Nathy Areh - Optic nerve injury (English) Posted on February 17, 2014

Name:Nathy Areh
Sex:Female
Age:65 years old
Country: English
Diagnoses:1.Optic nerve injury, 2.Hypertension 3. Hyperlipidemia 4. Hyperthyroidism 5.Thyroid nodule 6.Insomnia
Admission Date: 2014-01-27
Days Admitted to the Hospital:28

Before treatment:
The patient suffered from glaucoma and received operation 1 year ago. She suffered from dark vision of both eyes. Even under the sun, the patient still sees dark. The patient had blurred vision and visual field defect. She only has tubular vision. She went to a local hospital and was diagnosed with Optic nerve injury. She didn't receive special therapy. Her vision slowed down abnormally. From the onset of disease, the patient's weight had obvious change. The sleep quality was poor. She only slept 1 hour. The diet was almost normal. The defecation was normal. There was no history of familial hereditary disease.

Admission PE:
Bp: 131/86mmHg; Hr: 64/min, Br: 18/min. Temperature: 36.8 degrees. The development and nutrition were normal. The skin and mucosa were normal, with no petechia or stained yellow. Bilateral thyroid glands were enlarged. Right lobe nodules could be felt on touch, with no pressing pain. The skin temperature was normal. The thorax was symmetry. The respiration in both lungs was clear, with no moist rales. The heart sounds were strong, the cardiac rhythm was regular, and there was no obvious murmur in the valves. The abdomen was smooth and soft, with no mass. The liver and spleen were found to be normal through palpation.

Nervous System Examination:
Nathy Areh was alert and her speech was clear. The memory, orientation and calculation abilities were almost normal. Vision examination: with standard visual acuity chart from 3 meters, both visions were 0.8. She had blurred vision and tubular visual field. Visual field examination; right eye: temporal visual field was 30 degrees, nasal visual field was 45 degrees, upper visual field was 45 degrees, and lower visual field was 18 degrees. Left eye: temporal visual field was 30 degrees, nasal visual field was 30 degrees, upper visual field was 30 degrees, and lower visual field was 15 degrees. The diameter of left pupil was 3.0mms; the diameter of right pupil was 2.5mms. Both pupils had sensitive responses to light reflex. Both eyes had conjunctival congestion. Fundus: orange color, the arteriovenous ratio was 1:3. The border of optic nerve was not clear. The macular area was blurred. The reflex light was poor. The movement of both eyeballs was freely done, with no obvious nystagmus. The forehead wrinkle pattern was symmetrical. The nasolabial sulcus was equal in depth. The teeth were symmetry and the tongue was at the center of her oral cavity. The neck could move freely. The muscle tone of her four limbs was almost normal. The muscle strength of her four limbs was at about level 5. The abdominal reflexes were not elicited. The tendon reflex of her four limbs was normal. The sucking reflex and palm jaw reflex were negative. Bilateral Hoffmann sign was negative. The Rossolimo sign of both upper limbs was negative. The pathological reflex of both lower limbs was negative. The deep sensation and shallow sensation existed. The examination of coordinate movement was normal.

Treatment:
After the admission, the patient received the relevant examinations. She received treatment for nerve regeneration and activated stem cells. She also received treatment to improve the blood circulation, nourishment for the neurons and also to activate neural cells. She received treatment to regulate blood glucose, blood lipid, and blood pressure. These were accompanied with physical rehabilitation training.

Post-treatment:
Vision examination: with standard visual acuity chart from 3 meters, both corrected vision was 1.5. Visual field examination, right eye: temporal visual field was 43 degrees, nasal visual field was 51 degrees, upper visual field was 55 degrees, and lower visual field was 21 degrees. Left eye: temporal visual field was 45 degrees, nasal visual field was 45 degrees, upper visual field was 35 degrees, and lower visual field was 22 degrees. The insomnia was alleviated and she can now sleep for 4 hours in the night. The patient still looks at object darken.