Will optic neuritis definitely cause blindness?

Written by Zhang Hui
Neurology
Updated on September 24, 2024
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Optic neuritis is relatively common in neurology. It is a central nervous system demyelinating disease where the optic nerve is affected, leading to a significant decline in vision. However, patients with optic neuritis do not necessarily go blind. With prompt examination and treatment, mainly using corticosteroids, many patients can significantly recover their vision. However, neuromyelitis optica, another disease, tends to recur frequently. If there are many recurrences, it may lead to blindness. It may also cause corresponding lesions in the spinal cord, leading to paralysis and sensory disorders of the limbs. Therefore, it is crucial for patients to receive proper treatment in neurology, including immunosuppressants, and to regularly exercise to enhance physical fitness.

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Written by Zhang Hui
Neurology
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How is optic neuritis diagnosed?

Optic neuritis is classified as an ophthalmological or neurological disorder, caused by demyelination of the central nervous system. Diagnosis of this condition is crucial, and the following tests are recommended: Firstly, visual evoked potentials should be performed. This test can clearly show the corresponding lesions in the optic nerve. Secondly, magnetic resonance imaging (MRI) of the optic nerve is needed. MRI can reveal changes in the optic nerve, such as thickening and edema. Thirdly, some blood tests related to bleeding should be conducted. Specifically, testing for aquaporin-4 antibodies to determine if it is neuromyelitis optica. Additionally, a lumbar puncture is also necessary. This primarily aims to check for demyelination markers, such as oligoclonal bands. Once optic neuritis is diagnosed, timely treatment is required, mainly using corticosteroids or intravenous immunoglobulin.

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Neurology
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How many days does optic neuritis require hospitalization?

Patients with optic neuritis generally experience a decrease in vision, which may occur in one eye or in both if both optic nerves are involved. This condition is often caused by non-specific inflammatory responses that lead to the demyelination of the optic nerve, such as in multiple sclerosis and neuromyelitis optica, leading to changes in optic neuritis. This condition is quite severe and requires hospitalization. If not treated promptly, it can cause permanent vision loss, severely affecting the patient's future life. Typically, hospitalization lasts about 10-14 days. During this period, comprehensive examinations including MRI and lumbar puncture are needed, along with high-dose corticosteroid treatment lasting 10-14 days. After discharge, the patient must continue taking oral medications and undergo rehabilitation training.

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Neurology
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Early symptoms of optic neuritis

Optic neuritis primarily leads to a decline in vision in both eyes, though sometimes only one eye is affected. Diseases causing optic neuritis mainly include conditions like neuromyelitis optica and multiple sclerosis, which are central nervous system demyelinating diseases. These are autoimmune response diseases caused by immune function disorder of the body itself. The initial symptoms of optic neuritis might include a decrease in immunity, making patients more susceptible to colds, and symptoms such as general fatigue, headaches, a runny nose, and a sore throat might appear. Some patients might also experience gastrointestinal symptoms like diarrhea and abdominal pain. Additionally, some patients with optic neuritis might initially experience the sensation of foreign bodies moving in front of their eyes, along with other irritating visual symptoms. Treatment for optic neuritis must be prompt, as delayed treatment can lead to severe deterioration of vision, significantly impairing the patient's eyesight.

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Optic neuritis treated with steroids

Optic neuritis is a demyelinating disease of the central nervous system, primarily including optic neuritis caused by multiple sclerosis, as well as neuromyelitis optica and retrobulbar neuritis, among others. These diseases are caused by abnormal immune responses of the body and are closely related to immune dysfunction. Therefore, optic neuritis is mainly treated with corticosteroids. Corticosteroids can inhibit the body's immune response to achieve the purpose of alleviating the disease. However, the use of steroids should also pay attention to some related risks. For instance, there might be occurrences of osteoporosis and even osteonecrosis of the femoral head, potential disturbances in electrolyte, fat, and sugar metabolism in the body, the possibility of developing centripetal obesity, and the potential for gastric ulcers. Close monitoring is essential, and other immunosuppressants may be added if necessary. (Use of medications should be under the guidance of a doctor.)

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Written by Zhang Hui
Neurology
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How is optic neuritis treated?

Optic neuritis is generally caused by demyelinating diseases of the central nervous system, such as multiple sclerosis, neuromyelitis optica, and retrobulbar neuritis, all of which can lead to the onset. The main symptoms include a decline in vision, which can affect one eye or both eyes. The treatment of optic neuritis primarily includes: First, the use of corticosteroids, which can alleviate the inflammatory response in the body and help in the recovery of optic nerve functions, is widely applied. Corticosteroids can be used systemically, and if necessary, administered retrobulbarly. Second, the intake of other immunosuppressants and immunoregulatory treatments, mainly during the remission phase, is to prevent relapse. Third, treatment can also involve the use of intravenous immunoglobulin, although it is relatively expensive. Additionally, it is necessary to take some B vitamins for related treatment.