Case description: A rare phenomenon associated with obesity has almost caused blindness

The 14-year-old talent from Jerusalem started complaining of severe pain in her neck a few weeks ago, her mother thought it was mental stress because of the tests in her studies but the pain did not stop. Her worried mother decided to take her for an examination to the family doctor, who determined that there was no reason to worry and that it was probably a phenomenon caused by mental stress due to the tests. Later, shoulder pain and blurred vision and later blindness were added to the neck pain.

For weeks, no doctor was able to decipher the cause of the severe symptoms. During an emergency visit to a community ophthalmologist, who was fortunately aware of the phenomenon, Roni was referred to the Shaare Zedek emergency department. The emergency room tests found edema in the optic nerves and increased intracranial pressure with severe visual impairment. In Israel and around the world. “It is very rare for patients to need surgery for this disease. In most cases drug treatment and weight loss are the solution to treat the phenomenon, without significant damage to vision. When the cause of this phenomenon is actually high pressure inside the skull that causes headaches and endangers the optic nerve.

The cases include an increase in the number of severe cases, including three cases that required such surgical intervention, compared to only two that I have treated in the past in all my years as an ophthalmologist. “

An increase in the number of young people who are obese, and accordingly an increase in the number of cases of high-grade intracranial hypertension (IDIOPATHIC INTRACRANIAL HYPERTENSION) in parallel with the obesity epidemic. The chance of developing this phenomenon is 1-2: 100,000 and increases 19-fold when it comes to obesity. ” To measure the pressure that drains fluid and lowers the pressure temporarily, and in addition the drug treatment was started immediately. R. Udi Reich, Head of Eye Tumors and Senior Oculoplasticist in the Department, performed with Dr. Ortal Zacks an integrated and complex emergency surgery to drain the edema from the optic nerve sheaths.

Dr. Reich: “Roni came to us with edema A simplification that led to a decrease in the field of vision that stood at only 6% with heavy concern for the optic nerve and blindness for the rest of its life. We are alert because it is clear to us that on the spoon and at the tip of the blade is a literal term meaning the risk of blindness in a young girl. It is still improving day by day.

“Being overweight is a known health problem, and in girls and young women there is a danger of losing vision,” adds Dr. Reich. “If there are headaches that last for more than a few days, they should be checked quickly, including an eye exam. Ronnie’s case was more difficult to diagnose because she did not suffer from headaches. Something that would have turned on a warning light earlier.”

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