Sudden vision loss after heavy drinking

Introduction Alcoholic amblyopia (alcoholic amblyopia), also known as nutritional amblyopia, is seen in chronic alcoholics. It is a special visual impairment that occurs in patients with chronic alcoholism. The disease is most likely associated with one or more B vitamin deficiency. There may also be factors of alcohol toxicity. The disease is a posterior optic neuritis and involves a lesion of the macular optic disc fibers. Pathologically, the bilateral symmetry optic nerve fibers were lost in the myelin sheath, the retinal ganglion cells disappeared, and the macular area was the most important. In severe cases, the optic nerve fibers could be replaced by collagen connective tissue. Because alcoholic beverages produce 7 kilocalories per gram of alcohol, the wine contains no vitamins, minerals, amino acids and other nutrients. Therefore, alcoholics often show significant nutritional deficiencies. At the same time as nutritional dysfunction, the direct toxic effects of ethanol also cause further damage. Therefore, most cases can have both dystrophic and toxic effects.

Cause

(1) Causes of the disease

The cause of alcoholic amblyopia is associated with one or more B vitamin deficiency, and there are also alcohol toxic factors leading to optic neuropathy.

(two) pathogenesis

The disease is related to long-term drinking, and the pathogenesis is not fully understood. It has been reported that it is mainly caused by lack of nutrition, especially the lack of B vitamins. It is also associated with direct toxic effects of alcohol that cause optic nerve damage. Pathological changes showed that the bilateral symmetry optic nerve fibers were lost in the myelin sheath, the retinal ganglion cells disappeared, and the macular area was the most important. In severe cases, the optic nerve fibers could be replaced by collagen connective tissue.

an examination

Related inspection

Fundus examination

1. Progressive vision loss or blurred vision is the main manifestation of this disease. Vision loss may progress gradually over a period of weeks to months. The initial symptoms of the patient are difficult to read small characters and identify color. In a few days to several weeks, the visual sensitivity decreases, the blurred vision is unclear, and generally does not develop to blindness. However, some patients progress rapidly, after a large amount of drinking. Suddenly there was complete blindness. Vision loss can be unilateral or both eyes. Wearing glasses does not improve vision.

2. The dark spots in the center of the eyes often appear, mostly symmetry, and the reddish green is more pronounced than the dark point of the white field of view. The peripheral field of view is usually not affected, and the patient is unclear about the red-green color.

3. Fundus examination can be completely normal, but those with longer course of disease can also see the pale side of the optic disc, or the optic disc shrinking.

Differential diagnosis

Attention should be paid to the identification of optic neuritis or fundus disease caused by multiple sclerosis, optic neuromyelitis, and other causes.

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