What Happens To Untreated Optic Neuritis & When To Go To Doctor?

Good eyesight is an important criterion for health and quality of life. One of the leading roles in the process of vision belongs to the nervous system. Optic neuritis is an inflammatory disease that can lead to partial or complete loss of vision. However, timely recognition of clinical symptoms and proper treatment will fully restore the vision.(1)

What Happens To Untreated Optic Neuritis?

If you are lucky enough the symptoms may go away without treatment. But in most cases, when left untreated for long, optic neuritis may give rise to several complications. With the untimely diagnosis of optic neuritis and improper treatment (or lack of therapy) there is a high risk of complications:

  • Death of nerve endings and damage to the optic nerve
  • Blurred vision, blurred borders, blindness;
  • Severe swelling of the conjunctiva
  • The illness may relapse

Chances Of Cure For Optic Neuritis

The restoration of the organ of vision and complete cure depends on the stage at which the disease was detected, the features of its course, the timeliness of the anti-inflammatory therapy.

If the provoking factor is not removed, in 25% of cases of visits to the clinic there are complaints of relapse. One of the symptoms of the disease is a worsening of visual acuity or blindness. In some cases, it goes away spontaneously a couple of months after the start of treatment.(4)

When To Go To Doctor For Optic Neuritis?

Pathology is often a consequence of a running infection. Prevention is the timely detection and comprehensive treatment of diseases, preventing the spread of foci of inflammation in the body. Particular attention should be paid to colds and flu, infections of tissues and structures of the eye, nasopharynx, and skull.

Other preventative measures:

  • Avoid injuries of the eyeball; if a traumatic event occurs, visit a doctor to prevent complications;
  • Follow all the recommendations of a specialist for infectious diseases of the eyes, without self-medication;
  • Timely sanitize foci of infections in the nasopharynx, treat tooth decay;
  • When the first symptoms appear, visit a neurologist and an ophthalmologist;
  • Visit an ophthalmologist for prophylactic purposes twice a year and in case of a decrease in visual acuity as necessary.

If you feel any of the symptoms and have these issues, consult your doctor immediately to avoid complications.(4)

Treatment And Prognosis Of Optic Neuritis

Therapeutic measures should primarily be aimed at eliminating the cause of optic neuritis. Treatment of this disease is carried out in a hospital. Even before the causative agent was established, the following groups of drugs are prescribed to the patient:

  • Broad-spectrum antibacterial agents, except drugs from the group of aminoglycosides.
  • Anti-inflammatory drugs – mainly corticosteroids.
  • Desensitizing agents.
  • Dehydration drugs are injections of magnesium sulfate.
  • Detoxification – an intravenous infusion of glucose, saline solutions.
  • Metabolic – piracetam, B vitamins, potassium preparations.
  • Immunomodulatory.

After the exact cause of the disease is clarified, the doctors proceed to etiotropic therapy.(5)

Causes Of Optic Neuritis

Such a disease is always secondary and develops against the background of other infectious processes. As a rule, when questioning and examining a patient, the doctor always discovers the following disorders in history or at the time of examination:

  • Any inflammatory processes of the organ of vision – iritis, iridocyclitis, choroiditis, keratitis, conjunctivitis.
  • Lesion of bones of the orbital region of inflammatory or traumatic origin – periostitis, osteomyelitis.
  • Sinus inflammation.
  • Acute and chronic tonsillitis.
  • Specific infections – diphtheria, syphilis, gonorrhea, etc.
  • Neuroinfections – meningitis, encephalitis, arachnoiditis.
  • Inflammatory processes of the oral cavity – periodontitis, caries.
  • Demyelinating and autoimmune processes – multiple sclerosis, etc.

Very often, neuritis complicates the course of influenza or other respiratory viral infections. In this case, it can begin 5-7 days after the onset of the disease.(2)

Necessary Diagnostic Examinations For Optic Neuritis

In addition to a thorough examination of the patient and collecting an anamnes is (medical history), a specialist can conduct special ophthalmological examination methods. These include:

Ophthalmoscopy – examination of a patient in a dark room using a special magnifying lens. Using this method, you can examine the state of the nerve disk. In acute inflammation, the disc will be reddened and swollen. In some cases, minor hemorrhages are observed.

Fluorescence Angiography – The patient is given an intravenous fluorescent substance, after which the doctor examines the vessels of the fundus using a special device.(3)

References:

  1. Chiarello F, Marini E, Ballerini A, Ricca V. Optic neuropathy due to nutritional deficiency in a male adolescent with Avoidant/Restrictive Food Intake Disorder: a case report. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2018;23(4):533-535.
  2. Akaishi T, Nakashima I, Takeshita T, et al. Different etiologies and prognoses of optic neuritis in demyelinating diseases. Journal of neuroimmunology. 2016;299:152-157.
  3. Bennett JL. Optic Neuritis. CONTINUUM: Lifelong Learning in Neurology. 2019;25(5):1236-1264.
  4. Burton EV. Optic Neuritis: Clinical Manifestations, Pathophysiology, and Management. Neuroinflammation: Elsevier; 2018:337-353.
  5. Meer E, Shindler KS, Yu Y, VanderBeek BL. Adherence to Clinical Trial Supported Evaluation of Optic Neuritis. Ophthalmic epidemiology. 2019;26(5):321-328.

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