Optic neuritis is an inflammatory process in which nerve fibers of the organ of vision are damaged. Most often, it affects one eye and is accompanied by pain inside the organ, loss or worsening of visual acuity, the appearance of spots in the center of the image.
With untimely attention to the symptoms of the disease, it progresses and can lead to irreparable complications, in particular blindness.(1)
Who Is At Risk For Optic Neuritis?
Neuralgia and inflammation of the optic nerve most often occur between the ages of 20 and 40 in women. The risk group includes:
- People with reduced immunity, diabetes
- Persons abusing alcohol, toxic and narcotic substances
- Patients with advanced infections
- The presence of mutations at the gene level that can cause the development of inflammation of the nerve.(3)
Is There Any Blood Test For Optic Neuritis?
Relevant pathogens or antibodies can be tested using blood tests. Neuromyelitis Optica is sometimes associated with serious cases of optic neuritis antibodies. A blood examination will be performed to assess whether individuals with serious optic neuritis have developed neuromyelitis optica.(5)
Diagnosis Of Optic Neuritis
If the optic nerve hurts, the quality and visual acuity get decreased and other unpleasant symptoms include eye irritations. You may need to visit a neurologist and an ophthalmologist.
The following measures are taken to diagnose the disease:
- Visual acuity check;
- Ophthalmoscopy to check the condition of the fundus, determine edema and hyperemia (redness) of the eye disc and the presence of foci of hemorrhage;
- Fluorescence angiography to differentiate the diagnosis from other diseases with similar symptoms and assess the patient’s eye condition.
In difficult cases, the doctor resort to consulting other specialists and check the blood for sterility does an MRI, PCR studies, and may refer the patient to determine the nature and the provoking factor of the disease to an immunologist, infectious disease specialist or rheumatologist.(4)
Causes Of Optic Neuritis
The neurosis of the optic nerve is caused by inflammation and subsequent edema and compression of nerve fibers. As a result, its nutrition worsens, which leads to atrophy, the impaired passage of nerve impulses and a sharp decrease in vision.
The exact cause of neuritis has not been established. Estimated triggering factors:
- Infectious processes in the membranes of the brain (meningitis, encephalitis), parts of the eye (iridocyclitis, keratitis, periostitis), nasopharynx (tonsillitis, pharyngitis and frontal sinusitis)
- Neglected dental diseases (gingivitis, periodontitis, caries)
- The general weakening of the body and infection due to HIV, tuberculosis, malaria, lupus, gonorrhea
- Inferior treatment of influenza and SARS, diphtheria, typhus, and others
- Endocrine system diseases (diabetes mellitus)
- Damage to the nervous system and in particular the optic nerve with multiple sclerosis
- Blood diseases, collagen degradation, gout
- The weakening of the body against a background of severe, complicated pregnancy
- Various injuries of the eye, skull
- Abuse of toxic and narcotic substances, alcoholism.(2)
Symptoms For Optic Neuritis
With any form of the disease, often only one eye is affected, unlike neuropathy. Symptoms depend on the variety – intrabulbar or retrobulbar neuritis.
Signs of an intrabulbar form of the disease:
- Acute severity of symptoms during the first few days and rapid progression;
- Blind spots in the field of vision, otherwise called scotomas (mainly in the center);
- The development of myopia, visual impairment in most cases by 0.5-2 diopters;
- Altered color perception, the appearance in the field of view of colored blurry spots;
- Worsening of twilight vision and in the dark, a three-minute and more adaptation are necessary.
The duration of this form varies from 3 to 6 weeks and depends on the timeliness of diagnosis and treatment. In this case, vision can be completely restored or the patient will have unilateral blindness.
Retrobulbar neuritis is much less common. If the infectious process is localized in the center of the nerve, then the patient is concerned about scotomas, one-sided blindness or severe visual impairment of up to 6 diopters.
When foci of infection are found on the external nerve fibers, lateral vision worsens, visual acuity remains unaltered, and pains in the orbit are felt.
Pain can be aggravated by turning the head or eyeball movement.(3)
Common Treatment For Optic Neuritis
The therapy is carried out in a hospital and includes a complex of medications in the form of intravenous infusions, intramuscular injections, and tablet forms. The treatment course depends upon the cause of optic neuritis.
- Meer E, Shindler KS, Yu Y, VanderBeek BL. Adherence to Clinical Trial Supported Evaluation of Optic Neuritis. Ophthalmic epidemiology. 2019;26(5):321-328.
- Fabian ID, Abudi A, Kinori M, et al. Acute Optic Neuropathy and Development of Posttraumatic Stress Disorder. Paper presented at: Seminars in ophthalmology2017.
- Bennett JL. Optic Neuritis. CONTINUUM: Lifelong Learning in Neurology. 2019;25(5):1236-1264.
- 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.
- Yeshokumar AK, Banwell BL. Diagnostic Challenges in Pediatric Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder. Journal of Pediatric Neurology. 2018;16(03):185-191.
- Optic Neuritis or Retrobulbar Neuritis: Epidemiology, Causes, Signs, Treatment, Tests
- Does Optic Neuritis Show Up On MRI & Can Eye Test Detect It?
- Can Stress Cause Optic Neuritis & Does It Cause Headaches?
- What Is The Difference Between Optic Neuritis & Optic Neuropathy?
- Can You Have Optic Neuritis In Both Eyes & Does It Always Lead To MS?