Filed under: Boomer's Health
Optic neuritis is an inflammation of the optic nerve, the bundle of nerve fibers that transmit visual information to your brain from your eye. Pain and temporary vision loss are common symptoms of optic neuritis.
Optic neuritis usually develops in association with an autoimmune disorder that may be triggered by an infection. In some people, signs and symptoms of optic neuritis may be an indication of multiple sclerosis, a condition resulting in inflammation and damage to nerves in your brain and spinal cord.
Most people who experience a single episode of optic neuritis eventually recover their vision. Treatment with steroid medications may speed up vision recovery after optic neuritis.
Optic neuritis usually affects one eye, although it may occur in both eyes simultaneously. Optic neuritis symptoms may include:
The signs and symptoms of optic neuritis may be indications of an autoimmune disorder called multiple sclerosis. In 15 to 20 percent of people who eventually develop multiple sclerosis, optic neuritis is their first symptom.
When to see a doctor
Eye conditions can be serious. Some may cause you to permanently lose your vision and some are associated with other serious medical problems. Contact your doctor in the following situations:
The exact cause of optic neuritis is unknown. However, optic neuritis is believed to develop when the immune system mistakenly targets the substance (myelin) covering your optic nerve, resulting in inflammation and damage to the myelin. Normally, the myelin helps electrical impulses travel quickly along the optic nerve, from the eye to the brain. In the brain, those electrical impulses are converted into visual information. Optic neuritis disrupts this process, affecting vision. It's not certain what causes your immune system to target the myelin.
The following autoimmune conditions are often associated with optic neuritis:
Other autoimmune conditions, such as sarcoidosis and systemic lupus erythematosus, have also been associated with optic neuritis.
Not all potential causes of optic neuritis are autoimmune diseases. Other factors that have been linked to the development of optic neuritis include:
In addition, any process resulting in inflammation or compression of the optic nerve, including tumors, nutritional deficiencies or toxins, can interfere with the nerve's ability to conduct electrical impulses. This may cause vision loss and other symptoms that may mimic optic neuritis.
Risk factors for optic neuritis arising from autoimmune disorders include:
Complications arising from optic neuritis may include:
If you have signs and symptoms of optic neuritis, you may first see your family doctor or a general practitioner. However, when you call for an appointment, you may be referred immediately to a doctor who specializes in diagnosing and treating eye diseases (ophthalmologist).
Because appointments can be brief and because there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
Your time with your doctor may be limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out.
For optic neuritis, important questions to ask your doctor include:
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to talk more about. Your doctor may ask:
You're likely to see an ophthalmologist for a definitive diagnosis. The ophthalmologist may perform the following eye tests:
Other tests to diagnose optic neuritis may include:
Optic neuritis usually gets better on its own. In some cases, steroid medications are used to treat optic neuritis, because they help reduce inflammation in the optic nerve. Possible side effects from steroid treatment include weight gain, mood changes, stomach upset and insomnia. If you receive steroids, your treatment may involve:
In instances in which steroid therapy has failed and severe vision loss persists, a treatment called plasma exchange therapy may help some people recover their vision.
Preventing multiple sclerosis
If you have optic neuritis and you appear to have a high risk of developing multiple sclerosis based on your MRI results, you may benefit from drugs that help prevent multiple sclerosis. These drugs include interferon beta-1a (Avonex, Rebif) and interferon beta-1b (Betaseron). These injectable drugs are used to prevent or delay the development of multiple sclerosis in people with optic neuritis who have two or more brain lesions evident on MRI scans.
The prognosis following optic neuritis is generally good. Most people regain close to normal vision within 12 months after an episode of optic neuritis.
People with multiple sclerosis or neuromyelitis optica may have a greater risk for recurrent attacks of optic neuritis. People without any underlying conditions also may have recurrent optic neuritis. But, these people generally have a better long-term prognosis for their vision than do people with multiple sclerosis or neuromyelitis optica.