Nerve compression, blurred vision

Some elderly people have cerebrovascular diseases, especially those who have suffered cerebral infarction many years ago. They may suddenly feel that they can't see clearly, or even have one eye completely blind. The vision of the other eye also becomes very weak, and they can only see very close objects, and they are very blurry. As we age, our legs and feet become less convenient, and if we have problems with our eyesight, it will bring all kinds of inconvenience to our lives. This situation may be caused by the elderly's cerebrovascular disease compressing their optic nerve.

1. Compressive optic neuropathy

Due to direct compression or infiltration of intraorbital or intracranial tumors or metastatic cancer, it is sometimes easy to misdiagnose clinically and should be treated with caution.

2. Causes

Intraocular diseases include optic nerve glioma, meningioma, teratoma and malignant tumors. Intracranial space-occupying lesions are most common in the sellar region. The internal carotid artery is bent, sclerotic, or an aneurysm occurring in the terminal branch of the internal carotid artery, the anterior cerebral artery, or the anterior communicating artery can also gradually compress the unilateral optic nerve. Pituitary apoplexy may cause sudden loss of vision in one eye. Sinus cysts and polyps, especially the sphenoid sinuses and posterior ethmoid sinuses, are more likely to be hidden. Thyroid disease can cause eye muscle hypertrophy, increased orbital pressure and bone deformities, all of which can compress the optic nerve.

3. Clinical manifestations

Unilateral progressive and painless insidious visual loss is the main clinical feature. Vision is often foggy and blurred. Amaurosis fugax may occur immediately when looking at a certain location. It is caused by direct pressure on the optic nerve or interference with blood vessels. Loss of vision is often discovered by accident. Aneurysm may cause eye pain. Because intracranial tumors can compress the ipsilateral optic nerve and cause optic atrophy, the contralateral eye may develop optic disc edema due to intracranial hypertension in the later stage, which is often clinically called Foster Kennedy syndrome.

IV. Treatment

2. If the orbital tumor is located behind the orbit, it can usually be removed by orbital surgery. If the tumor is located where the orbit and cranium are connected, it can be combined with neurosurgery, especially transfrontal craniotomy. Due to the wide field of view, it is easy to completely remove the tumor surgically, which has many advantages and is now widely performed. Intracranial space-occupying lesions require neurosurgery. Meningioma is the most common unilateral optic nerve compressive lesion and can be completely removed and cured in the early stages. In later stages, when the tumor spreads to involve the anterior cerebral artery and internal carotid artery, it is difficult to completely remove the tumor during surgery.

2. The optic nerve is located in the human head and is very small. Cerebrovascular disease may be an embolism or a tumor. The most direct way is to remove the pressure on the optic nerve. Everyone knows that cerebrovascular diseases are difficult to treat. If it is an embolism, thrombolytic technology can be used and the tumor can be removed, but the prognosis cannot be guaranteed. The head is too complex and detailed. If they are older, many people will choose conservative treatment because their bodies cannot withstand the great trauma of surgery.