Damage to the eye nerve

Eyes are the windows to the soul and the vehicle through which people perceive everything in the world. With the rapid development of various electronic products in the 21st century, many people have overstrained their eyes. So what should we do if the eye nerve is damaged? It is generally believed that after the initial damage to the ocular nerves, the eyes will experience symptoms such as blurred vision, swelling, and pain. At the same time, damage to the ocular nerves can be further divided into homonymous hemianopsia, bitemporal hemianopsia, etc.

The ophthalmic nerve belongs to the central conduction bundle. Ophthalmic nerve damage is a disease in which the conduction function is impaired due to some cause within the optic nerve conduction pathway. There are many causes of optic nerve damage, the most common of which are trauma, ischemia, poisoning, demyelination, tumor compression, inflammation, metabolism, syphilis, etc. Their common pathogenesis is the conduction dysfunction of the optic nerve.

Clinical manifestations of ocular nerve damage:

1. Visual impairment is the most common and main clinical manifestation. In the early stage, there is often pain and distension in the posterior orbit and blurred vision. Then the symptoms worsen, indicating optic nerve damage and significant reduction or loss of vision.

2. Visual field defects can be divided into two types: ① Bitemporal hemianopsia: If the fibers that transmit visual conduction from both sides of the nerves to the nasal retina are affected due to tumor compression, the patient cannot receive bilateral light stimulation and thus develops bitemporal hemianopsia. As the tumor grows larger, one side loses vision due to heavy pressure, resulting in total blindness on one side and temporal hemianopsia on the other side. Finally, both sides become completely blind. ② Homonymous hemianopsia: Damage to the optic tract or the pathway after the lateral geniculate body can cause visual field defects on the nasal side on one side and the temporal side on the other side, which is called homonymous hemianopsia. The hemianopsia that occurs in the optic tract is different from that in the central nervous system. The former is accompanied by the disappearance of light reflex, while the latter is accompanied by the existence of light reflex; the former has complete hemianopsia, while the latter is mostly incomplete and presents as quadrantanopsia; the former has more significant subjective symptoms than the latter, while the latter usually has no subjective symptoms; the latter has preserved the central vision of the visual field, presenting a macular avoidance phenomenon.

Diagnosis and treatment of ocular nerve damage:

Etiological treatment: If the cause can be found, such as bacterial infection, antibiotics that can pass through the blood-brain barrier can be used. If the disease is caused by syphilis or tuberculosis, anti-syphilis and anti-tuberculosis drugs should be used. If caused by sinusitis, dental caries, tonsillitis, etc., the lesions should be eliminated. Corticosteroids: Corticosteroids can reduce tissue inflammatory response and tissue edema, alleviate visual function damage and shorten the course of the disease. In the absence of systemic and local contraindications, high-dose shock therapy is used initially, followed by gradual reduction. ① Systemic medication: dexamethasone 10-20 mg or hydrocortisone 100-200 mg added to 5% glucose or 500 ml of normal saline for intravenous drip; or prednisone 80 mg, taken orally once a day. ② Local medication: 0.5~1ml of prednisolone or 5mg of dexamethasone injected retrobulbarly, once every other day or once a week, depending on the condition.