OPTIC NEURITIS AND RETROBULBAR NEURITIS

 OPTIC NEURITIS AND RETROBULBAR NEURITIS

OPTIC NEURITIS AND RETROBULBAR NEURITIS …Both the conditions include inflammation of the optic nerve head from various toxic and infective conditions. When inflammatory changes are located in the most anterior part it is called optic neuritis or papillitis. In this stage ophthalmoscopic changes are seen. When the inflammatory changes are comparatively posteriorly located the condition is called retrobulbar neuritis. In this stage ophthalmoscopic changes are not seen. Ultimate fate of optic neuritis is optic atrophy.

CAUSES

General causes

Multiple sclerosis.

Viral-Measles, Mumps, Influenza, Herpes zoster ophthalmicus. Syphilis.

Neuromyelitis optica or Devic’s disease.

Meningitis.

Encephalitis.

Autoimmune disorder, particularly SLE.

Encephalomyelitis.

Avitaminosis.

Various toxic drugs and agents.

Local causes

Orbital and periorbital infection.

CLINICAL FEATURES OF  OPTIC NEURITIS AND RETROBULBAR NEURITIS

Pain behind the eyes and pain during ocular movements are very important symptoms. Even external pressure may induce pain. When the disc is inflammed features of papilloedema are seen but haemorrhages are rare. In retrobulbar neuritis disc is usually normal except after development of optic atrophy. General scotoma with red-green colour blindness is seen in optic neuritis due to involvement of macular fibres.

TREATMENT OF  OPTIC NEURITIS AND RETROBULBAR NEURITIS

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The underlying cause if possible can be treated. Analgesic drugs are helpful for pain. Steroids are said to be beneficial. IV Methyl prednisolone followed by oral Prednisolone may help in visual recovery. Ophthalmologic consultation is urgent.

 .OPTIC NEURITIS AND RETROBULBAR NEURITIS.