45yrs old male patient comes with a chief complaint of sudden diminution of vision LE VA RE 6/6 LE 1/60 LE ill sustained pupillary reaction fundus blurred disc margin with disc oedema macula Fr present diagnosis and mx??
Optic Neuritis, IV Injection Methyl Prednisolone 1 gm in a drip for 3 days followed by oral Prednisolone 1.5 mg/kg for one week then taper slowly over 6 weeks Inj Vitamin B1, B6 & B12 1 amp IM repeat after 1 week, oral Antibiotic cover, oral Rabeprazol, Antibiotic steroid eyedrops TDS, MRI Brain should be done to rule out MS Slight temporal yellowness indicate towards toxic optic neuropathy take detailed history including drugs
Optic neuritis — sub tenon injection dexona Followed by i/v methy prednisolone, vit B12 1000gm daily orally Most cases of optic neuritis develop multilple sclerosis within 5 to 10 yr. Patient has potential of developing MS though no sign or symptom of MS is found on MRI for 5 to 10 year. ON is only manefestation of impending MS
Can be non arteritic anterior ischemic optic neuropathy. check the field defects. Check blood sugar BP, and lipid profile.
Acute optic neuritis.
NEURO RETINITIS
Check for rapd......seems to be NAAION..hyperemic disc edema....investigate for blood sugar...bp...lipid profile etc. .. fields for altitudinal defect
It is papillitis LE, disc edema with profound visual loss is hallmark of this disease .
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