Optic Neuritis: Symptoms and treatment (original) (raw)

Optic neuritis is an inflammation of the optic nerve, a bundle of nerve fibers that relays visual information from the eye to the brain. The condition may cause vision disturbances that can resolve on their own.

The optic nerve features a fatty substance coating called myelin. This covering helps electrical impulses travel quickly from the eye to the brain, where the brain converts them into visual information.

Inflammation in the optic nerve can damage the myelin. This disrupts the process of visual cues that travel along the nerve fibers to the brain and can result in vision loss, pain with eye movement, or reduced color vision.

Optic neuritis is a condition with close links to multiple sclerosis (MS), an illness that causes inflammation and damage to nerves in the brain and spinal cord. It is often one of the first symptoms of MS.

This article examines optic neuritis, its possible causes, symptoms, treatments, and more.

Symptoms of optic neuritis can occur in one or both eyes and may include:

• blurred vision
• dim vision
• pain in the eye socket
• pain while moving the eye
• colors appearing dull

These symptoms can come on suddenly or gradually. Symptoms of optic neuritis may worsen when a person is hot or tired, for example, after exercise or during a hot bath.

Scientists do not know the exact cause of optic neuritis. One theory is that it develops when the immune system — which usually fights infection by attacking bacteria, viruses, and other foreign proteins — targets the myelin sheath instead.

People with autoimmune diseases, particularly MS, are more likely to get optic neuritis. According to a 2023 article, optic neuritis is an early symptom in around 15–20% of people with MS.

Another study in the article found that around half of those with an MS diagnosis will have experienced at least one case of optic neuritis in the previous 15 years.

Some evidence also suggests that viral illnesses can cause bouts of optic neuritis, as viral infections can sometimes cause an autoimmune response.

Some risk factors for optic neuritis include:

• Age: Optic neuritis is more likely to happen in those ages 20 to 40 years.
• Sex: Optic neuritis is around twice as likely to happen in females than in males.
• Ethnicity: Caucasian people are more likely to develop optic neuritis than other ethnicities.

Vision loss is usually temporary. It typically improves on its own over several weeks or months, so no treatment may be necessary. However, vision loss could be permanent in some cases.

If the symptoms are severe, such as when both eyes are affected, doctors may prescribe corticosteroids. This type of medication combats the inflammation in optic neuritis and helps improve vision in most people.

An eye doctor, either an ophthalmologist or optometrist, can diagnose optic neuritis. They can perform tests to check color vision, how eyes respond to light, and how well the eye can see detail, such as letters in an eye chart.

People who show symptoms of optic neuritis for the first time are likely to undergo imaging tests of the optic nerve and brain.

A CT or MRI scan can help doctors determine if a person has MS. The presence of lesions in the brain is a sign of the condition.

An eye doctor may also recommend an optical coherence tomography (OCT) scan. An OCT is a noninvasive test that uses light waves to take cross-section pictures of the retina.

This method allows the eye doctor to see each of the retina’s layers, which helps with making a diagnosis.

Most people recover their sight without treatment over several weeks once the inflammation in the optic nerve dies down. This tends to be the case when optic neuritis does not relate to another underlying condition.

Full recovery can take longer. In some instances, it may take up to a year after the first symptoms appear.

Although typical sight may return, some slight vision changes can remain. These changes include difficulty in telling specific colors apart or difficulty with depth perception.

However, in some cases, vision loss can be permanent.

Once a person’s vision has restored, it is possible for them to get optic neuritis again. This particularly true for those with MS.

If symptoms return, it is essential to consult a doctor right away. Immediate treatment for recurring symptoms could help prevent future episodes of optic neuritis.

This section answers some frequently asked questions about optic neuritis.

What can be mistaken for optic neuritis?

A 2018 article states that medical professionals can sometimes mistake optic neuropathy, ocular surface disease, and primary headache disorders as optic neuritis.

This is because they may have similar symptoms, including eye pain and vision disturbances.

However, doctors can usually differentiate the diseases when using MRI and CT scans. This will help determine the correct diagnosis.

Can you live a typical life with optic neuritis?

Yes, it is possible to recover from optic neuritis and live a typical life.

Vision loss from optic neuritis is usually temporary, often improving on its own over several weeks or months.

However, once a person’s vision returns, it is possible to get optic neuritis again. This can be the case for people with MS.

MS may require lifelong management. Learn more about MS treatments.

Optic neuritis is an inflammation of the optic nerve that can cause vision disturbances and eye pain. It usually resolves on its own, but recurring optic neuritis can be the result of multiple sclerosis.

If the symptoms are severe, doctors can prescribe corticosteroids to treat the inflammation. This helps improve vision in most people.