration of vision in one eye or both, depending on the type of lesion.
• Violation of the perception of colors by the affected eye.
• Photophobia.
• Pain in the eye, aggravated by movement of the eyeball and pressure on it.
• Reducing the size of the fields of view. The visible space may decrease along the edges of the visual fields, and the central areas and adjacent areas may also fall out.
• Gradually, the perception of the intensity of white light is also disturbed.
• Difficulty adapting vision to twilight lighting, a significant deterioration in dark vision.
• Neuritis of the optic nerve is accompanied by common symptoms- Weakness, fever, headache.
• Characterized by an increase in symptoms with fever.

Diagnostics

To clarify and confirm the diagnosis, ophthalmoscopy is mandatory, color perception is examined, and visual fields are analyzed. With an atypical course of optic neuritis, the absence of the effect of the therapy, CT or MRI examinations of the head are additionally prescribed.

Ophthalmological examination reveals the expansion of the pupil of the diseased eye, the lack of reaction to light. A friendly reaction (contraction of the pupils of both eyes when one is illuminated) is preserved. Narrowed field of view. With ophthalmoscopy, it is possible to identify characteristic changes in the fundus of the eye: swelling, redness and expansion of the optic nerve head, vasodilation. The most pronounced changes in intracranial neuritis, with retrobulbar they are minimal.

The diagnosis is more often made on the basis of the totality of data and in the presence of characteristic complaints. Especially important is the combination of visual impairment with painful sensations when moving the eye and pressing on it.

Treatment of optic neuritis

Should be very active and start immediately after diagnosis. It must be carried out in a hospital setting. Until the results of an in-depth examination are obtained, anti-inflammatory and antibiotic therapy In the future, the list of drugs may be supplemented.

The main groups of drugs used in the treatment of optic neuritis are as follows:

• Broad spectrum antibiotics to suppress bacterial infection.
• Corticosteroids are an extremely important group of drugs, anti-inflammatory hormones that slow down demyelination.
• Diuretics are prescribed to reduce swelling of the optic nerve.
• Drugs that improve microcirculation in the area of ​​inflammation for the speedy recovery of the nerve. These can be special infusion solutions or medicinal substances- antihypoxants, antioxidants, nootropics.
• Antiallergic drugs can also reduce the symptoms of neuritis.

Corticosteroids remain the mainstay of therapy, regardless of the cause of the disease. Only they effectively stop the destruction of the nerve sheath and contribute to its restoration. Treatment begins with intravenous drip of hormones, then they switch to injection and oral administration in the form of tablets. AT severe cases possible directly retrobulbar administration of glucocorticoids.

There are two main schemes for prescribing hormones. This is the average dose for long-term use or pulse therapy with periodic administration of large doses of glucocorticoids at the onset of the disease. In both cases, the cessation of treatment should be gradual, with dose reduction over a period of at least a week, preferably two weeks. The mode of taking drugs is selected individually by the attending physician, taking into account the clinical picture, concomitant pathology and the likelihood of complications.

Prognosis of optic neuritis

In the vast majority of cases, the prognosis is favorable. With the timely start of treatment, vision is restored completely or almost completely within 2-3 months from the onset of the disease.

However, one must not forget about high probability development of multiple sclerosis in the long term, especially in women, and carefully monitor the state of health. It is advisable to regularly visit a neurologist, and if the slightest signs suspicious of multiple sclerosis appear (imbalance, muscle weakness, constipation, paresthesia) refer to it additionally.

Neuritis of the facial (optic) nerve

A sharp decrease in vision is an occasion to visit not only an ophthalmologist, but also a specialist in neurology.

Eye diseases are usually accompanied by a gradual loss of the ability to see.

Therefore, in the case of optic neuritis, symptoms and treatment should be approached very seriously.

Rapid deterioration of vision may indicate concomitant neurological pathology, in particular, on optic neuritis - inflammation, leading to changes in the structure of the nervous tissue.

Neuritis can appear at any age, but is more common in people under 50 years of age. common feature considered fast developing decline vision.

are considered characteristic the following symptoms optic neuritis:

• Sensation of a "grid" before the eyes
• Yellowish white color
• Impaired color perception
• blind spots
• Decreased vision felt in hot weather
• Pain in the eyes
• twilight vision disorder
• Visual field changes

Types of optic neuritis

Depending on which part of the optic nerve is inflamed, the following types of neuritis are distinguished:

• Papillitis- damage to the intraocular segment of the optic nerve. It stands out in a special variety. With ophthalmoscopy, this area is clearly visible, unlike the rest of the parts.

The disease progresses rapidly. There is a sharp deterioration in vision, a change in visual fields and color perception. The main symptom is a decrease in vision from the stage of a blind spot to the loss of the ability to see. On examination, there is swelling and infiltrates in the retina, dilated vessels.

• At retrobulbar neuritis inflammatory processes develop in other parts of the nerve.

On examination, there are often no obvious abnormalities. Patients complain of dull pain when moving the eyeball, loss of parts of the field of view.

For more information about this type of disease, see the video:

The allocation of these types according to the topographic feature is conditional, since inflammation can also affect neighboring sections of the optic nerve. There are forms of neuritis according to the depth of the inflammatory focus:

• Perineuritis- inflammation that affects the sheaths of the optic nerve.
• Axial neuritis- inflammation of the macular area.
• Total form- inflammation of all layers.

Causes of neuritis

The mechanism of development of this disease is not entirely clear to modern scientists. Provoking factors include the following:

• Infectious diseases (influenza, measles, meningitis, encephalitis)
• Systemic diseases (diabetes mellitus, multiple sclerosis, blood and kidney diseases)
• Inflammatory eye diseases
• Chronic course of sinusitis, periodontitis
• Excessive use of alcohol and tobacco
• Nutrient deficiency
• Poisoning by harmful substances (lead, methanol)
• Tumor metastases
• Insect bites

Diagnostics

Diagnosis is difficult when it is required to distinguish mild neuritis without severe visual impairment from other eye diseases. One of the signs of neuritis is pain syndrome when moving the eyeballs. Diagnostics is carried out by the following methods:

1. Ophthalmoscopy

2. Samples of pupils for light reaction

3. Perimetry

4. EFI eyes

6. MRI of the brain

Optic neuritis. Treatment

Treatment is usually carried out in a hospital. Until the causes of the disease are clarified, the following drugs are prescribed:

• Antibiotics to suppress infection
• Dehydration aids
• Detoxification drugs
• Anti-inflammatory drugs
• vitamin therapy
• Preparations to improve microcirculation
• Means for reducing hypersensitivity

After clarifying the origin of the disease, a course of treatment is carried out aimed at eliminating the cause of the disease. In some cases, decompression of the optic nerve sheath is indicated - its opening in order to reduce pressure in the nerve.

Optic neuritis. Treatment with folk methods

The use of traditional medicine is possible with the consent of the attending physician. Self-medication is unacceptable: optic neuritis can result in complete and irreversible loss of vision. Herbal remedies are good as additional measures.

1. You will need one tablespoon of dried nettle per glass of water. Bring to a boil, leave for an hour, then drink a little before meals.

2. Squeeze juice from fresh aloe leaves, add boiled water in a ratio of one part to five. Use in the form of lotions.

3. Pine cones have a healing effect. They improve the condition of blood vessels and stop the destruction of brain cells.

To prepare the syrup, you need a glass of green cones. Grind them, pour 2-3 liters of water. Add 4-5 spoons of fragrant rue, chopped lemon and sugar in the amount of 200-250 g. Keep on fire for about 30 minutes, then filter. Drink one spoonful of syrup three times a day before meals.

4. Fresh milk contains a variety of nutrients: vitamins, amino acids, trace elements, fatty acid. ethnoscience recommends the use of neuritis natural milk fresh.

5. Raspberry has anti-inflammatory and antipyretic properties. Pour 200-250 g of berries with a liter of water, bring to a boil and leave for two hours. Then it is necessary to strain and take three times a day.

Prevention

Preventive measures are aimed at maintaining a healthy state of the body:

• Prevent and timely treat ENT diseases, caries
• Give up bad habits
• See a neurologist for anxiety symptoms
• Avoid traumatic situations

Optic neuritis may resolve on its own within a week or a few days.

However, there is a risk of death of the optic nerve fibers, and, as a result, deterioration or loss of visual function. Therefore, at the first sign of decreased vision, you should immediately contact a specialist.

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Optic neuritis

What is Optic Neuritis -

Inflammatory optic nerve disease accompanied by a decrease visual functions. There are proper optic neuritis and retrobulbar neuritis. In the first case in inflammatory process the optic disc is also involved. With retrobulbar neuritis, the inflammatory process is localized mainly behind the eyeball. In this case, the axial bundle of nerve fibers is affected.

What provokes / Causes of Optic Neuritis:

Cause:

• inflammatory diseases of the brain and its membranes (meningitis, encephalitis),
• general acute and chronic infections (flu, tonsillitis, erysipelas, typhus, smallpox, malaria, syphilis, tuberculosis, brucellosis, etc.),
• general non-communicable diseases (blood diseases, diabetes, gout, nephritis, etc.),
• focal infections (tonsillitis, sinusitis, otitis, etc.),
• abnormal pregnancy,
• alcohol intoxication,
• inflammatory processes in the inner membranes of the eye and orbit,
• injury,
• multiple sclerosis.

Pathogenesis (what happens?) During optic neuritis:

Inflammatory changes are manifested in punctate infiltration and cell proliferation. From the pia mater, the process passes into the layer of nerve fibers. When inflammation is localized in the optic nerve trunk, it is interstitial in nature. Edema and tissue infiltration occur with the participation of leukocytes, lymphocytes and plasma cells with further development neovascularization and connective tissue. Nerve fibers are affected secondarily and may subsequently atrophy. Deterioration of visual functions is caused by degeneration of nerve fibers in the area of ​​inflammation. After the process subsides, the functions of some nerve fibers can be restored, which explains the improvement in visual acuity.

Symptoms of optic neuritis:

Clinical picture depends on the severity of the inflammatory process. With mild inflammation, the optic disc is moderately hyperemic, its boundaries are indistinct, the arteries and veins are somewhat dilated. A more pronounced inflammatory process is accompanied by a sharp hyperemia of the disc, its borders merge with the surrounding retina. White spots appear in the peripapillary zone of the retina and multiple hemorrhages. Usually, the disc does not prominate with neuritis. The exception is cases of neuritis with edema. Neuritis is characterized early violation visual functions, expressed in a decrease in visual acuity and a change in the field of view. The degree of decrease in visual acuity depends on inflammatory changes papillomacular bundle. Usually there is a narrowing of the field of view, which may be concentric or more significant in one of the areas. Central and paracentral scotomas appear. The narrowing of the peripheral boundaries of the visual field can be combined with scotomas. Also characteristic is a sharp narrowing of the field of vision for red, and sometimes a complete absence of color perception. With the transition of neuritis to atrophy, the disc turns pale, the arteries narrow, "exudate and hemorrhages resolve.

Neuritis various etiologies can proceed with characteristic clinical symptoms. The edematous form of inflammation of the optic nerve is characteristic of relapses. neurosyphilis. AT early period secondary syphilis, neuritis occurs or with little pronounced changes disk in the form of hyperemia and indistinct boundaries, or in the form of pronounced papillitis with a sharp decrease in visual functions. Highly rare form is papular neuritis, in which the disc is covered with a massive prominence in vitreous body grayish white exudate.

Tuberculous neuritis manifest as a solitary tubercle of the optic disc or ordinary neuritis. A solitary tubercle is a grayish-white tumor-like formation located on the surface of the disc and spreading to the surrounding retina.

Optic neuritis in acute infectious diseases has approximately the same clinical picture.

At retrobulbar neuritis at the beginning of the disease, the fundus can sometimes be normal. More often there is a slight hyperemia of the optic nerve head, its boundaries are fuzzy. These changes may be more pronounced, as in neuritis. AT rare cases the picture resembles a congestive optic disc. At the same time, the disk is enlarged in diameter, its boundaries are not defined, the veins are dilated and tortuous. Retrobulbar neuritis most often develops in one eye. The second eye may get sick some time after the first. Simultaneous disease both eyes are rare.

By clinical course distinguish acute and chronic retrobulbar neuritis. In the first case, a sharp decrease in visual acuity occurs quickly (within 2-3 days); in the chronic course of the process, visual acuity decreases gradually. Acute retrobulbar neuritis is characterized by pain behind the eyeball and when the eye is pressed into the orbit. Visual acuity after its initial decline begins to recover after a few days. Only in rare cases does this not happen and the eye remains practically blind.

Usually, with retrobulbar neuritis, the central absolute scotoma is determined in the field of view. White color and other colors. At the beginning of the disease, the scotoma is large, later, if there is an increase in visual acuity, it decreases, becomes relative and, with favorable course disease may disappear. In some cases, the central scotoma passes into the paracentral annular. The disease leads to descending atrophy optic disc, often in the form of temporal blanching of half of the disc due to damage to the papillomacular bundle. With existing changes in the disc, atrophy may be secondary.

Some features in the course have retrobulbar neuritis of toxic origin. One of the most common causes of these neuritis is poisoning with methanol or liquids containing methanol. Against the background of general poisoning phenomena (unconsciousness or coma in severe poisoning, nausea, in milder cases, vomiting), after 1-2 days, a sharp decrease in visual acuity of both eyes develops, sometimes to complete blindness; At the same time, pupil dilation is observed, their reaction to light is weakened or absent. The fundus of the eye is normal or there is slight hyperemia of the optic disc.

In rare cases, there is a picture of ischemic neuritis - the disc is pale, its borders are blurred, the arteries are sharply narrowed. The further course of the process may be different. Within the first month after poisoning, vision may improve. This is followed by a significant deterioration of vision up to blindness. The decrease in visual acuity is caused by the development of atrophy of the optic nerves.

Alcohol and tobacco intoxication causes damage to the papillomacular bundle. Occurs with chronic alcoholism or when smoking strong varieties of tobacco containing a large number of nicotine. It is more common in men over 30 years of age. The disease proceeds according to the type of chronic retrobulbar neuritis, the fundus of the eye is often normal. Slight hyperemia of the optic disc is much less common. A relative central scotoma appears in the field of view with normal peripheral boundaries. It often takes the form of a horizontal oval extending from the fixation point to the blind spot. It is characteristic that when complete failure from the use of alcoholic beverages or smoking comes an increase in visual acuity and a decrease in scotoma. However, blanching of the temporal half of the optic disc persists.

Retrobulbar neuritis in diabetes mellitus has a chronic course and occurs usually in men. The lesion is almost always bilateral. Visual acuity decreases slowly. There are central absolute or relative scotomas with normal peripheral boundaries of the visual field. The optic discs are initially normal, later their temporal blanching develops.

Diagnosis of optic neuritis:

In typical cases, diagnosis is not difficult. It is more difficult to diagnose easily flowing neuritis without a decrease in visual function and neuritis with edema. In these cases, it is necessary to differentiate from pseudoneuritis and congestive disc. Pseudoneuritis is characterized by normal visual function and no change on follow-up. In the initial stage, the congestive disc differs from neuritis in the preservation of visual functions and the presence of partial or complete marginal edema of the optic disc.

The appearance of even single small hemorrhages or exudative lesions in the disc tissue or surrounding retina confirms the diagnosis of neuritis. These conditions can be most accurately differentiated using fundus fluorescein angiography. It also provides reference data for the delimitation of neuritis from a stagnant disc. It is also important to monitor the course of the disease. With symptoms suggestive of increased intracranial pressure, confirmed by lumbar puncture, the diagnosis is in favor of a congestive disc. most difficult differential diagnosis neuritis from edema and complicated congestive disc, as in both cases visual functions change rapidly. Here, too, an increase in intracranial pressure may confirm the diagnosis of congestive disc.

Retrobulbar neuritis, which occurs with inflammatory changes in the optic nerve, is differentiated from neuritis proper based on the discrepancy between the intensity of disc changes and visual acuity. A sharp decrease in visual acuity, central scotoma with small changes in the optic disc indicate retrobulbar neuritis.

Treatment of optic neuritis:

Urgent hospitalization required. Until the etiology of optic neuritis is clarified, treatment is aimed at suppressing infection and inflammatory response, dehydration, desensitization, improving metabolism in the tissues of the central nervous system, and immunocorrection.

Assign broad-spectrum antibiotics parenterally for 5-7 days (do not prescribe drugs that have an ototoxic effect - streptomycin, neomycin, kanamycin, gentamicin - due to their similar effect on the optic nerve). Corticosteroids are used in the form of retrobulbar injections of a 0.4% dexamethasone solution, 1 ml daily, for a course of 10-15 injections, as well as oral prednisone, starting at 0.005 g from 4 to 6 times a day for 5 days with a gradual dose reduction. Inside diakarb (acetazolamide) 0.25 g 2-3 times a day (3 days admission, 2 days break, at the same time take Panangin 2 tablets 3 times a day), glycerin 1-1.5 g / kg body weight, intramuscularly a solution of magnesium sulfate 25%, 10 ml, intravenously a solution of glucose 40%, a solution of hexamethylenetetramine 40%, intranasally into the middle nasal passage - swabs with a solution of adrenaline 0.1% daily for 20 minutes (under the control of blood pressure).

Inside vitamins of group B, piracetam (nootropil) up to 12 g / day, solcoseryl (actovegin) intramuscularly, for 2-3 months, 10 mg (> / 2 tablets) of dibazol are prescribed orally 2 times a day. After clarifying the etiology of optic neuritis, treatment is carried out aimed at eliminating the cause of the disease (specific treatment of tuberculosis, antiviral and immunocorrective therapy for herpes, surgery sinusitis, etc.). The same treatment, with the exception of the appointment of antibiotics, is carried out with bilateral toxic retrobulbar NZN, which arose as a result of poisoning with methyl alcohol or its derivatives.

Emergency treatment in such cases includes measures for detoxification - ingestion of a solution of ethyl alcohol 30% in a single dose of 90-100 ml, followed by a repetition of taking a half dose every 2 hours (can be administered through a probe or a 5% solution intravenously); the use of a solution of sodium bicarbonate (baking soda) 4% for gastric lavage and other routine measures to help with acute poisoning. The duration of the disease is about 4 weeks, there is no direct relationship between the severity of ophthalmoscopic changes in the optic nerve head and visual impairment.

Papillitis is usually acute, the process is often unilateral. Retrobulbar optic neuritis can be acute, unilateral, or chronic bilateral, with one eye falling ill first, and after a few weeks or months the second (a typical course against the background of optochiasmal leptomeningitis). Paleness of the temporal half of the disc becomes noticeable on the 3rd week of the disease. The outcome of optic neuritis can be a complete recovery and restoration of visual functions, but more often there is a partial (possible and complete) atrophy of the optic nerve.

Which doctors should you contact if you have Optic Neuritis:

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Other diseases from the group Diseases of the eye and adnexa:

Group B and methods of physiotherapy. Rarely, surgery is used.

Toxic defeat

Damage to the optic nerve can lead to:

• methyl and ethyl alcohols,
• substances found in tobacco smoke
• lead,
• quinine,
• antihelminthic drugs.

With the use of methyl alcohol, toxic damage begins with nausea, vomiting, and sometimes loss of consciousness. Large doses methyl alcohol can also be fatal. Visual disturbances occur a few hours after the use of methanol. In the optic nerve, an inflammatory process develops quite quickly, leading to atrophy of the optic nerves and death of nerve fibers.

Treatment of toxic damage to the optic nerve should begin with the cessation further action toxin and the appointment of detoxification therapy to remove dangerous substance from the body. Diuretics and anti-inflammatory drugs are prescribed to reduce swelling. In order to maintain the function of the optic nerve, drugs that improve the nutrition of the nervous tissue, as well as antioxidants and vitamins, are used.

neuropathy

There are the following types of neuropathies:

• compression ( nerve compression),
• ischemic ( disruption of oxygen delivery to the nerve),
• inflammatory,
• traumatic,
• radiation,
• congenital.

Optical neuropathy is manifested primarily by a violation of central vision. For early recognition, the following method is recommended: alternately closing your eyes, read small text or evaluate the intensity of colors, for example, on a TV screen.
Visual acuity in neuropathies is reduced, but is reversible. A weakened reaction of the pupil to light, a deterioration in light and color perception are also characteristic.

In therapy optic neuropathy drugs are used that protect nerve fibers and improve their nutrition and blood supply, biostimulants, and physiotherapy methods. Sometimes operations are performed to reduce pressure on the optic nerve.

glioma

Surgical treatment of optic nerve glioma. The best results are achieved with surgical interventions on early stage when the tumor has not yet spread into the cranial cavity.

Hypoplasia (underdevelopment)

Unfortunately, there are currently no truly effective methods of therapy for this pathology. Drugs that improve nerve nutrition, laser stimulation of the retina, transcutaneous electrical stimulation of the optic nerves and light stimulation are used.

Atrophy

Disorders of the circulation of aqueous humor in the eye (Glaucoma)

What is glaucoma?

Any glaucoma is characterized by a triad of symptoms: increased intraocular pressure, changes in the fundus and limited visual field.

In addition, there are also the following signs:

• blurred vision,
• pain, pain and a feeling of heaviness in the eyes,
• visual impairment in dark time days,
• the appearance of "rainbow circles" when looking at a bright light.

congenital glaucoma

The basis of this pathology is a congenital anomaly of the eye, which creates obstacles and difficulties in the outflow of intraocular fluid, which leads to an increase in intraocular pressure.

Causes of congenital glaucoma in the fetus- various pathological conditions women, especially in the first months of pregnancy:

• infections ( influenza, measles rubella, etc.),
• ionizing radiation, etc.

• increased intraocular pressure,
• lacrimation,
• photophobia,
• rapidly progressive increase in the size of the eyeball,
• an increase in the diameter of the cornea,
• corneal edema,
• slow pupil reactions
• changes in the optic disc.

Secondary glaucoma

Angle-closure glaucoma

Open angle glaucoma

Acute attack of glaucoma

• rapid loss of vision up to blindness,
• sharp pain in the eye and half of the head,
• vomit,
• corneal edema,
• pupil dilation,
• no pupillary response to light
• redness of the eye.

Glaucoma treatment

With closed-angle form, the method of removing the lens with the implantation of an intraocular lens is more often used.

Diseases of the oculomotor apparatus

Ophthalmoplegia

Ophthalmoplegia is divided into complete and partial. When complete, both external and internal muscles eyes. Partial ophthalmoplegia can be external, in which only the external muscles are paralyzed, and internal, in which only the internal muscles of the eye are paralyzed. With external ophthalmoplegia, the immobility of the eyeball is observed, and the reaction of the pupil to light is preserved. With the internal - the movements of the eyeball are preserved, but there is no reaction of the pupil to light, and convergence and accommodation are also disturbed.

In the treatment of ophthalmoplegia, the main emphasis is on the treatment of the underlying disease - it is necessary to eliminate the cause that caused ophthalmoplegia. In the primary form of ophthalmoplegia, vitamins of groups E and B, the introduction of prozerin and dibazol are also used.

Strabismus

The cause of this pathology can be:

• developmental defects, paralysis and damage to the oculomotor muscles,
• diseases of the nervous system,
• childhood infectious diseases
• head injury,
• nerve tissue tumors
• multiple sclerosis,
• wearing glasses with incorrect centering,
• long bang.

Ways to treat strabismus
1. Plenoptic therapy - increased visual load on the affected eye. In this case, various methods of stimulation are used with the help of a therapeutic laser and medical computer programs.
2. Orthoptic Therapy – treatment with the use of computer programs and synoptic devices that restore binocular vision.
3. Diplomatic therapy – restoration of stereoscopic and binocular vision in natural conditions.
4. Convergence trainer workouts is a method that improves convergence ( reduction to the nose) eye.
5. To surgical intervention resorted to in cases where conservative therapy turns out to be ineffective and does not give results within 1.5 - 2 years. Surgery cures strabismus, but special exercises to restore normal function eyes are still needed.

It is wrong to assume that strabismus can go away by itself. Moreover, if left untreated, it threatens to develop serious complications. Therefore, an ophthalmologist should be consulted immediately after the appearance of its first signs.

Amblyopia

There are the following types of amblyopia, depending on the causes of its occurrence:
1. Anisometropic amblyopia develops with significant differences in the refractive power of the eyes.
2. obscurative, or deprivation, - is a consequence of the suppression of visual activity in one eye, which is caused by congenital anomalies such as cataracts or clouding of the cornea. This species is characterized by the persistence of reduced vision even after the elimination of opacification.
3. Dysbinocular amblyopia, which develops with strabismus: the brain, in order to suppress double vision, perceives information coming from only one eye.
4. Hysterical (psychogenic blindness) - occurs with hysteria, often in combination with other functional disorders vision ( violation of color perception, photophobia, narrowing of the field of view, etc.).
5. Refractive amblyopia can develop with untreated refractive errors that lead to blurry focusing of objects with one eye.

Therapy of the disease that underlies amblyopia should be started as early as possible. Amblyopia does not go away on its own, does not disappear as the child grows older, and in all cases requires treatment. In the treatment of amblyopia, several areas are usually involved: elimination of strabismus, correct correction of defects optical system eyes and amblyopic eye training.

nystagmus

Bilateral nystagmus is much more common than unilateral. Depending on the direction of movement of the eyeballs, horizontal, vertical, rotational and diagonal nystagmus is distinguished.
This pathology can be congenital and accompanied by enough a strong decline visual acuity.

The cause of nystagmus almost always lies in various diseases of the areas of the brain that are responsible for eye movements and their coordination. In addition, nystagmus can develop with pathologies of the organ of balance and areas of the brain associated with its activity, in case of poisoning with drugs or narcotic substances.

Treatment of nystagmus lies in the treatment of the underlying disease, but complete cure pathological nystagmus is practically not amenable to. Symptomatically used vitamin therapy and antispasmodics, which can temporarily improve the condition.

Spasm of accommodation

Reasons for the development of accommodation spasm:

• poor illumination of the workplace;
• excessive eye strain computer, TV, doing homework in the evening);
• insufficient night sleep, lack of walks on fresh air and sports;
• discrepancy between the height of the chair and the desk height of the child;
• violation when reading the optimal distance to the book, which should be 30 - 35 cm;
• weakness of the back and neck muscles;
• circulatory disorders of the cervical spine;
• hypovitaminosis, malnutrition.

• feeling of pain and burning, redness of the eyes;
• eyes get tired quickly when working at short distances;
• near the picture becomes less clear, and far away the image blurs;
• sometimes there is double vision;
• the appearance of a headache, sometimes taken for age-related restructuring of the body.

Diseases of the orbit

exophthalmos

This condition occurs when:

• tumors of the orbit located behind the eyeball,
• tissue swelling,
• aneurysms and thrombosis of cerebral vessels,
• inflammatory processes in the orbit and paranasal sinuses,
• traumatic injuries of the eye.

enophthalmos

Refractive errors (ametropia)

Myopia

Myopia most often develops in school years, and in most cases associated with long work visual apparatus at close range ( writing, reading, drawing). Such activity is especially dangerous in case of improper, insufficient lighting. In addition, the weakening of the eye muscles also contributes to the development of myopia.

Currently, there are 7 officially recognized methods for correcting myopia:

• wearing glasses,
• wearing contact lenses,
• laser vision correction ,
• lens replacement,
• lens implantation,
• radial keratotomy,
• corneal plastic.

If measures are not taken to correct myopia, then myopia can progress, which can lead to irreversible changes in the eye and significant loss of vision.

farsightedness

One of the types of this pathology is presbyopia - age-related farsightedness. With age, vision deteriorates more and more due to a decrease in the accommodative abilities of the eye - the elasticity of the lens decreases, and the muscles that hold it weaken. Therefore, presbyopia is diagnosed in almost all people over the age of 50 years.

Farsightedness can be corrected with glasses or contact lenses. In addition, laser eye surgery methods are also used in its treatment.

Astigmatism

In the treatment of astigmatism, special glasses with cylindrical glasses or contact lenses are used, since optical lenses spherical shape are not able to fully compensate for this defect. Also, on the recommendation of an ophthalmologist, surgical treatment can also be used.

Untreated astigmatism can lead to the development of strabismus and a sharp decrease in vision. In addition, uncorrected astigmatism often causes headaches and pain in the eyes.

Anisometropia

The treatment of anisometropia lies in the systematic application of correct and methodical exercises for the eyes. Therapy should be carried out under the mandatory supervision of an ophthalmologist.

asthenopia

• burning, stinging and pain in the eyes,
• marked increase in lacrimation,
• headache,
• feeling of general fatigue.

The optic nerve is a connection of more than 1 million sensory processes or axons of retinal nerve cells that transmit information about the perceived image in the form of electrical impulses to the brain. AT occipital lobe brain, this information is finally processed and a person gets the opportunity to see everything that surrounds him.

Depending on which part of the optic nerve is damaged, inflammation of the intraocular part of the nerve or papillitis and retrobulbar neuritis are isolated - if the part of the optic nerve behind the eyeball is damaged.

The optic nerve delivers nerve messages to the area of ​​the brain responsible for processing and perceiving light information.

The optic nerve is the most important part of the entire process of converting light information. Its first and most significant function is to deliver visual messages from the retina to the areas of the brain responsible for vision. Even the smallest injury to this area can have serious complications and consequences.

Ruptures of nerve fibers threaten with loss of vision. Many pathologies are caused by structural changes in this area. This can lead to impaired visual acuity, hallucinations, disappearance of color fields.

Experts identify three main functions that directly controls the optic nerve:

1. Visual acuity - provides the ability of the eye apparatus to distinguish small objects at a distance.
2. Color perception - the ability to distinguish all colors and shades (the optic nerve is directly responsible for it).
3. The field of view is the part of the surrounding space that the fixed eye can see.

The optic nerve of the eye is very difficult to treat. It should be noted that it is almost impossible to completely restore this atrophied part. The doctor can only save the fibers that have begun to break down, if only they are partially still alive. For this reason, treatment primarily involves A complex approach, and the important goal is to stop Negative consequences preventing the disease from progressing further.

What is optic neuritis

Neuritis is an inflammatory disease of the optic nerve, accompanied by a decrease in visual functions. There are proper optic neuritis and retrobulbar neuritis.

1. Intrabulbar (papillitis). Papillitis is characterized by an early violation of visual functions - a decrease in visual acuity and a change in the visual field. The decrease in visual acuity depends on the degree of inflammatory changes in the papillomacular bundle.
2. Retrobulbar optic neuritis. This inflammatory process is localized mainly behind the eyeball. In this case, the axial bundle of nerve fibers is affected.
3. Neuroretinitis is papillitis, which is combined with inflammation of the nerve fibers of the retina. This pathology is characterized by the appearance in the macular area of ​​\u200b\u200bthe "star figure", which is a solid exudate. Neuroretinitis is one of the rarest types of optic neuritis, usually due to viral infection, syphilis, cat-scratch disease.

Nerve fibers can be affected secondarily and subsequently atrophy. Deterioration of visual functions causes degeneration of nerve fibers in the area of ​​inflammation. When the process subsides, some nerve fibers are able to regenerate their functions, which explains the restoration of visual acuity.

In order to promptly suspect inflammation of the optic nerve, you should know the most common causes that can lead to this condition.

Causes of the disease

The causes of optic neuritis are quite diverse, in principle it can be any acute or chronic infection. Frequent causes:

• Inflammation of the brain and meninges (,);
• Some acute and chronic common infections(influenza, tonsillitis, typhus, erysipelas, smallpox, malaria, tuberculosis, syphilis, etc.);
• General non-communicable diseases (blood pathologies, nephritis, diabetes, gout, etc.);
• Local infections (, otitis media, etc.);
• Pathology of pregnancy;
• Alcohol intoxication;
• Foci of inflammation of the inner membranes of the eye and orbit;
• Multiple sclerosis;
• Injuries.

Main risk factors:

• Age. NZN can occur at any age, but it is common in people between 20 and 40 years of age.
• Gender identity. Neuritis occurs 2 times more often in the female half of humanity.
• The presence of genetic mutations can lead to the development of ND.

Symptoms of optic neuritis

The first signs of the disease develop unexpectedly and can be manifested in different ways - from a decrease and loss of vision to pain in the orbit.

Among the more common symptoms of the disease are:

• Pain that appears when moving the eye (such a symptom occurs almost always);
• Decreased color perception;
• Decreased visual acuity. The severity of the symptom in NZN can be different. Most often, patients complain only of a slight loss of vision, which increases during physical activity or into the heat. The change in visual acuity is temporary, but rarely can be irreversible.
• Pain in the eye without movement;
• Fever;
• Deterioration of peripheral vision;
• Nausea and headache;
• Visual impairment after a bath, bath, hot shower or physical exertion;
• Blind spot in the center of vision.

Complications of optic neuritis can be the following conditions:

• Damage to the optic nerve. Most patients with optic neuritis will have permanent damage. nerve fiber varying degrees. It is also worth noting that there may be no symptoms of a violation of the integrity of the optic nerve.
• Decreased visual acuity. Almost all patients restore their previous visual acuity within a few months. In some people, visual changes persist even after the disappearance of all symptoms of optic neuritis.

Diagnostic methods

When diagnosing such eye disease The ophthalmologist takes into account several factors.

1. The ophthalmoscope when examining the optic nerve head can not always confirm the presence of the disease.
2. Sometimes, when making a diagnosis, an electrophysiological study of the damaged optic nerve, a study of the visual field, determination of color perception, and computed tomography of the brain are performed.

Sometimes a consultation with narrow specialists is prescribed to accurately confirm the diagnosis and establish the true cause of the progression of the disease.

Treatment for neuritis

To treat optic neuritis, doctors prescribe:

1. corticosteroids;
2. anti-inflammatory drugs. Release form - drops, ointments, tablets. Perhaps the appointment of injections;
3. antibiotics. As a rule, preference is given to broad-spectrum drugs;
4. drugs that positively affect blood microcirculation;
5. prednisolone.

Treatment should take place in a complex. The patient is required to take pills that contain steroids. Basically, the duration of admission is about 14 days. Also, a person is prescribed antibiotics that have wide range actions.

Important! Treatment of optic neuritis should be carried out only in a hospital, as there is a high probability of developing serious complications.

With a disease of the optic nerve, the patient needs to nourish his body with B vitamins. To do this, he is prescribed intramuscularly solcoseryl, piracetam and other medicines. You also need to take dibazol orally. You need to do this twice a day. Sometimes steroid therapy may not have the desired change, after which they tend to plasmapheresis.

If a pathology is detected in late stage used to relieve symptoms antispasmodic drugs. They affect the intensity of microcirculation. These include, in particular, medicines such as:

• xanthinol,
• Nicergoline,
• Sermion,
• Trental,
• nicotinic acid.

It is expedient and quite effective to carry out laser and electrical stimulation of the organs of vision, magnetic therapy.

The prognosis for the patient depends on the type of disease and severity. If you start the treatment of pathology on time and choose the most optimal tactics, you can achieve a complete recovery of the patient. However, often after the end of treatment, partial (in rare cases, complete) atrophy of the optic nerve occurs. If signs of optic nerve atrophy are detected, antispasmodics and drugs to improve microcirculation (sermion, trental, nicotinamide, nicotinic acid) are additionally recommended.

Disease prevention methods

To prevent the development of ocular neuritis, it is recommended to adhere to the following rules:

1. treat lesions promptly chronic infection in the ENT organs;
2. timely consult with a neurologist if any complaints appear;
3. immediately contact an ophthalmologist with the slightest decrease in visual acuity or the appearance of other eye symptoms;
4. avoid traumatic injury eyeball, etc.