{"id":21844,"date":"2015-06-19T19:21:26","date_gmt":"2015-06-19T17:21:26","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=21844"},"modified":"2015-06-19T19:21:26","modified_gmt":"2015-06-19T17:21:26","slug":"bolesti-za-okem-a-horsi-videni-mohou-upozornit-na-zanet-ocniho-nervu","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=21844","title":{"rendered":"Bolesti za okem a hor\u0161\u00ed vid\u011bn\u00ed mohou upozornit na z\u00e1n\u011bt o\u010dn\u00edho nervu"},"content":{"rendered":"<p><strong>Mezi velmi citliv\u00fdmi nervov\u00fdmi k\u0159i\u017eovatkami a propletenci se nach\u00e1z\u00ed i nervy o\u010dn\u00ed. Pokud pozorujeme bolesti za okem a zhor\u0161uje se n\u00e1m zrak, m\u011bli bychom vyhledat l\u00e9ka\u0159e.<\/strong> <!--more--><\/p>\n<p>P\u0159\u00edbram \u2013 O problematice onemocn\u011bn\u00ed o\u010dn\u00edho nervu si pov\u00edd\u00e1me s o\u010dn\u00edm l\u00e9ka\u0159em p\u0159\u00edbramsk\u00e9 nemocnice Jaroslavem V\u00e1chou.<\/p>\n<p>&#8211; Co je o\u010dn\u00ed nerv?<\/p>\n<p>Zrakov\u00fd nerv je ve skute\u010dnosti traktem b\u00edl\u00e9 hmoty mozkov\u00e9. Vych\u00e1z\u00ed ze zadn\u00ed \u010d\u00e1sti o\u010dn\u00edho bulbu, jeho nejv\u011bt\u0161\u00ed \u010d\u00e1st (25 a\u017e 30 mm) se nach\u00e1z\u00ed v o\u010dnici, pot\u00e9 proch\u00e1z\u00ed kost\u011bn\u00fdm otvorem, tzv. optick\u00fdm kan\u00e1lem, do oblasti st\u0159edn\u00ed j\u00e1my lebn\u00ed, kde kon\u010d\u00ed zk\u0159\u00ed\u017een\u00edm se zrakov\u00fdm nervem z druh\u00e9ho oka. D\u00e1le ji\u017e \u010d\u00e1ste\u010dn\u011b zk\u0159\u00ed\u017een\u00e1 nervov\u00e1 vl\u00e1kna, kter\u00fdch je v ka\u017ed\u00e9m zrakov\u00e9m nervu 1,2 milionu, pokra\u010duj\u00ed jako optick\u00fd trakt do mezimozku.<\/p>\n<p>&#8211; Jak\u00e1 je p\u0159\u00ed\u010dina vzniku z\u00e1n\u011btu?<\/p>\n<p>Paleta p\u0159\u00ed\u010din z\u00e1n\u011btu zrakov\u00e9ho nervu (neboli optick\u00e9 neuritidy) m\u016f\u017ee b\u00fdt velmi pestr\u00e1. Infek\u010dn\u00ed p\u0159\u00ed\u010diny jsou v\u0161ak vz\u00e1cn\u00e9 a vyskytuj\u00ed se sp\u00ed\u0161e p\u0159i p\u0159\u00edtomnosti dosud nerozpoznan\u00e9ho z\u00e1n\u011btliv\u00e9ho lo\u017eiska obli\u010dejov\u00e9 \u010d\u00e1sti hlavy (zubu, \u010delisti, vedlej\u0161\u00edch dutin nosn\u00edch). Stejn\u011b tak i d\u0159\u00edve \u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dina v podob\u011b tzv. specifick\u00fdch infek\u010dn\u00edch z\u00e1n\u011bt\u016f (jako nap\u0159. TBC, lues) je v \u00e9\u0159e o\u010dkov\u00e1n\u00ed a antibiotik u\u017e vz\u00e1cn\u00e1. Naopak z hlediska infek\u010dn\u00edch p\u0159\u00ed\u010din je v dne\u0161n\u00ed dob\u011b pot\u0159eba pom\u00fd\u0161let na borreliosu nebo na poruchu imunity nap\u0159. u AIDS. Nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou je dnes tak neinfek\u010dn\u00ed posti\u017een\u00ed p\u0159i roztrou\u0161en\u00e9 (mozkom\u00ed\u0161n\u00ed) sklerose. U pom\u011brn\u011b velk\u00e9 \u010d\u00e1sti optick\u00fdch neuritid je v\u0161ak p\u0159\u00ed\u010dina nezn\u00e1m\u00e1.<\/p>\n<p>&#8211; Objevuje se toto onemocn\u011bn\u00ed sp\u00ed\u0161e u mu\u017e\u016f \u010di \u017een a m\u00e1 na vznik vliv v\u011bk?<\/p>\n<p>Toto onemocn\u011bn\u00ed postihuje v\u00edce \u017eeny, a to asi dvakr\u00e1t. V\u011bkem podm\u00edn\u011bn\u00e9 onemocn\u011bn\u00ed to nen\u00ed. Typick\u00fd pacient s optickou neuritidou je sp\u00ed\u0161 mlad\u00fd \u010dlov\u011bk ve v\u011bku 15 a\u017e 45 let.<\/p>\n<p>&#8211; M\u016f\u017ee postihnout i d\u011bti a jak je v\u00fdskyt v tomto p\u0159\u00edpad\u011b \u010dast\u00fd?<\/p>\n<p>Pacient s optickou neuritidou v pubert\u00e1ln\u00edm a adolescentn\u00edm v\u011bku nen\u00ed v\u016fbec v\u00fdjimkou, zde m\u016f\u017ee j\u00edt \u010dasto pr\u00e1v\u011b o prvn\u00ed p\u0159\u00edznak neurologick\u00e9ho onemocn\u011bn\u00ed, nej\u010dast\u011bji roztrou\u0161en\u00e9 sklerosy. U men\u0161\u00edch d\u011bt\u00ed je v\u00fdskyt optick\u00e9 neuritidy vz\u00e1cn\u011bj\u0161\u00ed, v\u011bt\u0161inou doprov\u00e1z\u00ed exant\u00e9mov\u00e1 onemocn\u011bn\u00ed (nap\u0159. zard\u011bnky, spalni\u010dky) a na rozd\u00edl od neuritid v pozd\u011bj\u0161\u00edm v\u011bku tyto b\u00fdvaj\u00ed oboustrann\u00e9.<\/p>\n<p>&#8211; Jak\u00e9 jsou p\u0159\u00edznaky a kdy je nutn\u00e9 j\u00edt k l\u00e9ka\u0159i?<\/p>\n<p>Optick\u00e1 neuritida se projev\u00ed hlavn\u011b dv\u011bma p\u0159\u00edznaky \u2013 bolest\u00ed za okem a zhor\u0161en\u00edm vid\u011bn\u00ed. Oboj\u00ed se vyv\u00edj\u00ed postupn\u011b v \u0159\u00e1du hodin nebo sp\u00ed\u0161e n\u011bkolika m\u00e1lo dn\u016f a v naprost\u00e9 v\u011bt\u0161in\u011b pouze na jednom oku. Bolest v\u011bt\u0161inou nen\u00ed extr\u00e9mn\u011b intenzivn\u00ed, m\u00edv\u00e1 podobu r\u016fzn\u011b velk\u00e9ho tlaku a\u017e tup\u00e9 bolesti za okem. Zhor\u0161en\u00e9 vid\u011bn\u00ed pacient vn\u00edm\u00e1 jako relativn\u011b n\u00e1hle vznikl\u00e9 a v\u00fdrazn\u00e9 rozml\u017een\u00ed obrazu, v n\u011bkter\u00fdch p\u0159\u00edpadech a\u017e jako praktickou, eventu\u00e1ln\u011b i skute\u010dnou slepotu. O\u010dn\u00edmi vy\u0161et\u0159en\u00edmi se pak d\u00e1 prok\u00e1zat i porucha barvocitu, sn\u00ed\u017een\u00ed kontrastn\u00ed citlivosti, porucha reakc\u00ed zornic na osvit, v\u00fdpadek v zorn\u00e9m poli i p\u0159\u00edmo porucha veden\u00ed elektrick\u00e9ho potenci\u00e1lu zrakov\u00fdm nervem p\u0159i tzv. vy\u0161et\u0159en\u00ed VEP.<\/p>\n<p>MARK\u00c9TA JANKOVSK\u00c1<br \/>\nP\u0159\u00edbramsk\u00fd den\u00edk<br \/>\n<a href=\"http:\/\/www.pribramsky.denik.cz\/\">http:\/\/www.pribramsky.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Mezi velmi citliv\u00fdmi nervov\u00fdmi k\u0159i\u017eovatkami a propletenci se nach\u00e1z\u00ed i nervy o\u010dn\u00ed. Pokud pozorujeme bolesti za okem a zhor\u0161uje se n\u00e1m zrak, m\u011bli bychom vyhledat <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=21844\" title=\"Bolesti za okem a hor\u0161\u00ed vid\u011bn\u00ed mohou upozornit na z\u00e1n\u011bt o\u010dn\u00edho nervu\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":20406,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-21844","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/21844","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21844"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/21844\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/20406"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21844"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21844"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21844"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}