Optic nerve inflammation is known as optic neuritis. The causes may vary. Autoimmune diseases (a disease in which the immune function that originally removes foreign bodies that have entered from outside the body works on bodies own normal tissues) such as optic nerve spinal cord inflammation and optic neuritis due to multiple sclerosis, viruses, and bacterial infection may cause the disease.
Immediately after the onset of the disease, the cause cannot often be determined, and the diagnosis is made over time. In some cases, the cause is not known (idiopathic optic neuritis).
Optic neuritis is an inflammation of the nerves of the eyes. Symptoms are a sharp drop in vision, most often affecting only one eye. There are also young patients in their 20s and 30s. If you feel that it has become difficult to see suddenly, please consult an ophthalmologist as soon as possible.(1)
Can You Have Optic Neuritis In Both Eyes?
Individuals typically have optic neuritis only in one of the eyes, although both eyes may be affected. Particularly, children having optic neuritis experience it on both the eyes.
Does Optic Neuritis Always Lead To MS?
Optic neuritis is a prevalent concern for the eye where the optic neuritis becomes inflamed or demyelinated. It is an individual disorder, but often closely related to multiple sclerosis. Almost everyone who has optic neuritis experiences some MS signs, however some may not.(2)(3)
Symptoms Of Optic Neuritis
Eyesight develops as quickly as one week or less in one eye. Since the nerves behind the eyes are inflamed, moving the eyes will cause pain inside the eyes. This is called retrobulbar pain, but it is an important subjective symptom for early detection because this symptom first comes out and often causes visual impairment.
- Impaired vision (adults usually have one eye; children often have both eyes)
- Abnormal visual field (feeling dark spots in the center)
- Abnormal color vision (especially red and green are difficult to follow)
- Eye movement causes pain (back of the eye)
The progress of the symptoms is said to be different depending on the medical condition. Caution should be exercised because optic neuritis may be an early symptom of a systemic nervous system, such as multiple sclerosis or neuromyelitis optica.(4)
Causes Of Optic Neuritis
Optic neuritis is most common in adults aged 20 to 40 years. Multiple sclerosis is often the leading cause of optic neuritis. However, some patients with optic neuritis know later that they have no multiple sclerosis. Optic neuritis can also be caused by the following:
- Virus encephalitis (particularly children), meningitis, syphilis, sinusitis, tuberculosis, infections such as human immunodeficiency virus (HIV)
- Malignant tumors spreading to the optic nerve
- Chemical contamination such as lead, methanol, quinine, arsenic
- Reactions of some antibiotics or other chemicals or drugs
Rare causes include diabetes, pernicious anemia, some autoimmune diseases, Graves’ disease, a tumor affecting the orbit (cancer), bee stings, and injuries. Sometimes, the cause of the disease cannot be detected.
Optic neuritis is often a disease of unknown cause. Some infectious diseases, drugs, trauma or compression of brain tumors can cause inflammation of the eye nerves.(5)
Testing For Optic Neuritis
In addition to visual acuity, fundus, and visual field tests, magnetic resonance imaging (MRI), blood, and cerebrospinal fluid tests are performed as needed to find the cause of this disease.
How To Treat Optic Neuritis?
Treatment varies depending on the degree and type of disease, but usually, intravenous corticosteroids and vitamins are used.
In the treatment of optic neuritis, steroid infusion called steroid pulse therapy is often used. After this steroid pulse therapy has been completed, the patient will be treated with oral steroids. After treatment for optic neuritis, treatment with intravenous corticosteroids is given. Also, optic neuritis, a complication of multiple sclerosis, may be treated with interferon because of poor response to corticosteroids.
Since optic neuritis causes vision loss very rapidly, it is very important to see an ophthalmologist immediately if the back of your eyes hurts when you move your eyes. It is advisable to start treatment at an early stage, so if you have any problems with your vision, you should consult an ophthalmologist as soon as possible.(5)
- Stunkel L, Kung NH, Wilson B, McClelland CM, Van Stavern GP. Incidence and causes of overdiagnosis of optic neuritis. JAMA ophthalmology. 2018;136(1):76-81.
- Huang S-C, Castoldi V, Marenna S, et al. Onset of Optic Neuritis Precedes Motor disability in a Preclinical model of Multiple Sclerosis. Paper presented at: MULTIPLE SCLEROSIS JOURNAL2018.
- Kale N. Optic neuritis as an early sign of multiple sclerosis. Eye and brain. 2016;8:195.
- Wedig MP. Important: Asking Patients About Lead Symptoms. Deutsches Ärzteblatt International. 2016;113(8):136.
- Jenkins TM, Toosy AT. Optic neuritis: the eye as a window to the brain. Current opinion in neurology. 2017;30(1):61-66.