Optic neuritis is an inflammation of the myelin sheath of the optic nerve, responsible for carrying the visual information from the retina to the structures in the brain, and thus has a role in “awareness” and perception of the corresponding visual image. Very often the disease appears first manifestation of chronic demyelinating process, so its recognition and timely measures are essential.
What are the symptoms of the disease?
– Progressive visual impairment in one eye, rarely both eyes. The condition occurs for a few hours to several days and usually stays within a couple of weeks, then resolves spontaneously. It can be expressed as in blurry fields in visual perception and fully blindness. When it affected only one eye and the offense is mild, often thanks to the healthy eye, the patient may not even notice the ensuing defect;
– Pain – retro-orbital, which is felt behind the eyeball, in the depths of the eye, or pain in the eye itself. Often the pain is provoked and increases in eye movement. It may precede the occurrence of the decrease of eyesight and generally follows the course of the condition;
– Violation in color perception – patients may experience difficulty in recognizing certain colors lose their perception of contrast to see blurred or less bright than usual. These complaints can in some cases be more pronounced than the decrease in vision;
– Uhthof -vloshavane phenomenon of vision due to exposure to heat and physical exertion;
– Phenomenon Pulfrih – perception circular motion of objects that actually move straight. Probably due to the asymmetrical conductivity between the two optic nerves.
What are the reasons for the occurrence of the disease?
The exact cause remains unclear. It is about the occurrence of the autoimmune process in which the body’s immune system is directed against its own tissues, in this case against the myelin sheath of the optic nerve. Many cases of optic neuritis associated with the onset of demyelinating disease – multiple sclerosis and optic neuromyelitis. In the last state unless both optic nerve prejudice and spinal cord with recurrent episodes of blindness, weakness and paralysis. There are isolated cases of optic neuritis. It can also occur in the infectious process, affecting the paranasal sinuses and the orbit of the eyeball, and in the course of systemic viral disease and the like.
What people are affected?
The disease often affects people in a young age – from 20 to 45 years, the incidence in women is twice higher than in men.
How is it diagnosed?
Complaints from impaired vision are often the occasion for ophthalmological or nevrooftalmolog where you can establish a decrease in visual acuity, impaired color vision and perception of contrast and brightness of colors, visual field defects in the form of central Scotoma and others. Investigation of the fundus given only in 1/3 of the cases of the presence of inflammation of the optic nerve papilla – ie. papillitis as the process often develops retrobulbar. Study of visual evoked potentials could also offer a variation in conductivity of the visual pathways, even in subclinical proceeded inflammation of the optic nerve. MRI of the brain is one of the priority research to detect other foci of demyelination to form a picture of chronic demyelinating process – usually multiple sclerosis. In 10-12% of patients with optic neuritis was found such demyelinating plaques in the brain, which are still without clinical significance. 10-year risk of developing multiple sclerosis in patients even with only one plate is 56%. Other studies are made with the aim of rejecting the presence of other pathology within which may be evidenced optic neuritis.
What is the treatment and prognosis of optic neuritis?
Treatment depends on the underlying cause for the development of optic neuritis. The most often applied corticosteroids master acute deterioration of vision, without an effect in the long term. Re-growth vision often occurs spontaneously within a few weeks. Often, however, they remain known defects in the perception of colors and their brightness and contrast.