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Optic neuritis

Optic neuritis (or retrobulbar neuritis) is the inflammation of the optic nerve that may cause a complete or partial loss of vision. more...

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Causes

The optic nerve comprises axons that emerge from the retina of the eye and carry visual information to the primary visual nuclei, most of which is relayed to the occipital cortex of the brain to be processed into vision.

Inflammation of the optic nerve causes loss of vision usually due to the swelling and destruction of the myelin sheath covering the optic nerve.

Direct axonal damage may also play a role in nerve destruction in many cases.

Some causes are viral-bacterial infections (e.g. herpes zoster), autoimmune disorders (e.g. lupus) and the inflammation of vessels (vasculitis) nourishing the optic nerve.

Optic neuritis can also emerge as an attendant, first, or sole manifestation of multiple sclerosis.

Symptoms

Major symptoms are sudden loss of vision (partial or complete) and occasionally pain on movement of the eyes. Most patients with optic neuritis may lose their color vision, as well.

On medical examination the head of the optic nerve can easily be visualised by an ophthalmoscope. In many cases, only one eye is affected and patients may not be aware of the loss of color vision until the doctor asks them to close or cover the healthy eye.

Treatment and Prognosis

In most cases, visual functions return to near normal within 8 to 10 weeks, but they may also advance to a complete and permanent state of visual loss.

Therefore, systemic intravenous treatment with corticosteroids, which may quicken the healing of the optic nerve, prevent complete loss of vision, and delay the onset of other multiple sclerosis symptoms, is often recommended. It has been demonstrated that oral administration of corticosteroids in this situation may lead to more recurrent attacks than in non-treated patients (though oral steroids are generally prescribed after the intravenous course, to wean the patient off the medication). This effect of corticosteroids seems to be limited to optic neuritis and has not been observed in other diseases treated with corticosteroids.

Very occasionally, if there is concomittant increased intracranial pressure the sheath around the optic nerve may be cut to decrease the pressure.

When optic neuritis is associated with MRI lesions suggestive of multiple scelrosis (MS) then general immunosuppressive therapy for MS is most often prescribed.

Diagnosis

Optic neuritis is often diagnosed by the neurologist and managed by an ophthalmologist. However, ideally, a neuro-ophthalmologist should be consulted at a major university hospital center.

Read more at Wikipedia.org


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Crafting a new attitude: as an ambitious student, I struggled with multiple sclerosis. But my disease finally taught me to slow down and value balance
From Natural Health, 8/1/01 by Andreatta Geerdes

BECAUSE I FIRST NOTICED THE fuzzy yellow spot in my field of vision in science class, I thought I'd injured my eye by looking at the flash of light from a classmate's experiment. For the next few days, when I looked too far in any direction, my eyeball ached. In less than a week, I couldn't see out of that eye at all. I felt like an awkward Cyclops. I remember glancing into a mirror and being surprised by how normal I appeared, with my ponytail and dimples. I was 15 years old, a freshman in high school.

An ophthalmologist diagnosed my condition as optic neuritis and explained that my optic nerve was inflamed. He said the problem would clear up in about three months, so I didn't feel particularly worried.

After my appointment, I hurried back to school and started working on an assignment for the next day. I could barely see because my good eye was still dilated from drops for the eye exam, but I was obsessed with earning the highest grade in the class. A few months later, around the time that the aching and fogginess in my eye began to clear, I won first-place awards in five of my courses. They seemed to justify my toil.

A year later, I had a second bout with blurred vision and eye pain. My neck was stiff, so my mom took me to her chiropractor. I expected the spinal adjustments to relieve only my neck problems, so I was surprised when my eye troubles also vanished within days. Chiropractic care relieved two more episodes over the next year. The effect seemed miraculous, but I kept wondering if I was doomed to periodic blindness in one eye or the other for the rest of my life.

The Diagnosis

It wasn't until I was a senior in high school that a neurologist diagnosed multiple sclerosis (MS) as the cause of my eye troubles. He explained that optic neuritis is frequently the first symptom of MS and sent me for an MRI, which revealed the lesions characteristic of MS on my optic nerves and brain. Multiple sclerosis means "many scars," and these lesions are what give this nervous system disease its name. Symptoms appear after immune cells mistakenly use their powerful chemical weapons to attack the myelin sheath that protects nerve fibers. Where the insulating sheath is damaged, hardened patches of scar tissue form, interrupting nerve impulses. Scientists have not pinpointed the disease's cause, and its course is unpredictable.

I was young to have gotten MS--most patients are diagnosed between the ages of 20 and 40--but the neurologist said my excellent motor skills and recovery of sight meant I had a mild case. He predicted that I would continue experiencing the typical flare-ups and remissions of symptoms, but he assured me that I would never slur my words or become totally paralyzed like some of the MS patients I had read about.

He gave me a prescription for prednisone, an anti-inflammatory, to use during my next episode. But my parents and I reasoned that the drug's potential side effects, such as mood swings and lowered resistance to infection, outweighed its benefits, so I continued to rely on chiropractic adjustments for relief. I also continued to worry about getting worse.

My sixth and worst episode struck at the end of my junior year of college when I was overwrought about a recent breakup with a boyfriend and exhausted from school. This time it affected my limbs rather than my eyes. My legs felt as heavy as tree stumps, my right arm was weak, and my feet tingled. Although this lasted only a few weeks, I was terrified that I would become totally disabled. But for the first time I noticed that MS emerged from the shadows only when I was stressed and deaf to my body's pleas to relax, eat better, and rest.

Rejecting Perfection

Graduating from college relieved much of my stress. Although I had a full-time job, I had no assignments to complete or tests to pass, which gave me time to think about myself. I felt sure that my haphazard diet, physical inactivity, and anxiety about grades had pushed me into MS's grasp, and I made up my mind to do whatever was necessary to feel better. As a senior in college I'd taken a basic nutrition class that had sparked my interest in improving my diet. Now I began to make small changes, cutting out unhealthy snacks and drinking more water, and each time I saw positive results, I was inspired to make other changes.

Meeting and marrying my mellow husband helped me to make these changes. I joined the health club he belonged to and began exercising regularly--stretching, walking on a treadmill, and lifting weights. Working out two or three times a week relieves my tension, keeps my body toned, gives me enough stamina to complete my daily tasks, and helps me maintain a feeling of control over my body.

I've given up all foods containing additives, refined flour, refined sweeteners, and hydrogenated fats, and now eat only lean meats, fish, legumes, whole grains, vegetables, and fruits. The benefits of my improved diet include better eyesight, more energy, and a stronger immune system. Supplements of flaxseed oil and B vitamins help keep my nervous system healthy.

Because my husband accepts me as I am, I'm learning to overcome perfectionism and to let go of the idea that my worth is tied to my achievements. My days are balanced with activities that aren't related to school or work, like cooking, visiting friends, and cross-stitch sewing.

My last episode was eight years ago in college. Now that my MS is in remission, I sometimes wish I could go back in time and share with my young adult self all that this disease has taught me.

At a Glance

Andreatta Geerdes, 29 Westminster, Colo.

PROBLEM: Multiple sclerosis

OBSTACLE: I was obsessed with perfection and led an unhealthy, stressful life.

SOLUTIONS: Chiropractic adjustments and a change of diet, lifestyle, and outlook.

Tell Your Tale Have natural therapies helped you improve your life? Please share your story. Send your manuscript, address, and daytime phone number to My Story, Natural Health, 70 Lincoln Street, 5th Floor, Boston, MA 02111. Your manuscript should be approximately 1,500 words, typewritten and double-spaced. If we publish it, we will pay you $100. Manuscripts will be edited and cannot be returned.

Andreatta Geerdes, a freelance writer, received her master's degree in journalism last spring from the University of Colorado at Boulder.

COPYRIGHT 2001 Weider Publications
COPYRIGHT 2001 Gale Group

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