Optic neuritis is a disease that causes inflammation of the optic nerve and abnormalities in visual function. Caution should be exercised because optic neuritis can damage not only the optic nerve of the eye but it may affect the nerves of other parts of the body (multiple sclerosis and optic myelitis).
Most people with idiopathic neuritis recover completely and 74% of their sight may get recovered within one week of treatment. But there are some cases where the patient had not got the vision back.
It may occur as the first symptom of multiple sclerosis, and it often occurs from the loss of vision in one eye, causing pain in the back of the eyeball and eventually may cause loss of vision in both eyes.
The age of onset is said to be slightly higher in women in their 20s and 30s, but it can also occur in children and people in their 60s. One in every 100,000 people gets affected by this disease 1.(1)
Can Stress Cause Optic Neuritis?
Owing to the autonomous or sympathetic nervous system dysfunction and dysregulation, persistent tension and elevated levels of cortisol can damage the eye and cause vision loss. Thus, stress and tension can be the main triggers of visual system disorders, including optic neuropathy and glaucoma. Nevertheless, optic neuritis is not seen because of stress.(2)
Can Optic Neuritis Cause A Headache?
It is possible to experience a headache due to optic neuritis. People suffering from the disease often have a dull headache at the back of the eyes. They also experience pain while trying to move the eyeball. This pain often disappears when the disease progresses and vision loss takes place.(3)
Causes Of Optic Neuritis
The exact cause of optic neuritis is not well understood. The capsule (myelin sheath), which surrounds the nerves in layers, becomes inflamed and injured, causing optic nerve inflammation and abnormal optic nerve function.
At present, it is said that autoimmunity against the protein that creates the myelin sheath may be the cause. Viruses and bacterial infections are also considered.
Recently Aquaporin 4 is found to be involved in the development of autoimmunity. It is a protein antibody in the central nervous system. It often causes damage to the optic nerve and spinal cord, and it is said that it recurs in elderly women and progressively becomes more serious in people with binocular vision.(4)
Symptoms Of Optic Neuritis
A characteristic symptom is the feeling of tightness in the eyes and eye pain, as well as a sudden loss of vision on one or both eyes, as well as a loss of vision in the middle or a loss of partial vision. Visual acuity is less than 0.1 in 2-3 days.
A few days before the onset of vision loss, the pain in the back of the eyeballs is severe, blurring the entire eye, not being able to see what you are trying to see or gradually missing part of the visual field.
It is characterized by symptoms that are difficult to see during exercise or bathing when the body temperature rises. As a subjective symptom, pain at the back of the eyeball caused by eye movement, and retrobulbar pain is common. If such a subjective symptom appears, it is recommended to consult a specialist immediately.
Post-balloon pain is a condition in which the back of the eye hurts when you move your eyes. This makes it difficult to distinguish colors and makes it difficult to see the difference between red and green colors. Also, a counter-reaction may be impaired, making flickering difficult to understand or a fundus abnormality.(5)
Optic Neuritis Treatment
For the treatment of optic neuritis, MRI will check for tumors behind the eyeballs and head MRI will check for multiple sclerosis and optic neuromyelitis.
If it is determined to be optic neuritis, intravenous adrenal steroids are given, and if complications such as multiple sclerosis or neuromyelitis optica occur, treatment with interferon is performed.
Optic neuritis develops very quickly, so if the back of your eye hurts when you move your eyes, consult a specialist immediately.(5)
- Dudley MZ, Salmon DA, Halsey NA, et al. Do Vaccines Cause Optic Neuritis or Neuromyelitis Optica (NMO)? The Clinician’s Vaccine Safety Resource Guide: Springer; 2018:325-328.
- Fabian ID, Abudi A, Kinori M, et al. Acute Optic Neuropathy and Development of Posttraumatic Stress Disorder. Paper presented at: Seminars in ophthalmology2017.
- Falcão-Gonçalves AB, Bichuetti DB, de Oliveira EML. Recurrent optic neuritis as the initial symptom in demyelinating diseases. Journal of Clinical Neurology. 2018;14(3):351-358.
- Cadavid D, Balcer L, Galetta S, et al. Safety and efficacy of opicinumab in acute optic neuritis (RENEW): a randomised, placebo-controlled, phase 2 trial. The Lancet Neurology. 2017;16(3):189-199.
- Burton EV. Optic Neuritis: Clinical Manifestations, Pathophysiology, and Management. Neuroinflammation: Elsevier; 2018:337-353.