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Optic Nerve Diseases
Optic Nerve Diseases
DEPARTMENT OF OPHTHALMOLOGY,
FACULTY OF MEDICINE, HASANUDDIN UNIVERSITY
MAKASSAR
2003
1. Optic neuritis
2. Papiledema
3. Optic atrrophy
4.
Optic Neuritis
Optic neuritis (ON) is inflammation of the optic nerve.
ON may be divisible into 2 types :
1. Intra ocular optic neuritis (papillitis)
2. Retrobulbar optic neuritis
Etiology :
1.
- retinitis
- Symphatetic ophthalmia
- meningitis
- Sinus or orbital inflammation
2. General Inflammation conditions
- demyelinating diseases
- syphilis
- tuberculosis
3. Leber`s Diseases
4. Endogenous toxin,
- acute infective fever (influenza, measeles, mumps)
- septic foci (tonsilitis, sinusistis)
- metabolic diseases ( DM, avitaminosis, anemia)
5. Exogenous toxins, such tobacco, ethyl alkohol, arsenic, quinine, etc.
Papillitis
It is inflammation of the optic nerve head (intraocular part of the optic nerve.)
Clinical features :
Symptoms,
-Unilateral with suddenly loss of central vision
-There are may be some pain in behind of eyeball
Sign,
-Optic disc hyperemic with blurred margins
-On the progressed conditions, swelling and edema of the disc and
surrounding retina
-Retinal veins are engorged and soft exudate of the disc.
-Flame shaped haemorhages around the disc.
-Fine floating opacities of the posterior vitreous humour
-Relative central scotoma
Treatment :
Should be directed to remove the underlying cause.
-Rest to the eye, and protection from light.
-Neurotropic, such as Vit. B complex
-Systemic antibiotic
-Costicosteroid
Retro-Bulbar Neuritis
It is inflammation of the retro-bulbar portion of optic nerve.
Retrobulbar neuritis can be divided into 2 parts : acute and chronic
retrobulbar neuritis,
Clinical features :
Symptoms,
-Sudden and profound loss of central vision
-There are may be some pain with the movement of the globe
-Headache as the same side of the lesion
Sign,
-The eye appear normal externally
-Fundus examination reveals no obvious changes.
-Scotometry reveals central or centro-caecal scotoma.
Course
In most cases, there is spontaneous recovery and recurrences are not uncommon.
Treatment
Same as papillitis
Papilloedema
It is a passive, non inflammatory edema of the optic disc due mostly
to raised intracranial pressure. Most of cases are bilateral.
Etiology :
a.
b.
c.
Clinical features :
Symptoms, are often negligible
Papillitis
Papilloedema
-Disc swellings 2 D
-Venous engorgmenet and
retinal haemorrhages +++
-Loss of sight sudden and profound
-Transient and recovery 1-2 weeks
-Field defect central scotoma for red
and green color
-Disc swelling 6D
-Venous engorgmenet and
retinal haemorrhages+
-Visual loss negligible and gradual
- Blindness in untreated patients
-Field defect concentric contractrion
of the peripheral field
Treatment
Remove the underlying causes (intracranial)
-Tumor remove with surgical intervention
-Abcess- drainage