=Symptoms.=—The ophthalmoscope must be used in diagnosis. There is at
first cloudiness of the retina; the outlines of the papilla become
indistinct. We may note light patches of exudates. The vessels are
more tortuous and often there are hemorrhagic spots. Opacities in
the vitreous due to the exudate may be seen. Vision is disturbed in
proportion to the inflammation. Weeks or months are required for
recovery. Atrophy may set in and cause blindness.
=Cause.=—Many general diseases are found back of this trouble, e. g.
albuminuria, diabetes, leukemia, syphilis, gout and arteriosclerosis.
Idiopathic cases occur with none of these diseases present, which gives
a field for osteopathic research.
=Treatment= should be directed against the general disease when
present. For local effects treatment should be given to all the centers
and localities that affect the trophism, nerve supply and circulation
to the eye. Protect the eye by dark glass or confinement to a dark room
and complete rest. Keep the bowels free and produce diaphoresis.
Optic Neuritis
This disease when manifest in the eye ball is called papillitis. If
back of the bulb it is =retrobulbar neuritis=.
=Symptoms of papillitis.=—Pupils are dilated and sight diminishes. The
color of the papilla is altered to a white, reddish or gray and may
show extravasation of blood. The papilla is swollen (choked disc), the
arteries are thin and the veins are engorged. It takes months for the
inflammation to clear. Atrophy is likely to occur.
=Causes.=—Brain diseases are the most frequent cause, e. g. tumors.
Syphilis, febrile diseases, nutritive disturbances, lead poisoning,
heredity and growths in the orbit are cited as causes.
=Symptoms of Retrobulbar Neuritis.=—There is little or no change in
the papilla. The diagnosis must be made mostly from the way the vision
is affected. The rule is a central scotoma in the field of vision. The
first colors to disappear are red and green. In the acute form there
is quick disturbance of vision. The eye looks normal outside and shows
practically no change inside.
=Cause.=—Toxemia, cold, influenza; nasal, nasopharyngeal and sinus
disease (ethmoids), and infectious diseases are causes. Idiopathic
inflammation of the optic nerve is noted by most oculists. Here the
profound effects of spinal lesions upon the eye adds some important
light.
=Treatment of Papillitis and Retrobulbar Neuritis.=—In each individual
case the treatment requires consideration of the causal factor. There
may be required constitutional treatment in many cases. In others the
cause may be found in the nose, nasopharynx, or spine. Effort should be
made to remove the lesion in each case. Diaphoresis will aid in acute
stages.
Atrophy of the Optic Nerve
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