symptom

physical signs

diagnosis

1. Pseudo optic disc edema: Although the optic disc is red and slightly bulging, it does not exceed 1 to 2D in most cases and remains unchanged throughout life, regardless of the surrounding disc area. Periretinal hemorrhage and exudation. Naked or corrected vision is normal, visual field may be slightly changed, The main feature is that the optic disc is not obscured by blood vessels.

2. Anterior ischemic optic neuropathy (AION): sudden and severe loss of vision. There is usually no pain during eye movement. exist Non-arteritic ischemic neuropathy often involves segmental optic disc filling. Blood and edema. Visual field defects are most common inferiorly and are often arcuate. Or sector-shaped visual field defect, distributed horizontally, generally without central darkness point.

3. Leber hereditary optic neuropathy (LHON): It is a disease of adolescents (usually occurs in teenagers or twenties) Mitochondria associated with bilateral optic neuropathy in men Hereditary diseases, women are the carriers and transmitters of genes There are fewer physical illnesses. Acute or subacute symptoms in both eyes simultaneously or successively Painless visual loss with central visual field defect and color vision impairment hinder. Superficial capillaries near the optic disc were obviously dilated, but there was no fluorescence Photoreceptor leakage; no obvious edema of the optic disc, only congestion, followed by For optic nerve atrophy.

4. Toxic or metabolic optic neuropathy: progressive painless severe loss of vision in both eyes, possibly secondary to chronic smoking Grass poisoning, alcohol or acute methanol poisoning, severe malnutrition, drugs Toxicity such as ethambutol, chloroquine, isoniazophene, chlorpropamide, etc., heavy gold Poisoning, severe anemia, etc.

Demyelinating optic neuritis: The purpose of using glucocorticoids is to shorten the course of the disease and reduce recurrence.

Early vision is normal, but there may be temporary and transient blurred vision; headache, diplopia, nausea, and vomiting may occur; vision loss is rare. Acute severe or chronic optic disc edema can cause visual field defects and severe vision loss.

Fundus manifestations: Early optic disc edema may be asymmetrical, with blurred borders, often covering blood vessels, and may be accompanied by nerve fiber layer edema.

Visual field examination: The physiological blind spot is enlarged and the peripheral visual field is normal. However, when the optic disc edema is severe or the optic nerve atrophy develops, the central vision may be severely reduced and the peripheral visual field may be narrowed, especially under the nose.

Optic discitis: no symptoms of increased intracranial pressure, severe vision loss, often unilateral, relative afferent pupillary disorder, Color vision loss, eye movement pain. The bulge of the optic disc does not exceed 3D, and the hemorrhage and exudation of the fundus are not as good as those of the optic disc. Disc edema is common.

1. Primary optic atrophy: damage to the optic nerve, optic chiasm, optic tract and lateral geniculate body behind the lamina cribrosa. As a result, its shrinkage process is downward. The optic disc is light or pale, with clear borders, and the visual Ehmoid holes are visible in the cup, and retinal blood vessels are generally normal.

2. Secondary optic atrophy: The primary lesions are in the optic disc, retina, and choroid, and the atrophy process is upward.