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Optic Neuritis-Causes and Symptoms

by | Aug 18, 2024 | Info | 0 comments

Optic Neuritis Overview

Optic neuritis (ON) is inflammation of your optic nerve. It can cause vision loss and pain when you move your eyes. As the inflammation goes away, your symptoms will usually get better.

What is Optic Neuritis?

The optic nerve carries visual information from your eye to your brain. ON is when your optic nerve becomes inflamed.

The inflammation can cause vision loss in one or both of your eyes. This loss of vision is usually temporary. In some cases, you may also feel pain when you move your eyes.

ON can flare up due to an infection or nerve condition. Early diagnosis and treatment can improve the outcome. As you recover and the inflammation goes away, your vision will likely return over time.

Whenever you notice changes to your vision, it’s important to get it checked out by a doctor or ophthalmologist.

Causes of Optic Neuritis

There are many possible causes of ON. Some cases are idiopathic, which means they have no known cause.

Multiple sclerosis and other nerve conditions

Multiple sclerosis (MS) is the most common known cause of optic neuritis. The condition is often the first symptom of MS. About 50 percent of people with MS will develop optic neuritis at some point.

Other nerve conditions that can cause ON include:

  • Myelin oligodendrocyte glycoprotein antibody disease, condition that causes nervous system inflammation
  • Schilder’s disease, a long-term (chronic) demyelinating condition that begins in childhood
  • Neuromyelitis optic (NMO) spectrum disorder, a rare condition that can cause inflammation of the optic nerve

Autoimmune conditions

ON can also be caused by autoimmune conditions, such as:

  • Sarcoidosis, a condition that causes inflammation in various organs and tissues
  • Sjögren’s Syndrome, a disorder that typically affects tear and saliva glands
  • Systemic lupus erythematosus (SLE), a long-term condition that can affect different organ systems
  • glial fibrillary acidic protein immunoglobulin G disease, a rare condition

Infections and Other Causes

Infections that can cause optic neuritis include:

Other possible causes include:

  • Alcohol and tobacco use
  • Certain medications
  • Exposure to toxic substances
  • Some nutritional deficiencies


Symptoms of Optic Neuritis

The symptoms of optic neuritis can vary, depending on what’s causing it.

The most common symptoms of optic neuritis include:

  • Dyschromatopsia, or the inability to see colors correctly
  • Periocular pain, or pain around your eye that’s often worsened by eye movements
  • Vision loss in one eye, which can vary from mild to severe

Other Symptoms

Other possible symptoms can include the following:

  • Changes in the way the pupil reacts to bright light
  • Photopsia, seeing flashing lights or floaters in one or both eyes
  • Uhtohoff’s phenomenon, or Uhthoff’s sign, which is when vision worsens with an increase in body temperature

Unilateral Optic Neuritis

When optic neuritis affects one eye only, it’s called unilateral optic neuritis. Unilateral optic neuritis is more common. But it’s also possible for optic neuritis to affect both eyes. This is known as bilateral optic neuritis.

Sometimes, conditions other than optic neuritis can cause similar symptoms. These include:

  • Anterior ischemic optic neuropathy, when part of your optic nerve is not getting enough blood
  • Leber hereditary optic neuropathy, a type of vision loss that is passed down in families


Risk Factors of Optic Neuritis

Factors that increase the chance of developing optic neuritis include the following:

  • Being 20 to 40 years old
  • Having a diagnosis of MS
  • Individuals assigned female at birth

The risk of developing MS may be higher for people who live in temperate regions, like western Europe and the northern United States.

Diagnosis of Optic Neuritis

A doctor will typically begin by asking you about your symptoms and medical history. They’ll then perform a physical exam. To ensure the best treatment, the doctor may perform additional tests to determine the cause of your optic nerve.

Tests for optic nerve can include blood tests or a cerebrospinal fluid (CSF) analysis.

The doctor may also request imaging tests, such as:

Treatment of Optic Neuritis

In most cases, you can treat optic neuritis with corticosteroids to help reduce nerve inflammation and swelling.

Steroid medication may be taken orally, injected, or administered intravenously. These medications typically come with some side effects, so be sure to talk with your doctor or pharmacist to learn what to expect.

If your optic neuritis is the result of another condition, treating that condition will often help to resolve optic neuritis. For example, a doctor may prescribe antibiotics if a bacterial infection is causing optic neuritis.

Depending on what’s causing the optic neuritis, treatments can also include:

  • Adrenocorticotropic hormone
  • Intravenous immunoglobulin (IVIG)
  • Plasma exchange 
  • interferon injections

Outlook

Experiencing vision loss can be worrisome, but in many cases, the symptoms of optic neuritis are temporary. After the optic neuritis episode resolves, most people will not have permanent, severe vision loss. However, it can take some time for your vision to recover, from weeks to months.

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