Optic Neuritis

What is Optic Neuritis?

Optic Neuritis is an inflammation and swelling of the optic nerve. The optic nerve is critical to our vision because it carries images to the brain. It does not function as it should if it becomes infected, damaged, or swollen. Most cases occur in women between the ages of 20 and 40. Optic neuritis affects more Caucasians and Asians than African Americans.

What Are the Symptoms of Optic Neuritis?

With optic neuritis, symptoms may appear in one or both eyes. They can develop over time or appear very quickly. These symptoms include:

• Blurry vision
• Colors appearing faded
• Vision perception making it seem like there isn’t enough light
• Pain in the back of the eye
• Pain when moving the eye
• Difficulty when trying to see at night
• Occasional flashing lights
• Symptoms are worse when tired or hot

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How Is Optic Neuritis Diagnosed?

Your Grand Rapids Ophthalmology eye doctor will examine your eyes, including:

• Look at the optic nerve inside your eye with an ophthalmoscope
• Test your peripheral vision
• Assess how your pupils respond to light
• Test to see how well you see colors
• Evaluate your visual image system by ordering an MRI, CT scan, or visual brain wave recording
• Test the thickness of the retinal nerve fiber layer with the Optical Coherence Tomography (OCT)

What Causes Optic Neuritis?

Doctors are not sure what causes optic neuritis. Sometimes optic neuritis appears after a viral infection. Many scientists believe it is an autoimmune disease where the immune system attacks the optic nerve.

What is the Connection between Optic Neuritis and Multiple Sclerosis?

There is a strong correlation between optic neuritis and multiple sclerosis. Both are autoimmune disorders. People with recurrent optic neuritis are at high risk for developing MS. Myelin is a material produced by cells in the central nervous system. It helps speed up nerve activity and insulates electrical conduction in the nerves. In optic neuritis, scientists believe that demyelination occurs with the optic nerve. In this process, the myelin is stripped off the nerve by disease. With MS, demyelination happens over time in other parts of the brain and spinal cord. Patients with recurrent optic neuritis and two or more lesions on the brain seen on an MRI may benefit from drugs called beta interferons. These drugs can postpone or help prevent the development of MS.

How Is Optic Neuritis Treated?

Sometimes, optic neuritis does not need treatment and resolves on its own. Patients with continued poor vision may require treatment with medications called corticosteroids. These are usually given through an IV, with follow-up oral steroid medication. A treatment called plasma exchange therapy has improved vision for some patients. More clinical research on patients is needed to prove if it is effective for optic neuritis.

Is There A Cure for Optic Neuritis?

In about 80% of patients, symptoms improve after a few weeks. Others may continue to have some ongoing vision loss. This can include difficulty driving at night or reduced color vision. Optic neuritis can recur, although this is not very common. When it does, the patient may have an autoimmune disease. Severe optic neuritis can be associated with a disease called Neuromyelitis Optica (NMO) or Devic’s Disease. This disease is often confused with multiple sclerosis because the symptoms are similar.