Retrobulbar
NeuritisIntroduction Most of the cases of retrobulbar
neuritis occur in patients who suffer from multiple sclerosis. Other cases do
not have any explanation (they are called "idiopathic retrobulbar neuritis").
After 2 to 8 weeks there may be a spontaneous recovery (called "remission").
This, however, is more in cases that are idiopathic. With multiple sclerosis
there are often several bouts of retrobulbar neuritis and each bout leads to some
more scarring in the optic nerve. The final result often is increasing visual
loss, optic nerve atrophy and blindness. Signs
and Symptoms Eye pain is quite prominent as a symptom and this
is associated with a rapid loss of vision. The pain is particularly severe with
eye movements and is of a deep gnawing character deep behind the eye.
Diagnostic
Test Quite in contrast to optic neuritis the fundus looks normal
to the eye specialist in most cases. There can be some dilated blood vessels (hyperemia)
in the fundus. Treatment Treatment
is difficult as often high doses of corticosteroids have to be used to get a remission
of a bout of retrobulbar neuritis. However, when the corticosteroid is weaned
the condition can flare up again. As mentioned above, each recurrence leads to
more permanent visual loss and optic nerve atrophy, which puts the clinician in
a bind.
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