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Optic neuritis - All Information

Definition of Optic neuritis:

Optic neuritis is inflammation of the optic nerve. It may cause sudden, reduced vision in the affected eye.

Causes, incidence, and risk factors:

The cause of optic neuritis is unknown.

Sudden inflammation of the nerve connecting the eye and the brain (optic nerve) can cause the nerve to swell and destroy its outer shell (myelin sheath). The inflammation may occasionally be due to a viral infection, or it may be caused by autoimmune diseases such as multiple sclerosis.

Risk factors are related to the possible causes.

Symptoms:

Sudden (acute) loss of vision in one eye
Changes in the pupil's reactions to bright light
Loss of color vision
Pain when you move the eye

Signs and tests:

A complete medical examination can help rule out related diseases. Tests may include the following:

Color vision testing
MRI of the brain
Visual acuity testing
Visualization of the optic disc by indirect ophthalmoscopy

Treatment:

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

Corticosteroids given through a vein (IV) may speed up recovery, but they can cause side effects.

Further tests may be needed to determine the cause of the neuritis. The condition causing the problem can then be treated.

Expectations (prognosis):

Patients 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 such as systemic lupus erythematosus has a poorer outlook.

Complications:

Body-wide side effects from corticosteroids
Vision loss

About 20% of patients with a first episode of optic neuritis will develop multiple sclerosis.

Calling your health care provider:

Call your health care provider immediately if you have a sudden loss of vision in one eye.

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

Your vision decreases
You develop pain in the eye
Your symptoms do not improve with treatment

External and internal eye anatomy

Reviewed last on: 10/6/2008
Paul B. Griggs, MD, Department of Ophthalmology, Virginia Mason Medical Center, Seattle, WA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Germann CA, Baumann MR, Hamzavi S. Ophthalmic diagnoses in the ED: optic neuritis. Am J Emerg Med. 2007;25:834-837.

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