Difficulty reading small print and color

Introduction The initial symptoms of patients with alcoholic amblyopia are difficult to read small characters and color recognition, and gradually develop into a decrease in visual sensitivity of both eyes in a few days to several weeks. Alcohol amblyopia, also known as nutritional amblyopia, is seen in chronic alcoholics and is a special visual impairment in patients with chronic alcoholism. 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.

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.

According to the patient's long-term or heavy drinking history, combined with the typical clinical manifestations of progressive vision loss or blurred vision, the general diagnosis is not difficult.

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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