A B C D E F G H I J K L M N O P R S T U V W

OPTIC NEUROPATHY

How does Optic Neuropathy occur ?

RETINAL ARTERY OCCLUSION The artery can block if the walls of the vessels thicken and harden. Also, a small solid particle called an embolus can travel along the artery and block it as it narrows down. Disease causing inflammation of the artery wall can cause blockage as well. When this happens, the nerve fibres and the retina cells on the inside surface of the retina die from lack of oxygen. ISCHAEMIC OPTIC NEUROPATHY The optic nerve blood supply is from small vessels. These can collapse if the blood pressure is reduced because of hardening of arteries or blocked vessels from fat deposits. Inflammation of ciliary vessels supplying the optic nerve can also block them off.

Why does Optic Neuropathy occur ?

RETINAL ARTERY OCCLUSION Hardening of arteries is more common in older people. Smoking, high blood pressure, diabetes and excess fats in the bloodstream can worsen this. An embolus often comes from fatty deposits in the carotid artery in the neck. Heart beat irregularities and heart valve disease can also give an embolus. The most important inflammation to affect the retinal artery is a condition called temporal arteritis. ISCHAEMIC OPTIC NEUROPATHY Ageing, high blood pressure, smoking, diabetes and excess fat in the bloodstream lead to a failure of blood circulation. Temporal arteritis often affects the optic nerve by inflammation of the retinal artery, or more usually, the ciliary arteries.

Treatment Involved for Optic Neuropathy

RETINAL ARTERY OCCLUSION If it can be rectified quickly, no permanent damage is done. In the case of the retina, it takes 1 to 2 hours to kill the cells. If a case is seen very early, the eye can be massaged and the pressure quickly lowered to attempt to dislodge any embolus. Unfortunately, it does not often work, and cases are usually seen too late. The inflammatory condition, temporal arteritis, is ruled out by a blood test. Later on, attention may be paid to the carotid arteries in the neck. Sometimes a neck scan is done to see if there are rough or narrowed areas in the carotid artery. The regularity of the heartbeat is also checked. If the patient is below the age of 70, and a blockage of the carotid artery is discovered, surgery to unblock this is a possibility. ISCHAEMIC OPTIC NEUROPATHY A blood test is done to help decide if temporal arteritis is responsible. Treatment is then by steroids (cortisol-like) drugs. If not, there is no special treatment.

During Treatment for Optic Neuropathy

RETINAL ARTERY OCCLUSION Unless very early treatment reverses the occlusion, no improvement takes place. ISCHAEMIC OPTIC NEUROPATHY Over several weeks, a partial recovery of vision can take place. With temporal arteritis, there is less likelihood of recovery. Once steroid treatment is started, it carries on for years, under medical supervision.

After Treatment for Optic Neuropathy

RETINAL ARTERY OCCLUSION This condition is linked to disease in other arteries. Coronary thrombosis (heart attacks) and strokes are more likely. Further eye involvement is possible. ISCHAEMIC OPTIC NEUROPATHY The same process may happen in the other eye over time. In temporal arteritis, control with steroids is vital to prevent this happening.

If Optic Neuropathy is Left Untreated

RETINAL ARTERY OCCLUSION AND ISCHAEMIC OPTIC NEUROPATHY If an underlying case is found and treated, then further attacks can be prevented. Otherwise blindness could result by involvement of both eyes, especially in the case of temporal arteritis.

Effects on Family of Optic Neuropathy

RETINAL ARTERY OCCLUSION AND ISCHAEMIC OPTIC NEUROPATHY In temporal arteritis, patients may need to be reminded both to keep in touch with their doctor and to take the steroid tablets regularly. If both eyes are involved, the sudden loss of vision is devastating and a lot of support is needed.