Vision loss: the most common and dangerous main causes

Vision loss: the most common and dangerous main causes
Loss of vision, in whole or in part, can lead to many pathological conditions and processes. The main causes of acquired vision loss are massive eye diseases: cataracts and glaucoma. Follow the article to learn more about the causes of vision loss

What is vision loss?

Vision loss is the most common and serious leading cause of blindness in adults. It can be caused by a number of different things, including age-related macular degeneration, glaucoma, and other diseases. In some cases, vision loss can be gradual, so people may not realize that they have lost vision until it is too late. At other times, vision loss can be sudden and completely unexpected.

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According to the World Health Organization, vision loss is the most common and serious leading cause of death, affecting more than 500 million people worldwide. It is also the main cause of disability. Vision loss can be caused by a number of things, including age, illness, injury, and genetic conditions.
Common Vision loss includes:

Diseases of the retina

The retina is a unique (and currently non-implantable) tissue of the eye. It is a thin layer of photosensitive receptor cells that lines the fundus and receives a focused Image by the optics of the eye. The retina of the eye is very fragile and prone to adverse conditions and influences. and almost all problems with the retina (retina) are somehow connected with its blood supply, and therefore with nutrition.

 To any interruption in this ongoing process. be it a lesion of the choroid (trophic choroid), diabetes mellitus, systemic arterial hypertension, etc.. the retina reacts almost instantly to degenerative changes. and with further prolonged atrophy (tissue nutrition disorders). partially or completely exfoliates from the choroid, which means, respectively.

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One of the most common scenarios of retinal damage

 is a transient (sudden and transient) circulatory disorder in the basin of any major artery or vein, including the central artery and vein of the retina itself. 

As a rule, in such cases, a vision suddenly becomes veiled or blurry (sometimes in a limited part of the visual field); often such symptoms are accompanied by severe weakness and insensitivity of the opposite extremities (that is, located on the opposite side of the affected eye). 

This type of paroxysmal symptom can last from several minutes to several hours, but in any case, this condition should alert and serve as a reason for an immediate visit to the doctor.

The fact is that with a probability of 90% it can be assumed that the described disorders are caused by blockage of the central artery of the retina (CAS occlusion) by the separation of cholesterol plaques.

A special vascular system. 

The remaining 10% is caused by stenosis (narrowing of the lumen) of the carotid artery, in which the total arterial pressure can sharply drop as well as due to CVA - acute cerebrovascular accidents, that is, strokes and pre-stroke conditions.
If doctors have already warned about such individual risks (for example, as part of a physical examination or physical examination). 

then therapeutic and preventive measures should be taken, in particular. drugs to indirectly reduce blood viscosity. prophylactic use of acetylsalicylic acid, etc,

 However, such appointments should be made by a specialist: any self-medication here is literally life-threatening.

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Retinal diseases leading to vision loss include retinal detachment and central retinal atrophy. In the first case, the vision disappears very quickly, in the second - a gradual process lasting several years.

Migraine headache

At a young age, migraines - that is, headaches localized on one side-can lead to transient blindness in one eye. Loss of visual functions is usually found at the very beginning of an attack or serves. as a harbinger of it. However, there is always a possibility that in fact, the cause is not migraine. but arterial disease or heart disease. 

It is also necessary to carry out a differential diagnosis of migraine blindness using the so-called. Dim migration (visual aura). which usually affects both eyes, and only in the right. or left visual field, is felt as a visual effect even in the dark or with the eyes closed.

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Vision loss: due to ischemic neuropathy

Ischemia is a histological condition caused by a pronounced lack of blood supply; neuropathy is a pathology of nerve fibers that transmit electrochemical signals from organs to the brain and vice versa. Accordingly, anterior ischemic optic neuropathy is a lesion of the nerve tissue of the optic disc (optic disc). combined with the retina as a direct receiver of the visual signal. due to which the lesion occurs due to insufficient blood supply (vascularization of the optic disc is: conducted along the so-called posterior ciliary artery).

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The main symptom is an immediate and unexpected loss of vision in one eye. without any precursors. and pain. Fundoscopy is necessary for confirmatory diagnosis; the main criteria are swelling and traces of hemorrhage on the observed surface of the optic disc. As a rule, ischemia of the optic disc develops against the background of chronic arterial hypertension.

In old age, the cause often becomes a specific type of vasculitis 

inflammation of the temporal arteries; such cases are very rare in the total volume of ischemic optic neuropathy (about 5%). and require immediate hormonal treatment to avoid the spread of blindness to the second eye. Clinical signs of temporal arteritis are localized seals. pain on palpation. absence or sharp decrease in pulse in the temporal arteries. and symptoms of the rheumatic log. 

Posterior ischemia of the optic nerve is much less common and more difficult to diagnose since there are no visible signs of fundus ophthalmoscopy; meanwhile. such neuropathy can lead to ischemic necrosis (death and infarction). of the optic nerve that lies behind the eye.

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Arterial hypotension, anemia, their combination. as well as massive blood loss (for example, due to surgery or trauma). serve as a provoking background. 

In addition

 a hypertensive crisis or unreasonably intensive measures to urgently lower blood pressure can lead to spasms of the retinal arteries, and edema. and ischemic infarction of the optic nerve in areas behind the handle (behind the eye). The result is an immediate loss of vision.

Optic neuritis is an inflammatory process from the group of demyelinating, that is, the destruction of nerve membranes. If a part of the optic nerve hidden by the eyeball is damaged. it is impossible to diagnose such inflammation.

posterior ischemia, or ophthalmoscope:

 there are no visible signs. The difference between posterior neuritis is that a sharp failure of vision is often accompanied by pain, especially when the eyeball is rotated. Statistics show that young people are more prone to experience. Posterior neuritis is often the first and frequent symptom of such a well-known severe demyelinating disease as multiple sclerosis. As a rule, a three-day course of hormonal therapy is prescribed to restore visual functions.

Vision loss due to toxic neuropathy

Sudden bilateral blindness can be caused by damage to the nerve cells of the optic nerve by toxic substances such as methyl alcohol, thallium, carbon monoxide, automotive antifreeze, arsenic, and land and compounds. 

A slower atrophic process, not accompanied by edema of the optic disc, may be accompanied by the use of certain antibiotics (streptomycin, chloramphenicol, isoniazid, etc.), as well as antiarrhythmic drugs (amiodarone, digoxin).

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the pressure inside the skull has risen

Chronic high cerebrospinal fluid pressure can lead to congestion of the optic nerve head. Blindness is often preceded by a harbinger symptom - in particular, a fog before the eyes, which rolls over with a sharp change in body position and can last for several seconds or minutes. 

If Vision does not recover on its own, emergency medical care for suspected "intracranial" blindness should include not only an examination by an ophthalmologist but also consultation with specialized specialists (neurologist, neurosurgeon). The first response is usually a methylprednisolone drip.

Infarction of the occipital lobe of the brain as a cause of vision loss

Sudden bilateral blindness may be caused by damage, not to the initial, but to the final, brain sections of the visual analyzer. Thus, acute ischemia and infarction are in the area of the visual cortex (in the occipital region of the brain). often occur with occlusion of the basilar artery. or chronic arterial hypertension. 

The harbingers of cortical blindness are all kinds of disorders in sensitivity. motor skills, speech, coordination, and other neurological symptoms characteristic of cerebral circulatory insufficiency of the occipital lobe.
A differential diagnostic feature of cortical blindness is the preservation of pupillary reactions, which are not found in cases of acute neuropathy 

Loss of vision sometimes becomes a very specific symptom  

translated literally, this term means lack of awareness of the disease: such a patient is convinced that everything is in order with his vision, you just need to find glasses or turn on the light in a field.

Acute vision loss as a symptom of hysteria

Hysterical mental disorders are accompanied by a very wide variety of pseudosomatic diseases. It includes all types of pseudoplegia, seizures simulating epilepsy (the so-called hysterical arc, it can be easily distinguished by a specialist), mutism (lack of speech), characteristic forced postures, artistic gait, a lump in the throat with difficulty breathing, etc.

The most reliable diagnostic criteria are the correlation of false Hysterical Blindness. with a certain condition of emotional significance for the patient (in the absence of any objective neurological symptoms); protracted and detailed complaints with tragic hysterical overtones (as opposed to loss of vision. when blindness is generally denied).

 the obligatory presence of viewers and listeners (as they say in a psychological environment, there is no hysteria on a desert island), whom the patient unconsciously seeks to plunge into a panic, while maintaining his vaguely dramatic mood. or, conversely, complacency.