Is Optic Neuritis?
The optic nerve carries visual information from your eye to your
brain. Optic neuritis (ON) is when your optic nerve becomes inflamed. ON can
flare up suddenly from an infection or nerve disease. The inflammation usually causes
temporary vision loss that typically happens in only one eye. As you recover
and the inflammation goes away, your vision will likely return.
Those with ON sometimes experience pain. There are other
conditions with symptoms that resemble the symptoms of ON. Doctors may use
optical coherence tomography (OCT) or magnetic resonance imaging (MRI) to help
reach the correct diagnosis.
ON doesn’t always require treatment and can heal on its own.
Medications, such as corticosteroids, can help speed recovery. Most cases of ON
have complete (or nearly complete) vision recovery within 2 to 3 months, but it may take up to 12
months to achieve the visual recovery.
Is at Risk for Optic Neuritis?
You’re more likely to develop ON if:
- you’re a female between the ages of 18 and 45
- you’ve been diagnosed with multiple sclerosis
- you live at a high latitude (e.g., Northern
United States, New Zealand)
Causes Optic Neuritis?
The cause of optic neuritis isn’t well understood. Most cases are
idiopathic, which means they have no identifiable cause. The most common known
cause is multiple sclerosis (MS). In fact, ON is often the first symptom of MS.
Optic neuritis can also be due to infection or an inflammatory immune system
Nerve diseases that can cause ON include:
- neuromyelitis optica
- Schilder’s disease (a chronic demyelinating
condition that begins in childhood)
Infections that may cause ON include:
- Lyme disease
- viral encephalitis
Other causes of ON include:
- sarcoidosis: an illness that causes inflammation
in various organs and tissues
- Gullain-Barre syndrome: a disease in which your
immune system attacks your nervous system
- post-vaccination reaction: an immune response
- some chemicals or drugs
Are the Symptoms of Optic Neuritis?
The three most common symptoms of optic neuritis are:
- vision loss in one eye: can vary from mild to
severe and lasts for 7 to 10 days
- periocular pain: pain around the eye that’s often
worsened by eye movements
- dyschromatopsia: inability to see colors
Other symptoms can include:
- photopsias: seeing flashing lights (off to the
side), in one or both eyes
- changes in the way the pupil reacts to bright
- Uhthoff’s phenomenon (or Uhthoff’s sign): when eye
vision worsens with an increase in body temperature
Is Optic Neuritis Diagnosed?
A physical exam, symptoms, and medical history form the basis of
a diagnosis of optic neuritis. To ensure correct treatment, your doctor may
perform additional tests to determine the cause of your optic neuritis.
Types of illness that can cause optic neuritis include:
- demyelinating disease, such as MS
- autoimmune neuropathies, such as systemic lupus
- compressive neuropathies, such as meningioma (a
type of brain tumor)
- inflammatory conditions, such as sarcoidosis
- infections, such as sinusitis
ON is as inflammation of the optic nerve. Conditions whose symptoms
resemble ON but aren’t inflammatory include:
- anterior ischemic optic neuropathy
- leber hereditary optic neuropathy
Because of the close relationship between ON and multiple
sclerosis, your doctor may want to perform the following tests:
- optical coherence tomography, which looks at the
nerves in the back of the eye
- brain MRI, which uses a magnetic field and radio
waves to create a detailed image of the brain
- computed tomography (CT), which creates a
cross-sectional X-ray of the brain or other parts of the body
Are the Treatments for Optic Neuritis?
Most cases of ON recover without treatment. If your ON is the
result of another condition, treating that condition will often resolve the ON.
Treatment for optic neuritis includes:
- intravenous methylprednisolone (IVMP)
- intravenous immunoglobulin (IVIG)
- interferon injections
There are possible adverse effects from the use of
corticosteroids such as IVMP. Rare side effects of IVMP include severe
depression and pancreatitis.
Common side effects of steroid treatment include:
- sleep disturbances
- mild mood changes
- stomach upset
Is the Long-Term Outlook?
Most people with ON will have partial to complete vision recovery
within 6 to 12 months. Thereafter, healing rates decrease and damage is more
permanent. Even with good vision recovery, many patients will still have a
varying amount of damage to the optic nerve.
The eye is a very important part of the body. Address warning
signs of lasting damage with your doctor before they become irreversible. These
warning signs include your vision worsening for more than two weeks and no
improvement after eight weeks.