Congestive optic discs in the fundus. Congestive optic nerve nipple in children

The appearance of a congestive optic disc (OPND) is associated with swelling of local tissues, which occurs against the background of diseases of the meninges and adjacent structures. In this case, the main cause of the development of the disorder is considered to be intracranial hypertension, which causes headaches and other severe symptoms. Due to swelling of the optic nerve fibers, the retinal vessels are sharply dilated.

If a congestive optic disc is detected, treatment is aimed at reducing intraocular pressure, for which medications are used.

The structure of the optic nerve and the course of the disease

The optic disc is pale pink. With swelling, the color of these tissues changes. Deviations of the optic disc in ophthalmology are diagnosed using a special device (ophthalmoscope).

The optic nerve runs from the disc to the meninges. It is these fibers that transmit information about what a person sees. Next, the incoming data is processed by the subcortical part of the brain, and then by the occipital lobe.

Depending on its location, the optic nerve is divided into several parts:

• intraocular;
• intraorbital;
• intratubular;
• intracranial.

All parts of the optic nerve converge in the bony canal. Here the tissues enter the brain. The normal size of the optic nerve head is 3 cm.

The nature of the symptoms caused by swelling of the optic disc is determined by the localization of the pathological process. Moreover, in all cases, due to the pressure experienced by the disc tissue during hypertension, the quality of vision decreases.

ZDZN is unilateral or bilateral in nature. That is, the tissue of the optic nerve extending from one or both eyes swells. The first option is characterized by mild symptoms. With bilateral edema, the pathological process progresses rapidly: the first signs of visual impairment are observed after several hours or days.

Reasons for the development of edema

Regardless of the characteristics of the symptoms of congestive optic disc, the causes of the development of the pathological process are due to increased intracranial pressure. It develops due to an imbalance of fluids in the skull. Due to the accumulation of cerebrospinal fluid in the area of ​​the optic nerve, disc atrophy develops over time, leading to the onset of complete blindness.

Possible causes of the development of perineural papilledema include brain diseases:

• benign and malignant tumors;
• intracranial bleeding;
• traumatic brain injury;
• suppuration of tissues inside the skull;
• cerebral edema;
• accumulation of cerebrospinal fluid inside the skull (hydrocephalus);
• craniosynostosis (congenital pathology);
• improper fusion of skull tissues (after injuries or due to birth trauma).

Brain infections that cause meningitis and encephalitis lead to optic disc congestion. Also, ZDND is often diagnosed against the background of the following pathologies:

• renal failure;
• hypertension;
• stroke;
• lymphoma;
• sarcoidosis;
• leukemia

The risk group for developing optic nerve edema includes people with diseases of the organs of vision. Often, PVD develops against the background of glaucoma.

One of the causes of disc edema is inflammation of the optic nerve. This pathology occurs against the background of various diseases, including atherosclerosis. Nerve fibers become inflamed due to impaired blood microcirculation. Toxic poisoning of the body causes similar consequences. Moreover, exposure to ethanol is considered the most dangerous.

Stages of development of congestive optic disc

The development of papilledema goes through 5 stages, although some researchers distinguish 3 stages. This gradation is based on the nature of the changes that have occurred in the structure of intracranial tissues.

Perineural edema develops during the following stages:

• initial;
• expressed;
• pronounced;
• preterminal;
• terminal.

Congestion of the optic discs at the initial stage is characterized by minor damage. The tissues located above and below swell first. Then the pathological process spreads to the nasal side. Over time, the swelling covers the entire area of ​​the disc, including the vascular infundibulum. At this stage of development, there is a slight expansion of the veins.

At the second stage, disc prominence occurs, which is characterized by an increase in its size. At this stage, the arteries narrow and the veins dilate. At a pronounced stage, the boundaries of the disc are blurred. Minor hemorrhages in the retina are also possible due to disruption of the integrity of the capillaries.

As the pathological process progresses, the intensity of the general symptoms of stagnation increases.

During this period, the size of the disc increases greatly compared to the norm. Local tissues turn red due to impaired outflow of venous blood. The vessels are practically not visible through an ophthalmoscope due to the proliferation of the disc. The number of hemorrhages at a pronounced stage increases.

This stage is characterized by the appearance of whitish lesions in the structure of the eye. The symptom occurs against the background of the onset of tissue degeneration.

Having reached the preterminal stage, the pathological process causes atrophy of the optic nerve. The disc takes on a grayish tint. Swelling at this stage decreases. At the same time, hemorrhages and white lesions disappear. Edema tissues are localized mainly along the borders of the disc.

At the terminal stage, optic nerve atrophy restarts, causing decoloration. The optic disc becomes pale gray, and its boundaries lose their previous outline. The number of arteries in the last stage decreases, but the number and condition of veins remains virtually unchanged. The proliferation of glial and connective tissues cannot be ruled out.

Symptoms of the disease

During the first 6 months after the onset of edema, the pathological process is asymptomatic. In rare cases, glare spots appear. It is also possible that vision and color perception may temporarily become blurred, and the silhouettes of people and objects become blurred. At the same time, symptoms characteristic of increased intracranial pressure are concerning:

Symptoms of papilledema at the initial stage of development of optic disc disease are diagnosed during an ophthalmological examination, which shows the presence of minor hemorrhages on the retina around the disc. The reaction to light remains unchanged.

The appearance of a congestive optic nerve nipple is noted at the stage when atrophy of local tissues develops. This causes blind spots (scotomas). In advanced cases, the patient stops seeing large sectors. In addition, loss of peripheral vision is possible.

Diagnostics

If signs of congestive optic disc disease occur, you should consult an ophthalmologist. Without timely treatment, the pathological process causes blindness in one or both eyes.

Diagnosis of optic nerve disc disease is carried out using an ophthalmoscope.

The device allows you to examine the condition of the fundus and identify swollen tissue. Before the procedure begins, special drops are injected into the organs of vision to dilate the pupil. After this, a directed beam of light is applied to the retina of the eye.

To differentiate congestive optic disc from brain diseases, MRI and CT are used. If necessary, a cerebrospinal fluid examination is performed to determine the causes of the development of spinal disc disease. In some cases, a biopsy of brain tissue is used.

Methods for treating edema

The basis for the treatment of congestive optic disc consists of procedures whose action is aimed at eliminating the root cause of the development of the pathological process. In particular, techniques are used to eliminate increased intracranial pressure. For this purpose, the treatment regimen for papilledema is often supplemented with surgical intervention.

Surgeries are performed if cerebral palsy is caused by brain tumors of any nature. During the procedure, overgrown tissue is excised. Also, as part of surgery, a hole is sometimes drilled in the skull, which temporarily normalizes the pressure.

For swelling of the optic nerve, corticosteroids are indicated: Methylprednisolone or Prednisolone. To stop the pathological process, hormonal drugs are used in the form of tablets or solutions.

To eliminate stagnation of cerebrospinal fluid inside the skull, diuretics are prescribed: Furosemide, Acetazolamide and others. These drugs are also used as tablets or as an intravenous solution. With the help of diuretic drugs, the removal of excess fluid from the body is accelerated, due to which swelling disappears.

In case of infection of brain tissue, broad- or narrow-spectrum antibacterial drugs are used. In addition to these medications, antihistamines are used to eliminate swelling.

In advanced cases, fenestration of the optic nerve sheath (shunting) is performed. In this procedure, the surgeon creates holes in the tissue surrounding the disc through which excess fluid can drain. Several shunts are also installed to divert cerebrospinal fluid from the spinal cord towards the abdominal cavity.

This type of surgery is mainly used for benign tumors in the skull.

Preventive measures

When treating inflammatory pathologies, it is recommended to strictly follow medical prescriptions and avoid overdose of medications. This is especially true when antibacterial medications are used. It is also important not to interrupt treatment ahead of schedule, even if the symptoms of the disease do not bother you for several days.

Despite the fact that there are no specific methods for preventing this disorder, the measures described above help reduce the risks of developing DLD.

The pathology develops against the background of increased intracranial pressure, which is caused by infections, inflammatory and other ailments. In case of PVD, the use of corticosteroids and diuretics is indicated. In advanced cases, the deviation is treated with surgery by shunting the affected optic nerves.

06.10.2014 | Viewed by: 5,065 people

In most cases, congestive optic disc (congestive optic disc) is not understood as a pathology, but as a condition inherent in increased intracranial pressure.

There are several stages during this disorder:

1. Initial stage.

Reduces to swelling along the periphery of the optic disc. In this case, in the area of ​​the fundus, the blurred boundaries of the optic disc are visualized, which manifests itself from the top. The disc itself is somewhat hyperemic.

2. Second stage.

Severe stagnation of the onset of the onset is called. Edema covers not only the periphery, but also the central parts of the disc. In a healthy person, the disc has a depression in the middle; with swelling it disappears, and this area protrudes towards the vitreous body. Hyperemia and redness of the optic disc increases.

Gradually it becomes cyanotic, the venous network changes - the vessels dilate, bulge onto the swollen disc itself.

In some cases, minor hemorrhages are diagnosed in the area of ​​the affected disc.

Visual function at this stage of disc stagnation is still preserved. If the patient continues to see, but the pathological changes are great, then this condition is called “the first scissors of stagnation.” Often a person exhibits only migraine-like pain in the head, or no unusual symptoms at all.

The first 2 phases of optic disc edema can be corrected if the cause of this condition is removed. The clarity of the optic disc boundaries will gradually be restored, and the swelling will subside.

3. The third stage, or pronounced swelling of the optic disc.

The disc swells even more, bulges into the vitreous, and more extensive hemorrhages appear on the optic disc itself, on the retina of the eye.

The retina also begins to swell, deform, and compression of the nerve fibers occurs. After their death, the optic nerve cannot recover, as it is replaced by connective tissue cells.

4. Fourth stage.

The optic nerve atrophies and dies. The optic disc becomes much smaller, the swelling also subsides, the condition of the veins normalizes, and hemorrhages resolve. This stage is otherwise called the “second scissors of stagnation.”

The processes boil down to an improvement in the visual condition of the fundus, but a sharp drop in visual acuity.

Causes of optic disc congestion

If the reason for which pathological processes occur affects the optic disc for a long time, then vision is irreversibly lost.

Most often, the causes of the above processes are:

• head injuries, especially those that cause bone displacement and reduction of the cranial cavity;
• changes in the condition of the skull bones;
• swelling, dropsy of the brain;
• tumors, aneurysms;
• brain inflammation.

In turn, dropsy of the brain can develop due to severe allergization of the body, against the background of blood pathologies, kidney damage, and hypertension. Sometimes the onset of optic disc edema begins due to injuries to the orbit, in various ophthalmological diseases with a drop in the level of intraocular pressure.

Stagnation of the optic disc develops against the background of impaired drainage of interstitial fluid from the area of ​​the nerve that is located in the orbit. In the normal state of the organs of vision, the outflow of excess fluid occurs by directing it into the cranial cavity.

If the pressure in the eyes drops, the fluid is retained and flows poorly due to insufficient impact on the nerve in the orbit.

The vision of a patient with stagnation of the optic disc can be quite normal for a very long time. But if the cause of this condition exists for a long time, and the pressure on the optic nerve itself increases, then the phenomena of atrophy gradually develop.

Atrophic processes lead to the death of nerve fibers, and connective tissue appears in their place. In this case, blindness occurs.

Treatment of a stagnant disc

Without completely eliminating the cause of optic disc congestion, this symptom cannot be eliminated. Thus, therapy for congestive optic disc disease is reduced to treating the underlying disease.

The diagnosis of papilledema is not directly related to the condition of the eyes, but is most often determined by ophthalmologists. The disease is swelling of the optic nerve of a non-inflammatory nature. It develops against the background of increased intracranial pressure; various disturbances in the functioning of the central nervous system can be provoking factors. In the first stages of the disease, it does not show significant symptoms, but as it progresses, tissue atrophy begins and, as a result, vision decreases. Therapy is aimed at eliminating the main cause; if a formation is present, surgical removal is used.

The disease is considered secondary and develops against the background of an existing pathology; in 67% of cases, the main disease is a tumor.

What is the essence of the disease?

The optic nerve is responsible for transmitting the images received through the eyes to the corresponding receptors in the brain. Through this process, visual function is carried out. The organ received its name because of its unique shape. To nourish the organ, a large number of blood vessels are involved, which originate in the fundus. Impaired fluid circulation in them causes swelling of the optic nerve head.

The process begins due to an increase in ICP levels. Normal pressure is in the range of 120-150 mmHg. Art. If the level increases, progressive congestion is observed, and when it decreases, pseudocongestive optic disc is diagnosed. This process can develop only on one side, but more often bilateral nerve damage is observed. The disease develops in children and adults, but patients over 45 years of age are at risk.

Possible reasons

The presence of a brain tumor in a patient causes an increase in intracranial pressure.

Various factors can provoke an increase in ICP. This is what specialists try to find when diagnosing. First of all, a study of brain activity is carried out. In most cases, the cause is the formation of a tumor in the skull, localized in the upper part of the head. In addition, the following conditions can provoke the disease:

• traumatic brain injuries;
• inflammatory process of tissues against the background of an infectious disease;
• degenerative pathologies of the central nervous system;
• cerebral edema;
• pathologies of the circulatory system;
• chronic form of hypertension;
• circulatory disorders caused by kidney dysfunction.
• spinal oncology;
• genetic pathologies;
• diabetes.

Symptoms and stages

Signs depend on the stage of development of the disease. Often, stagnation in the first stages does not show any symptoms at all; a person may complain of periodic headaches. Common symptoms of the pathology also include decreased vision. Moreover, the higher the level of tissue swelling, the worse the visual functions. Symptoms increase with development and ultimately lead to tissue atrophy. The congestive optic disc goes through the following stages in pathogenesis:

At the second stage, pinpoint hemorrhage appears on the eye.

• Initial. It is characterized by limited swelling, observed only at the edges of the nerve. During diagnosis, the contours of the disc are blurred.
• The second is pronounced stagnation. At this stage, swelling is observed throughout the organ, because of this the disc is deformed and affects the vitreous body. The vessels dilate and provoke pinpoint hemorrhage. Visual acuity at this stage remains normal.
• Pronounced stagnation. The disc significantly increases in size and puts pressure on the vitreous body, the prominence of the optic disc reaches 2.5 mm. As a result, massive foci of hemorrhage are formed in the vessels of the retina and disc. Compression of nerve fibers leads to their death. The process of visual impairment begins.
• The last stage is secondary atrophy. The swelling subsides and the size of the disc is restored, but it activates the process of death of the optic nerves. The patient's vision sharply decreases to the point of complete blindness.

At an advanced stage, the process reaches atrophy of the optic nerve. As a result, a person will experience complete irreversible loss of vision. Congestive optic disc is an extremely dangerous disease; in the first two stages, it is easily treatable, so early diagnosis is necessary for a favorable outcome. First, the ophthalmologist collects anamnesis and examines the fundus. The presence of problems is indicated by traces of pinpoint hemorrhages, an increase in the size of the blind spot and dilated vessels. To determine the full picture, consultation with a neurosurgeon and neurologist is necessary. A number of instrumental studies are prescribed:

• Measuring intraocular pressure.
• Ophthalmoscopy to study visual fields.
• MRI and CT to determine brain pathologies and detect tumors.

803 10/08/2019 5 min.

A congested optic disc is swelling of this area. It is not inflammatory in nature and is rather a sign of increased pressure inside the skull. Pathology is usually found during a fundus examination procedure.

Description

A congestive disc can develop due to impaired outflow of fluids within the tissues from the area of ​​the optic nerve. Usually this outflow goes into the cranial cavity, but with abnormal deviations, fluids may be retained due to insufficient pressure on the optic nerve of the eye cavity. You may also be interested in information about what it looks like

Visual function is not affected for a long time with this symptom. The atrophic process begins after a long period of time, when stagnation places constant strong pressure on the nerve. Nervous tissue begins to gradually transform into connective tissue. Because of this, vision loss gradually occurs.

The photo shows a congestive optic disc:

Congestive optic disc

The pathology generally goes through 4 stages:

1. The initial stage is characterized by swelling of the edges of the disc. When examined by an ophthalmologist through an ophthalmoscope, this appears as blurring of the edges of the disc, originating at the upper border. It may become red.
2. The advanced stage is manifested by complete disc swelling. The disc protrudes into the vitreous body due to the disappearance of the depression in it. The redness noticeably increases and even takes on a bluish tint, and the blood vessels dilate. Visually, it looks as if vessels are climbing onto the swollen disc, manifesting itself as pinpoint hemorrhages. A patient with this condition is usually only bothered by headaches, but vision remains in its original form. Often there are no complaints at all. When the disease that caused the symptom is cured, the swelling subsides on its own and without consequences for vision, followed by restoration of the disc boundaries.
3. A pronounced stage is manifested by a strong protrusion of the disc into the vitreous body. In this area there are foci of hemorrhages in large numbers. The retina begins to swell, the nerve tissues are compressed and gradually die, and connective tissue grows instead.
4. The fourth stagnant stage with atrophy is the reverse process of the previous three stages. The swelling begins to gradually subside, the hemorrhages go away, the condition of all elements improves, but at the same time vision decreases significantly.

But what central serous chorioretinopathy looks like and how treatment occurs is indicated

Video shows problems with the optic nerve:

If the cause of stagnation continues to affect this area, then atrophy of the nerve fibers develops and the patient permanently loses vision. This problem should be solved in the office of an ophthalmologist and neurologist. Correctly selected treatment for the root cause will help get rid of the symptom and preserve visual function.

Serious pathological processes always develop before the functioning of the organ of vision is disrupted. When the process of vision loss starts, tissue atrophy is already underway.

But what could be the causes of photophobia of the eye, and what can be done about such a problem is outlined

Reasons for appearance

This manifestation can occur due to a number of serious pathologies hidden in the patient’s body. In particular, intracranial pressure with this consequence develops if there is:

Swelling of the optic nerve nipple often develops due to injuries to the eye, orbit, as well as diseases associated with the organ of vision, if these are accompanied by a decrease in pressure inside the eye.

Symptoms of pathology

Symptoms in general may not be felt for quite a long time. Most often, pathology is detected in the later stages, when edema has started the process of atrophy(you can see why swelling of the upper eyelid of one eye in a child appears) . If it was detected during a preventive examination in the initial stages, then the patient may not have experienced any negative manifestations before or occasionally endure moderate headaches. At the initial stages, visual acuity is preserved.

The developed congestive optic disc may give minor signs of pathology. However, patients often simply do not pay attention to this pathology.

The main manifestations of this stage of pathology:

• Visual disturbances of a transient nature. May occur in both eyes or just one, for example when standing up for a few seconds.
• Visual acuity is either normal or slightly reduced.
• The area of ​​the blind spot increases.

Chronic pathology is manifested by several factors at once, which patients can no longer ignore, since visual fields are gradually narrowing and visual acuity is constantly changing. During the atrophic process, visual acuity drops sharply. This can be either complete blindness or partial loss of vision. But how to check visual acuity at home will help you understand this

A congested optic disc is only a symptom of increased pressure inside the skull.

You may also be wondering why there are treatment options for this disease.

What is the first thing you need to know about congestive optic disc? It is very similar to other diseases in the same area. Therefore, correct treatment cannot be prescribed without a full diagnosis.

Diagnostics

The process of diagnosing not only the pathology, but also the cause that caused it is extremely important. It is also important to differentiate a congestive disc from other diseases that cause swelling of the disc:

• Optic neuritis;
• Ischemic neuropathy;
• Hypotension;
• Retinal vascular thrombosis;
• Disc pseudoedema;

An ophthalmologist looks through an ophthalmoscope. After this, if there is a characteristic picture of pathological processes in the area of ​​the optic disc, the cause of the disease is identified.

Diagnosis should be carried out to a greater extent to differentiate this pathology from other serious deviations, since the approach to treatment is radically different.

Treatment

It is impossible to cure a congestive optic disc unless the root cause that caused this pathology is eliminated. In this case, only supportive medications for nerve tissue can be prescribed:

There is no specific treatment for this pathology, as it is caused by other pathologies. Without eliminating them, it will not be possible to achieve complete recovery. But if swelling does not subside during therapy, then dehydration and osmotherapy are prescribed, which will help reduce the amount of fluid in the tissues and reduce the negative impact of the processes on the nerve fibers.

If atrophy has already developed, then appropriate treatment is carried out. Often such changes are corrected using a laser.

After prescribing adequate therapy for the initial disease, the ophthalmologist monitors the patient’s condition, checking the fundus at certain intervals. If the swelling does not subside, then therapy is carried out in the direction of eliminating excess fluid in the affected area.

Date: 03/08/2016

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With high intracranial pressure, congestive optic disc may develop. In fact, this is swelling of this organ. It can be unilateral or bilateral. If there is no increased intracranial pressure, then other disorders occur. If a patient is diagnosed with papilledema, this can be caused by a variety of reasons, which will be discussed below.

What happens when an illness appears

The development of the disease is associated with an increase in intracranial pressure in the patient due to the presence of a tumor in the skull. A congested optic disc can be caused by the following reasons:

1. Traumatic brain injury.
2. Hematoma that occurs after hitting the head or falling.
3. Inflammation that engulfs the brain and all its membranes.
4. Various formations that have a large volume, but are not tumors.
5. Disturbances in the normal functioning of the sinuses and blood vessels of the brain.
6. Hypertension (intracranial), the origin of which is unknown.
7. Development of signs of hydrocephalus.
8. The occurrence of tumors on the spinal cord.

A congestive optic disc usually has a degree of damage expressed by the amount of intracranial pressure. But if this factor is absent or weak, then the indicator that determines the congestive optic disc will be the presence and location of neoplasms in the cavities of the cranium. It is determined in relation to the veins and liquor system of the cerebral hemispheres of the brain. The closer parts of the tumor are to the sinuses, the more congestive optic disc will develop. Clinically, this often manifests itself as swelling of this organ. The patient experiences blurred patterns and boundaries of the disc itself. Hyperemia of its constituent parts is possible. The process is usually bilateral, but in some cases the disease develops in one eye. In this case, atrophy of this disc itself and impaired vision in the second organ are possible.

Edema appears first at the lower edge and then moves upward, causing damage to the temporal and nasal lobes of the affected eye. During the course of the disease, one can distinguish the initial stage, the development of edema of maximum magnitude, and the reverse process.

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Main symptoms of the disease

During the development and increase of the edematous stage, the disc begins to grow into the vitreous body of the eye. The increase in edema spreads to the retina, and the size of the blind spot begins to increase, which can be determined by examining the field and angle of vision. The patient may have normal vision for a long time - this is the main symptom characterizing a congestive optic disc. This sign allows it to be used to diagnose the disease. Such patients usually complain of a severe headache, and general practitioners send them for a fundus examination.

Another sign of the onset of the disease is a sharp, short-term deterioration in the patient’s vision, which can lead to blindness. This occurs due to spasm of the blood vessels that supply the nerve endings of the eye. The frequency of occurrence of such sensations depends on a number of reasons, for example, on the degree of damage to the discs. Recurrence of attacks can reach several spasms within an hour.

With the disease, the size of the retinal veins sharply increases, which indicates difficulties with the passage of blood through the veins. Bleeding from the organs of vision may occur, which is localized around the affected discs and adjacent areas of the retina.

Hemorrhage can also occur with obvious swelling of the discs, which indicates severe disturbances in the blood supply to the eye. But bleeding can also occur at the initial stage of the disease. Their cause in such cases is immediate surges in intracranial pressure, for example, with an artery aneurysm, a malignant tumor, or the effects of toxins on the walls of blood vessels.

As edema develops, small ruptures in blood vessels and whitish, cotton-like lesions may appear. This occurs in areas where swollen tissue accumulates and can cause blurred vision.

This process can also manifest itself during the transition to the second stage of disease development. In this case, the disk has unclear outlines and pale colors. The veins retain their functions, there are no hemorrhages, and whitish lesions disappear. But secondary atrophy can lead to a sharp deterioration in the functioning of the visual organs, and vision, as a rule, drops sharply in patients. Various defects occur in the quadrant below the patient's nose. These phenomena are caused by intracranial pressure.

The disease can be divided into the following stages:

Initial period:

• no visual impairment is noted;
• the discs enlarge and enter the vitreous body;
• their edges are unclear, swelling of some areas of the retina begins to develop;
• The pulse in the veins disappears in 1/5 of all patients.

Further development of the disease:

Chronic period:

• visual fields narrow, visual acuity either improves or falls;
• discs begin to bulge;
• whitish lesions and bleeding are absent;
• Shunts or drusen appear on the surface of the affected disc bodies themselves.

Secondary atrophy:

• visual acuity drops sharply;
• the discs have unclear boundaries, several blood vessels are visible on them, and their entire field has a gray tint.

If you do not consult a doctor in time, complete blindness in one or both eyes is possible.