Pre symptom of retrobulbar optic neuritis?

summary

Retrobulbar optic neuritis is generally divided into acute and chronic, the latter is more common. The retrobulbar optic nerve can be divided into many different types because of the different parts of the optic nerve involved: the lesion most often invades the optic disc macular bundle fiber, which is also called axial neuritis because it is in the central part of the retrobulbar orbital optic nerve; When the optic nerve is invaded by the nerve sheath, it is called perineural stromal inflammation, which is only a pathological change and is not easy to be diagnosed clinically; If the whole optic nerve fiber is transected and involved, there will be no light perception and dark shadow, which is called transverse optic neuritis. Pre symptom of retrobulbar optic neuritis? Let's talk about it

Pre symptom of retrobulbar optic neuritis?

Symptoms binocular or monocular vision rapidly decreased, often in a few hours or 1 ~ 2 days of severe visual impairment, severe can completely lose light perception. Due to the inflammatory swelling of the optic nerve, the dural sheath around the optic nerve also swells, and then affects the total tendon ring at the muscle cone of the orbital apex, especially the muscle sheath of the superior rectus and medial rectus. Therefore, 80% of patients often feel slight swelling and pain at the back of the eyeball, especially when looking up and inside. Sometimes it can cause slight pain when pressing the eyeball with the hand.

According to visual acuity and fundus, especially visual field examination, typical cases are easy to be diagnosed. Color contrast sensitivity test and VEP are helpful in diagnosis. Abnormal cells in cerebrospinal fluid, γ- It should be suspected as multiple sclerosis. The monoclonal antibodies in cerebrospinal fluid (CSF) can be increased by 90%, but non-specific hla-a3 and B7 are also helpful for diagnosis.

It often occurs in monocular eyes, and can also affect both eyes. Most of them show sharp vision loss, or even no light perception. The pupil is moderately dilated and insensitive to light. Traction pain or deep orbital pain occurred during eye movement. In the early stage, the fundus is normal, and in the late stage, there may be varying degrees of light color on the temporal side of the optic disc. There were central, paracentral and dumbbell shaped dark spots in the visual field, and the peripheral visual field was also reduced. The central visual field should be emphasized instead of the peripheral visual field, and the red should be emphasized, and the small visual mark should be used as far as possible. When exercise or hot bath appear temporary blurred vision, and in the cold temperature or drink pterin drink vision can improve sex, this phenomenon is called unthoff sign. It is more common in optic neuritis caused by multiple sclerosis and Leber's disease. It can also be seen in other optic neuritis. It is speculated that the increased body temperature may directly interfere with axonal conduction and release of chemicals.

matters needing attention

The onset of the disease is sudden, and the visual acuity drops seriously. Once diagnosed, the combination of Chinese and Western methods should be actively used to save the visual acuity. During the illness, we should pay attention to avoid emotional stimulation and keep the two stools unblocked. If the disease occurs during lactation, weaning should be done immediately. Postpartum onset, pay attention to strengthen nutrition.