Oleh : Ilham Akbar AR

Pembimbing : Dr. Rahmat Syuhada, Sp.M (K)

Optic Nerve Anatomy

The optic nerve is the nerve

that carries stimuli to the
brain and retina. The length of
the optic nerve ranged
between 35-55 mm (average
40 mm)
Optic neuritis
Optic neuritis is an inflammation or
demyelination of the optic nerve due to
various diseases
 Etiology

1. local inflammation 2. General inflammation

– Uveitis – Multiple sklerosis
– ophthalmia simpatika – syphilis
– Meningitis – tuberculosis
– Orbital sinus disease and
infection
 Etiology

3. Leber's disease
4. endogenous toxins
• Acute infectious diseases, such as influenza, malaria,
measles, mumps, pneumonia
• Septic focus on the teeth, tonsils, focal infections
• Metabolic diseases: diabetes, anemia, pregnancy,
avitaminosis
5. Intoxication exogenous toxins such as tobacco, alcohol.
 Risk factor

1.Age
2.Gender
3.Race
 Classification

Papilitis

Papillitis is disc swelling caused by

local inflammation in the nerve
optic nerve and can be seen by
inspection funduskopi.
 pathogenesis

Retina contains photoreceptor cells activated by light and connect

to other retinal cells Then send the signal projections called axons
into the brain Inflammation that occurs in optic neuritis which will
cause visual signal is disrupted and the view is becoming weaker.
 Symptoms and Signs

1. In quick time vision will be greatly decreased,

sometimes to the blind.
2. pain in the eyes, especially when the emphasis.
3. Sometimes accompanied by fever or after a fever
is usually the children who suffer from viral
infection or upper respiratory tract infection.
 On examination the pupils met their
RAPD pupil is a common disorder with
signs of Marcus Gunn pupil.
On fundus examination found papil
hyperemia of the optic nerve with a blurred
boundary, central retinal vein dilation and
papilledema.
 retrobulbar neuritis

Retrobulbar neuritis inflammation of the optic

nerve located behind the eyeball so as not to
cause abnormalities of the eye fundus.
 Symptoms and Signs

1. Severely impaired vision

2. amaurosis fugax
3. eyeball when you move it would be hard on the
back of the eyeball
4. Visual field defects in retrobulbar neuritis
 Diagnosis

The diagnosis is made based on history, clinical

signs and symptoms, but in retrobulbar neuritis is
quite far behind the optic disc and on inspection
ophthalmoscopy not found anything, there should
be investigations such as MRI, analysis of
cerebrospinal fluid, Visually Evoked Potensials
Test (VEP ) and serology.
 Differential diagnosis

1.Nonarteritic anterior ischemic optic

neuropathy
2.Viral syndrome and post viral
3.Retinal detachment
4.Vena Artery Occlusion centralist
5.papil edema
 Management

Steroid therapy (intravenously [methylprednisolone, 1 g/d

for 3 days with or without a subsequent tapering course
of oral prednisolone] or orally [methylprednisolone, 500
mg/d to 2 g/d for 3–5 days with or without subsequent
oral prednisolone, or prednisolone, 1 mg/kg/d tapered
over 10–21 days]) accelerates recovery of vision but does
not influence the final visual outcome.
 Prognosis

Most patients recover completely

or nearly perfect after 6-12 weeks.
90% patients recover eyesight
achieve 20/40 vision or better.
Thankyou 