General Symptoms:

• Central vision loss affects direct vision in front of the eyes.
• Visió Blurred vision.
• Difficulty in distinguishing colors.
• In some cases, there may be peripheral vision loss (side vision) or night blindness.

Characteristics:

• Usually bilateral: it affects both eyes, although vision loss may be more severe in one eye than the other.
  
• It can be stationary or progressive: vision loss may not worsen over time or may deteriorate gradually.
• No cure: damage to the optic nerve is irreversible, but in some cases, there may be treatments to slow the progression of the disease or improve the patient’s quality of life.

Types of Hereditary Optic Neuropathies:

• Leber’s Optic Neuropathy: This primarily affects men between the ages of 15 and 35. It is characterized by rapid and painless central vision loss in one eye, followed by involvement of the second eye weeks or months later. In some cases, there may be some recovery of vision over time.
• Dominant Optic Atrophy: This is considered the most common hereditary optic neuropathy. It affects individuals of all ages, but vision loss typically begins in childhood or youth. The disease progresses slowly, and spontaneous improvement in vision has not been observed.
• Other Hereditary Optic Neuropathies: There are many other less common hereditary optic neuropathies, each with its own characteristics and symptoms.

The post Hereditary Optic Neuropathies appeared first on Oftalis.

Types of Ischemic Optic Neuropathy (ION):

• Arteritic ION: This condition is associated with giant cell arteritis, an autoimmune disease that inflames the arteries. It is considered a medical emergency due to its rapid vision loss and requires urgent treatment to prevent total vision loss in one or both eyes.
• Non-arteritic ION: More common and also known as optic nerve infarction, this type primarily affects people over 45 years old who have cardiovascular risk factors such as hypertension or diabetes mellitus.

Symptoms:

• Unilateral vision loss, usually affecting either the upper or lower half of the visual field.
• Sudden and painless onset.
• Changes in pupil size.

Diagnosis:

The diagnosis primarily focuses on identifying arteritic forms, as they require urgent treatment to prevent vision loss in the contralateral eye. Collaboration with internal medicine or rheumatology services is essential for rapid identification and treatment.

Treatment:

• Arteritic ION: High-dose corticosteroids are used to reduce inflammation and prevent vision loss in the other eye.
• Non-arteritic ION: Control of cardiovascular risk factors (diet, exercise, medication) is necessary to prevent future ischemic episodes in the affected eye or other organs.

The post Ischemic Optic Neuropathy appeared first on Oftalis.

Types of Nystagmus:

• Pendular N.: Both phases of eye movement, the forward and the return, have the same speed.
• Spring N.: One of the two phases of eye movement is faster than the other.
• Positional N.: Nystagmus worsens or appears only in certain head positions.
• Optokinetic N.: Occurs when fixating on moving objects, such as when traveling in a car or train.

Causes:

• Physiological: A normal type of nystagmus that does not indicate any health problems. It can occur when fixating on moving objects, looking at a bright light, or when very fatigued.
• Pathological: Can be caused by various health issues, such as:
  
  • Severe vision loss, especially in childhood.
  • Damage to the vestibular structures of the inner ear or brain.
  • Neurological diseases like multiple sclerosis, stroke, or head trauma.
  • Certain medications.
  • Excessive alcohol or drug use..

Symptoms:

• The primary symptom of nystagmus is the involuntary movement of the eyes. Other symptoms may include:
• Altres símptomes poden incloure:
  • Blurred or double vision.
  • Difficulty focusing.
  • Sensitivity to light.
  • Dizziness or nausea.
  • Headaches.

Diagnosis of Nystagmus:

The diagnosis of nystagmus is based on the patient’s medical history, a complete ophthalmological examination, and neurological tests. In some cases, imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) may also be performed.

The post Nystagmus appeared first on Oftalis.

Oculomotor paralysis refers to the inability or difficulty in performing one or more eye movements. This can occur as a result of an injury to the muscles that control eye movement or to the nerves that innervate them.

What are the symptoms of oculomotor paralysis?

The most common symptoms can vary depending on the affected cranial nerve and the severity of the condition. Below are some of the most common symptoms associated with this pathology:

• Binocular diplopia: When both eyes are open, we experience double vision, which disappears when one eye is closed.
• Strabismus: The eyes do not move together in the same direction, causing misalignment. The position will depend on the affected muscle or muscles.

• • Paralysis of the III cranial nerve: difficulty moving the eye upward, downward, and inward. As a result, the eye may be deviated outward (temporally). If the paralysis is complete, it can also cause mydriasis (dilation of the pupil) and ptosis (slight drooping of the eyelid compared to the other eye).

  • Paralysis of the IV cranial nerve: difficulty moving the eye downward and inward (nasally). Characteristically, it causes double vision when performing near-vision activities (reading, sewing, etc.). The eye may be deviated upward.

  • Paralysis of the VI cranial nerve: difficulty moving the eye outward (temporally). Characteristically, it causes double vision when looking at distant objects (looking out the window, driving, etc.). The eye may be deviated inward.

  • Ptosis: La parpella superior d’un ull cau més que l’altre.

  • Difficulty focusing: It may be difficult to focus on objects at close or far distances.

  • Blurred vision: Vision may be blurred or distorted.

  • Eye pain: In some cases, there may be eye pain or headaches.

  • Torticollis: To avoid double vision, some patients tilt their heads so that when looking straight ahead, their eyes are positioned in a way that requires the least deviation, thereby experiencing less diplopia.

The post Oculomotor Paralysis appeared first on Oftalis.

Causes of the Condition

The exact cause is not always known, but several factors can increase the risk of developing it, such as:

• Multiple Sclerosis (MS): Optic neuritis is a common symptom of multiple sclerosis, an autoimmune disease that affects the central nervous system.
• Infections: Some infections, such as Lyme disease or syphilis, can affect the optic nerve and lead to this condition.
• Inflammatory Diseases: Certain inflammatory diseases, such as sarcoidosis or vasculitis, can impact the optic nerve and cause optic neuritis.
• Trauma: An injury to the eye or head can damage the optic nerve and result in this condition.
• Vitamin Deficiencies: A deficiency in certain vitamins, such as B12, has been linked to optic neuritis.

Symptoms of Optic Neuritis

In this case, symptoms may appear suddenly or gradually and may include:

• Vision loss in one or both eyes: The loss of vision can be mild or severe and may affect part or all of the visual field.
• Eye pain: The pain may worsen with eye movement.
• Blurred vision: Vision may appear hazy or foggy.
• Reduced color perception: Colors may appear faded or less vibrant.
• Difficulty seeing in the dark: Night vision may be impaired.

The post Optic Neuritis appeared first on Oftalis.

According to the direction in which the eye deviates, strabismus can be classified as:

• Esotropia or convergent strabismus: deviation of the eyes inward.
• Exotropia or divergent strabismus: deviation of the eyes outward.
• Hypertropia: deviation of the eyes upward.
• Hypotropia: deviation of the eyes downward.

The consequences and treatment vary mainly depending on whether it occurs during childhood or adulthood.

Childhood Strabismus

Childhood strabismus can be caused by a congenital alteration in the development of the extraocular muscles (the muscles that allow the movement of the eyeballs) or by eye diseases that reduce the vision in one eye (such as congenital cataracts, diseases affecting the retina or optic nerve, etc.). However, the most common causes are refractive errors (myopia, astigmatism, and especially hyperopia).

The main concern with strabismus occurring during childhood is the risk of amblyopia, commonly known as “lazy eye.” Amblyopia arises because one eye does not receive a clear enough image, and therefore, the visual pathways do not develop properly, preventing that eye from achieving maximum vision. While this can vary from person to person, we have until approximately 8 years of age to stimulate the vision of the strabismic eye and avoid amblyopia.

Another important consequence of childhood strabismus is the deficient development of stereopsis, or 3D vision.

Patients may complain of visual fatigue, difficulty reading or performing near-vision activities, or torticollis to avoid positioning the eyes where the deviation is most pronounced.

To treat childhood strabismus, we can use:

• Glasses: important when the etiology is a refractive error to ensure the image reaches the retina clearly.
• Penalization of the healthy eye: to force the deviated eye to work and avoid amblyopia. This can be done in various ways, but the most common is through occlusions.
• Visual therapy: aimed at stimulating the vision of the deviated eye or encouraging certain eye movements.
• Surgery: Depending on the causes of strabismus, surgery can weaken some muscles (muscle recessions) or strengthen muscle action (muscle resections).

The post Strabismus appeared first on Oftalis.