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Globisz Michal - Ischemic optic neuropathy (Poland) Posted on September 18, 2014

Author Tracy Views Posted at 2014/09/18

Name: Globisz Michal
Sex: Male
Country: Poland
Age:67 years
Diagnosis:Ischemic optic neuropathy
Date: August 19, 2014
Days Admitted to Hospital: 21 days

Before treatment:
The patient's left eye suffered from progressive blurred vision 20 years ago without obvious incentive. The patient's central visual field had a dark spot. The dark spot was enlarged and the central vision field was blurred. The patient lost almost all the vision in one week. He went to a local hospital and was diagnosed with ischemic optic nerve injury and the reason was unclear. Then his vision had no obvious decline in the following 20 years. The patient's right eye suffered from the same symptom in June 1, 2014 and his right vision declined gradually. He was hospitalized for one week in local hospital. He received pentoxifylline and methylprednisolone for treatment. During his stay in the hospital, the patient's vision was stable. Then the patient's vision declined again and the retrobulbar neuritis and Early ischemic neuropathy were considered. The patient received cerebrospinal fluid examination and head MRI examination. All the tests showed no abnormalities.

At present, the patient's vision was poor. The patient could distinguish person or big object's outline from 3 meters. The patient could see big fonts in 10cm. He couldn't read time in a wrist watch. His vision was poorer at night than in daytime.

Admission PE:
Bp: 125/80mmHg; Hr: 71/min, Br: 18/min. Globisz Michal's development and nutrition were normal. The skin mucosa was normal with no hemorrhaging spots or yellow stains. The thorax was symmetrical. The respiratory sounds of both lungs were clear, with no dry or moist rales. The heart sounds were strong, the rhythm was regular, and there was no obvious murmur in the valve area. The abdomen was flat and soft. Through palpation, the liver and spleen were not enlarged.

Nervous System Examination:
Globisz Michal was alert and his speech was clear. His orientation, calculation ability and comprehension were almost normal. The diameter of both pupils was 3.0mms, and both pupils were sensitive to indirect and direct light stimuli. Left vision:  From 3 meters, the patient could distinguish person's outline. The patient could distinguish fingers number from 2 meters. Right vision: the patient could distinguish person's outline from 2 meters. The patient could distinguish fingers number from 15cm. The left naked eye vision: the vision was 0.06 from 1 meter. The correct vision was 0.06 from 3 meters. The right naked eye vision: the vision was 0.08 from 30cm. The vision of both eyes with standard visual acuity chart: both eyes' corrected vision were 0.06 from 3 meters. Both eyes' corrected vision were 0.08 from 2 meters. Both eyes' corrected vision were 0.12 from 1 meter. The patient could see words clearly from 10 cm. The color vision of both eyes was almost normal. He had poor ability to distinguish black color.  Under ophthalmoscope: arterial sclerosis in his both eyes. The arteriovenous ratio was 1:3. The color of fundus was normal. There was no black deposit. The border of macula lutea was unclear. The optic nerve head presented with slight edema. The eyeballs could move to each side freely. There was no obvious nystagmus. The forehead wrinkle pattern was symmetrical, the nasolabial sulcus was equal in depth, the teeth were symmetrical and the tongue was centered in the oral cavity. There was flexible movement in the neck. The muscle tone of all four limbs was almost normal; the muscle strength of all four limbs was almost at level 5. The abdominal reflexes were elicited normally. The tendon reflexes of his four limbs were normal. The sucking reflex and the palm jaw reflex were negative. Bilateral pathological reflex of four lower limbs was negative. The deep sensation and superficial sensation were normal. The coordinated movements were normal.

Treatment:
We gave Globisz Michal a complete examination and he was diagnosed with ischemic optic neuropathy. The patient received treatment for retina and optic nerve regeneration and to activate stem cells in vivo. He received treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and to nourish the neurons.

Post-treatment:
Both visions have improved. The color of fundus has obviously changed. The retina color of 3/4 fundus is almost normal and present orange. Only 1/4 fundus area near macula lutea is dark than normal. The border of optic nerve head was clear. The arteriovenous ratio was 2:3. Vision examination: the patient can distinguish the outline of person from 5 meters. The patient can distinguish the fingers from 3 meters. Right eye vision: right eye can distinguish person's outline and fingers movement from 2.5 meters. Right eye can distinguish fingers number from 50cm. The patient can distinguish fingers number more easy when background color difference is bigger. Left eye naked vision is 0.08 from 2 meters. Left eye naked vision is 0.15 from 1 meter. The corrected vision of left eye is 0.25 from 3 meters. Right eye naked vision is 0.06 from 1.5 meter, and it is 0.0 from 1 meter. The corrected vision of right eye is 0.25 from 2 meters. The standard visual acuity chart: both eyes corrected vision is 0.25 from 3 meters. He can see words clearly from 30 cm (All the above examination results are corroding to standard visual acuity chart from 3 meters distance).

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