What is the definition of Optic Neuritis?

The optic nerve carries images of what the eye sees to the brain. When this nerve become swollen or inflamed, it is called optic neuritis. It may cause sudden, reduced vision in the affected eye.

What are the alternative names for Optic Neuritis?

Retro-bulbar neuritis; Multiple sclerosis - optic neuritis; Optic nerve - optic neuritis

What are the causes for Optic Neuritis?

The exact cause of optic neuritis is unknown.

The optic nerve carries visual information from your eye to the brain. The nerve can swell when it becomes suddenly inflamed. The swelling can damage nerve fibers. This can cause short or long-term loss of vision.

Conditions that have been linked with optic neuritis include:

• Autoimmune diseases, including lupus, sarcoidosis, and Behçet disease
• Cryptococcosis, a fungal infection
• Bacterial infections, including tuberculosis, syphilis, Lyme disease, and meningitis
• Viral infections, including viral encephalitis, measles, rubella, chickenpox, herpes zoster, mumps, and mononucleosis
• Respiratory infections, including mycoplasma pneumonia and other common upper respiratory tract infections
• Multiple sclerosis

What are the symptoms for Optic Neuritis?

Symptoms may include:

• Loss of vision in one eye over an hour or a few hours
• Changes in the way the pupil reacts to bright light
• Loss of color vision
• Pain when you move the eye

What are the current treatments for Optic Neuritis?

Vision often returns to normal within 2 to 3 weeks with no treatment.

Corticosteroids given through a vein (IV) or taken by mouth (oral) may speed up recovery. However, the final vision is no better with steroids than without. Oral steroids may actually increase the chance of recurrence.

Further tests may be needed to find the cause of the neuritis. The condition causing the problem may be able to be treated.

What is the outlook (prognosis) for Optic Neuritis?

People who have optic neuritis without a disease such as multiple sclerosis have a good chance of recovery.

Optic neuritis caused by multiple sclerosis or other autoimmune diseases has a poorer outlook. However, vision in the affected eye may still return to normal.

What are the possible complications for Optic Neuritis?

Complications may include:

• Body-wide side effects from corticosteroids
• Vision loss

Some people who have an episode of optic neuritis will develop nerve problems in other places in the body or develop multiple sclerosis.

When should I contact a medical professional for Optic Neuritis?

Call your health care provider right away if you have a sudden loss of vision in one eye, especially if you have eye pain.

If you have been diagnosed with optic neuritis, call your health care provider if:

• Your vision decreases.
• The pain in the eye gets worse.
• Your symptoms do not improve within 2 to 3 weeks.

REFERENCES

Calabresi PA. Multiple sclerosis and demyelinating conditions of the central nervous system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 383.

Moss HE, Guercio JR, Balcer LJ. Inflammatory optic neuropathies and neuroretinitis. In: Yanoff M, Duker JS, eds. Ophthalmology.  5th ed. Philadelphia, PA: Elsevier; 2019:chap 9.7.

Prasad S, Balcer LJ. Abnormalities of the optic nerve and retina. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 17.