What Can Mimic Optic Neuritis & Can I Drive If I Have It?

Optic neuritis is just the inflammation of the optic nerve. It can be caused due to a variety of reasons and all of them will lead to optic neuritis which means many of the diseases can mimic as optic neuritis apart from autoimmune optic neuritis. Various retinopathies and retinal diseases like best disease, Stargardt’s disease, etc. can mimic the symptoms of optic neuritis.

What Can Mimic Optic Neuritis?

Ischemic optic neuropathy, compressive neuropathy, toxic neuropathy resulting due to toxins, etc. are few of the other causes which are responsible for similar symptoms as that of optic neuritis. Few of the other conditions like paraneoplastic syndromes where the symptoms are not due to underlying pathology but due to some other process going on in the body(1).

Infectious causes can also generate similar conditions like that of optic neuritis. One of the most common infectious cause is cat scratch disease caused by Bartonella henselae belonging to Bartonella group of bacteria. It produces the symptoms of neuroretinitis and present as macular star appearance on retina examination. Other autoimmune disorders can also generate similar symptoms apart from multiple sclerosis and neuromyelitis optica. CRION (Chronic relapsing inflammatory optic neuropathy) is a very rare syndrome associated with optic neuritis(2). Few hereditary diseases like Leber hereditary optic neuropathy (LHON) is one of the rarest causes which are hereditary and can mimic the symptoms of optic neuritis to a great extent(3).

Optic neuritis does not produce clinical symptoms straightaway but there is a period of pathological progression of the disease without clinical symptoms in which only the inflammation extends. When the optic neuritis becomes evident and starts producing symptoms related to visual acuity then it becomes very difficult to see the objects in the field of vision. Once the visual acuity is affected, it means the progression of the pathology of the optic nerve has reached to a large extent. Progression of the condition can be stopped and even reversed by the use of steroids which can be used in both oral and intravenous forms.

Sometimes the condition of optic neuritis responds well to the treatment and visual acuity is restored. In that condition, it is a prior requirement to get the visual acuity tested beforehand driving any vehicle. If the doctor is convinced that the visual acuity is correct and there is no photophobia or glare which can hinder the driving, only then it should be done. Otherwise, it is best to abstain from driving until the condition regresses completely or there is no relapse.

Can I Drive If I Have Optic Neuritis?

But in many cases, it is impossible to reverse the visual acuity loss and it would not be a prudent decision to drive any vehicle with reduced visual acuity or without any corrective glasses or other methods. Repeated visual acuity testing must be done during optic neuritis to assess the loss again and again and change the correction accordingly.

Conclusion

Optic neuritis is an autoimmune condition can be triggered by a variety of reasons but most of them are multiple sclerosis and neuromyelitis optica. Since the condition is associated with inflammation of the optic nerve, it can result from causes other than autoimmune like infectious, paraneoplastic, hereditary, etc. Mimicking diseases that present with similar symptoms as that of optic neuritis create a lot of confusion and can result in misdiagnosis sometimes.

Optic neuritis also results in the decrement of visual acuity of the patient and patient may need glasses or laser surgeries sometimes to get it corrected. If the visual acuity is not corrected then the patient should not drive and regress from doing other works also which require careful visualization. Visual acuity should be tested and certified by a recognized doctor before the driving is done by the patient.

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