Presentation
An abnormal fundus examination on initial presentation is a significant predictor of visual impairment at 3 months after presentation. [omicsonline.org]
Case 2 A 27 year old man presented with a 4 months history of generalised headache. Five days prior to presentation he awoke with left sided facial and limb weakness which improved spontaneously though incompletely over the subsequent days. [ispub.com]
Presentation of ophthalmic disease Ocular manifestations in SLE are fairly common, potentially sight threatening and may be the presenting feature of their disease [ 4, 5 ]. SLE may affect almost any part of the eye and visual pathway. [academic.oup.com]
Experts from Harvard Medical School and the Massachusetts Eye and Ear Infirmary present authoritative, state-of-the-art recommendations in a rapid-access outline format. [books.google.com]
Entire Body System
- Anemia
The stomach ulcer was treated with gastric surgery, date unknown, with resultant pernicious anemia. [journal.opted.org]
EYES - ANEMIA - nerves, optic - tea drinkers, in SPIG. EYES - ANEMIA - nerves, optic alumin-p. dig. kali-p. spig. Eyes - ANEMIA, conjunctiva - optic nerve - tea drinkers, in Spig. Eyes - ANEMIA, conjunctiva - optic nerve alum-p. dig. kali-p. spig. [homeopathyworldcommunity.ning.com]
: Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med 1988, 318 :1720–1728. PubMed CrossRef Google Scholar 41. [link.springer.com]
However, the optic neuropathy associated with pernicious anemia and vitamin B 12 deficiency can even be seen in well-nourished individuals. Gastric bypass surgery may also cause a vitamin B 12 deficiency from poor absorption. [en.wikipedia.org]
Degeneration of the disc may also accompany arteriosclerosis, diabetes, glaucoma, hydrocephalus, pernicious anemia, and various neurological disorders. [medical-dictionary.thefreedictionary.com]
- Fever
[…] sinuses. [2], [3] Optic neuropathy due to sinusitis and mucocele should be considered in patients who have clinical evidence of optic neuritis with seemingly atypical features, particularly in elderly patients with severe sinus disease, a history of fever [ruralneuropractice.com]
History headache and vomiting, initially no visual symptom. sudden loss of vision; H/o fever, or upper respiratory tract infection. 2. Laterality usually bilateral. usually unilateral. 3. [thamburaj.com]
Eyes - PARALYSIS, eyes - optic nerve, amaurosis - typhoid fever, after Lyc. Eyes - PARALYSIS, eyes - optic nerve, amaurosis - years, of seven, duration PHOS. [homeopathyworldcommunity.ning.com]
The clinical criteria included fever, headache and neck stiffness of >2 weeks duration. [omicsonline.org]
PAN can present as a systemic vasculitis with symptoms including fever, weight loss, myalgias, and arthralgias. Alternatively, the vascular lesions can be restricted to specific organs. [frontiersin.org]
- Malnutrition
The mechanism is unclear, but this has been reported to be more common in individuals who are already suffering from malnutrition. [en.wikipedia.org]
Nutritional disorders: malnutrition, malabsorption, and B12 and other vitamin deficiency. In: Merritt’s Neurology 12 th Edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. Schrier SL. [journal.opted.org]
The toxic factors on the degenerative processes due to malnutrition may cause selective affection of the inner portion of the nerve,-axial neuritis. [ijo.in]
Jaw & Teeth
- Jaw Claudication
In a young patient, previous history of eye pain, paraesthesiae, ataxia or weakness suggest demyelination In an older patient, previous history of transient visual loss, diplopia, temporal pain, jaw claudication, fatigue, weight loss and myalgia suggests [patient.info]
Neuropathy (AION) A manifestation of giant cell arteritis; patient usually over 70 years of age; visual loss is sudden and in some cases bilateral; the visual loss is frequently accompanied by periocular pain and preceding headaches, jaw claudication [thamburaj.com]
Giant cell arteritis patients usually present with systemic symptoms, including anorexia, weight loss, jaw claudication, headache, scalp tenderness, abnormal temporal artery, neck pain, myalgia, malaise and anemia. [webeye.ophth.uiowa.edu]
Cardiovascular
- Hypertension
The most common cases seen in the examination is benign intracranial hypertension. ) Unilateral disc swelling inflammatory causes: papillitis vascular causes: arteritic or non-arteritic ischaemic optic neuropathy, central retinal vein occlusion neoplastic [mrcophth.com]
Changes in retinal vessels Changes in retinal vessels - disruption and the caliber of retinal vessels - are observed more often with hypertension, sclerosis of cerebral vessels. [minclinic.ru]
Hypertensive encephalopathy 5. Intracranial vascular lesions: sub-arachnoid hemorrhage, sagittal sinus thrombosis, etc. 6. Head-injury - long standing contusions, carotid-cavernous fistula 7. [thamburaj.com]
Kaye AH, Galbraith JEK, King J: Intracranial pressure following optic nerve decompression for benign intracranial hypertension: Case report. J Neurosurg 1981;55:453–456. [karger.com]
Other associated systemic diseases have also been reported, including sleep apnea, arterial hypotension due to a variety of causes, malignant arterial hypertension and migraine. b. [webeye.ophth.uiowa.edu]
Musculoskeletal
- Myalgia
In a young patient, previous history of eye pain, paraesthesiae, ataxia or weakness suggest demyelination In an older patient, previous history of transient visual loss, diplopia, temporal pain, jaw claudication, fatigue, weight loss and myalgia suggests [patient.info]
PAN can present as a systemic vasculitis with symptoms including fever, weight loss, myalgias, and arthralgias. Alternatively, the vascular lesions can be restricted to specific organs. [frontiersin.org]
Giant cell arteritis patients usually present with systemic symptoms, including anorexia, weight loss, jaw claudication, headache, scalp tenderness, abnormal temporal artery, neck pain, myalgia, malaise and anemia. [webeye.ophth.uiowa.edu]
Eyes
- Central Scotoma
The visual field defect of a maculopathy is almost invariably a central scotoma with a zone of metamorphopsia that surrounds it. [medtextfree.wordpress.com]
SITA Standard 30-2 Humphrey Visual Field testing from the initial visit in February 2011 shows central scotoma OS. [journal.opted.org]
However, in high-degree myopia, it may extend to the upper and lower borders, or form a complete ring around the optic disc and form a central scotoma. Tilted Disc A tilted optic nerve occurs when the nerve exits the eye at an oblique angle. [decisionmakerplus.net]
LHON affects prevalently young males, who suffer an acute/subacute loss of central vision that leads to rapid decrease of visual acuity due to central scotoma. [journals.plos.org]
However, the prognosis is worse in SLE associated optic neuritis, with more than half having a persistent central scotoma and progressing to optic atrophy. [academic.oup.com]
- Blepharospasm
All chapters have been updated to include the latest information on new disease entities, diagnostic techniques, drugs, and treatments, including LASIK and LASEK surgery, cataract extractions, intraocular lenses, use of botulinum for blepharospasm, and [books.google.com]
Blepharospasm is also reported and may be troublesome. [academic.oup.com]
Workup
A thorough examination of the retina, with appropriate imaging when indicated, is an important component in the workup and management of all optic neuropathies, and patients with retinopathy should have periodic OCT scanning of the retinal nerve fibre [bjo.bmj.com]
Visual Field Test
- Central Scotoma
The visual field defect of a maculopathy is almost invariably a central scotoma with a zone of metamorphopsia that surrounds it. [medtextfree.wordpress.com]
SITA Standard 30-2 Humphrey Visual Field testing from the initial visit in February 2011 shows central scotoma OS. [journal.opted.org]
However, in high-degree myopia, it may extend to the upper and lower borders, or form a complete ring around the optic disc and form a central scotoma. Tilted Disc A tilted optic nerve occurs when the nerve exits the eye at an oblique angle. [decisionmakerplus.net]
LHON affects prevalently young males, who suffer an acute/subacute loss of central vision that leads to rapid decrease of visual acuity due to central scotoma. [journals.plos.org]
However, the prognosis is worse in SLE associated optic neuritis, with more than half having a persistent central scotoma and progressing to optic atrophy. [academic.oup.com]
Treatment
[…] medical treatment of glaucoma. [books.google.com]
What can I expect my treatment to include? Before treatment begins, we have a comprehensive discussion with you about your options, and we perform a vision exam. [restore-vision.com]
Proliferative retinopathy usually requires treatment with laser (panretinal photocoagulation) akin to the treatment of proliferative diabetic retinopathy [ 23 ]. [academic.oup.com]
Treatment of the optic nerve and retina diseases Treatment options for diseases of the optic nerve and retina is chosen individually in each case. [minclinic.ru]
Prognosis
Prognosis is variable, with moderate to severe visual loss and nystagmus. Systemic abnormalities include spastic gait, ataxia and mental handicap. 23. [slideshare.net]
It was found that the prognosis for useful vision is in general favorable in this group of cases. [pediatrics.aappublications.org]
Optic atrophy secondary to vascular, traumatic, degenerative, and some toxic causes has a negative prognosis. [tsbvi.edu]
Surgical repair with lysis of adhesions and packing of the sella has been reported to improve visual prognosis. Delayed radionecrosis of chiasm and optic nerves Late delayed radiation effect on the central nervous system is well known. [pituitary.org]
Unfortunately, a prompt diagnosis is of extreme importance, since the sooner an appropriate treatment is initiated, the better the prognosis and the less probability of permanent visual damage. [frontiersin.org]
Etiology
In 27 % of the cases no cause could be found while in the rest of 73% cases definite etiological factor was present. [ijo.in]
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Etiologic classification Regardless of etiology, optic atrophy is associated with variable degrees of visual dysfunction, which may be detected by one or all of the optic nerve function tests (see Other Tests). [thehealthscience.com]
Regardless of etiology, optic atrophy is associated with variable degrees of visual dysfunction, which may be detected by one or all of the optic nerve function tests (see Other Tests). [emedicine.medscape.com]
Etiology and clinical manifestations of vitamin B12 and folate deficiency. In: UpToDate, Mentzer, WC (Ed), UpToDate, Waltham, MA. Accessed Oct. 6, 2015. [journal.opted.org]
Epidemiology
EPIDEMIOLOGY AND CAUSES OF OPTIC ATROPHY IN GENERAL OUTPATIENT DEPARTMENT OF LUMBINI EYE INSTITUTE. [nepjol.info]
Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. [frontiersin.org]
Epidemiology Frequency United StatesAccording to Tielsch et al, the prevalence of blindness attributable to optic atrophy was 0.8%. [3] According to Munoz et al, the prevalence of visual impairment and blindness attributable to optic atrophy was 0.04% [thehealthscience.com]
The case report explores multiple facets of vitamin B12 deficiency including pathogenesis, epidemiology, manifestations, differential diagnosis and treatment modalities. [journal.opted.org]
EPIDEMIOLOGY AND PATHOGENESIS The most common optic neuropathies in young and older adults are optic neuritis and nonarteritic anterior ischemic optic neuropathy, respectively. [medtextfree.wordpress.com]
Pathophysiology
Pathophysiology The optic nerve comprises approximately 1.2 million axons that originate at the ganglion cell layer of the retina. [thehealthscience.com]
Traumatic optic neuropathy The exact pathophysiology of traumatic optic neuropathy is poorly understood, although optic nerve avulsion and transection, optic nerve sheath hematoma, and optic nerve impingement from a penetrating foreign body or bony fragment [emedicine.medscape.com]
Pathophysiology There is a loss of axons and shrinkage of myelin, leading to widening of the optic cup. Presentation [ 1 ] This depends on the causative condition. Optic disc atrophy in isolation results in the following symptoms and signs. [patient.info]
Pathophysiological mechanisms which relate these two distinct disease entities include compressive optic neuropathy secondary to mucoceles, direct extension of sinus infection to the optic nerve from suppurative paranasal sinusitis, from osteomyelitis [ruralneuropractice.com]
The pathophysiology of non-arteritic anterior ischemic optic neuropathy is not known, but is related to impoverished circulation in optic nerve head. [hxbenefit.com]
Prevention
Many causes of optic nerve atrophy cannot be prevented. Prevention steps include: Older adults should have their provider carefully manage their blood pressure. Use standard safety precautions to prevent injuries to the face. [medlineplus.gov]
They have to be also aware of the preventive measures and precautions to be taken, which include: Avoidance of multiple sex partners Practice of safe sex (use of condoms that prevent entry of the syphilis bacteria) Excessive craving for drugs and alcohol [dovemed.com]
Conclusion: Early diagnosis and prompt treatment with penicillin is essential to prevent visual impairment in syphilitic optic neuropathy. [ispub.com]
Primary prevention (removal of the process causing the damage) is the goal to prevent loss of axons and optic atrophy (neuropathy). [eyewiki.aao.org]
With others, there is no treatment, or treatment may only prevent further vision loss. Optic glioma (Medical Encyclopedia) Optic nerve atrophy (Medical Encyclopedia) Optic neuritis (Medical Encyclopedia) [ Read More ] [icdlist.com]