Diseases of Optic Nerve

Optic Neuritis
•

Inflammation of Optic Nerve .

Neuritis includes
Optic
•

(a) Papillik 's

(b) Retro bulbar Neuritis

(c) Neuro retinitis

Inflammation of Optic disc ( 1ˢᵗ part ) is seen in Papi kits

◦

and Neuro retinitis

2nd 3rd 4ᵗʰ

part of Optic Nerve is
•

Inflammation of ,
&

seen in Retro bulbar Neuritis .

 Causes :

sclerosis
Ii , Multiple
Iii ) Hit B12
deficiency
Iii , Hit B2
deficiency
( in Diabetes

Clinical Features :

Condition unilateral
is
usually
• .

sudden and
•
Monocular ,
progressive profound vision loss

Pulfrich phenomenon ( altered perception of moving objects )

•
Uhthoff sign ( worsening on inc .
body temp .
)

Pain behind eyeball in Retro bulbar neuritis

esp
•
.

•
Visual evoked response ( EP )
" shows reduced amplitude
and delayed transmission time .

• Central swtoma

• Colour blindness ( Red >

Green )

Treatment :

(is IV methyl pnednisolone &

Oral prednisone

Iii , Gla tetramer acetate ( 20mg Sc )

Liii ) Interferon p - ta & -

Lb
 Papilledema
disc due to raised
•

Swelling of optic
intracranial pressure
.

• Non -

inflammatory swelling ( Painless )

Tumor cerebellum midbrain and

of
•
,

parieto occipital region produce

papilloedema more
rapidly .

Clinical Features :

in severe headache

iii Vision is normal

initially
iii , Amaurosis sign
As
Transient visual loss

Blind
1in
Enlargement of spot
Painless loss of Vision
 Ophthalmoscope findings :

disc
c'
Blurring of optic margin
Venous Venous
ciis
engorgement 4
congestion
Venous
( iii ,
loss
of pulsations
in Paton 's lines : Radial Retinal lines
cascading from
disc
optic .

f-risen 's Grading :

 Optic Atrophy
•

Atrophy of optic nerve .

Signs :

Pallor disc
( is
of optic
blood wends (7-10)
Kestenbaum index Small -

Iii ,
-

In
optic atrophy -
< 7
 -
Visual loss in optic atrophy does
not correlate
Types
.

( is Primary Optic Atrophy ( Optic atrophy without

any
antecendent disc
optic swelling )
Iii , Secondary Optic Atrophy ( Optic atrophy due to existing
optic disc swelling )

Ciii , Consecutive Optic Atrophy .

( Optic atrophy due to diseases
inner retina & its blood supply )
of

Causes : 1¥ (
(Mlc → Multiple IN
sclerosis ) °
Retinitis
Optic Neuritis Papi Medema
-

◦
◦

pigmentosa
Trauma •

Papi / titis
/ CRYO
•

° CRAO .

◦ Tumor ◦ Ant . iscemia

agents
Toxic Optic Neuropathy
◦
Hereditary
C
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