Optic neuritis – Symptoms, Causes, Diagnosis, and Preventions

Introduction

Optic neuritis is swelling or inflammation of the Optic nerve, which carries information from our eyes to the brain. It can be associated with Multiple sclerosis, or it can follow viral infections also.

Symptoms of Optic neuritis

Common symptoms of Optic neuritis are

• sudden, usually unilateral vision loss.
•  pain while moving the eyes or at the back of the eye socket.
• Faded, dim and blurred vision.

In most cases, only one eye gets affected, and the symptoms worsen when the body heat rises.

Can Optic neuritis be recurrent?

Yes, Optic neuritis can recur in the same eye or affect the other eye. According to PubMed central, recurrent Optic Neuritis (ON) can occur unilaterally or bilaterally. One major cause of recurrent unilateral Optic neuritis is Multiple sclerosis. Recurring cases might be difficult to diagnose.

Causes of Optic neuritis

Most cases are idiopathic, meaning no definite cause could be found after a thorough evaluation. But neurological conditions, infections, toxins, medications, trauma and autoimmune diseases can sometimes cause Optic neuritis. Hence it should be thoroughly evaluated. Alcohol and smoking can also cause Optic neuritis.

Neurological causes of Optic neuritis include,

• Multiple sclerosis
• Neuromyelitis Optica Spectrum
• Other rare demyelinating diseases.

Autoimmune causes commonly associated with Optic neuritis are

• Systemic lupus erythematosus
• Sjogren syndrome
• Sarcoidosis

Infections associated with Optic neuritis

Diseases like tuberculosis, syphilis, measles, shingles, Lyme, herpes and HIV can be the causative factor.

Diagnosis

Clinical examination by an ophthalmologist is mostly enough to come to a diagnosis. Specific tests are performed to find out the cause of Optic neuritis.

Investigations  

The following diagnostic examinations are done to confirm Optic neuritis.

• MRI scan to rule out neurological causes like Multiple sclerosis
• Blood investigations
• CSF examination in certain cases
• OCT of the Optic nerve in case of subtle findings
• VEP in selected cases if only the back portion of the nerve is involved.

Management

The management process of Optic neuritis are as follows.

• The patient is admitted, and all investigations are completed.
• The patient is immediately started on Intravenous methylprednisolone for three days, followed by oral steroids for 11 days, along with supportive medications.
• Depending on the investigation result, selective treatment for the cause is given.

Prevention of permanent vision loss

In case of untreated or delayed treatment, the chance for permanent vision loss is high.

Consult your doctor without delay if you experience any of the above-discussed symptoms. Treatment, if started early, has a good visual prognosis.

Conclusion

Optic neuritis is swelling or inflammation of the Optic nerve, which carries information from our eyes to the brain. It can be associated with Multiple sclerosis, or it can follow viral infections also. Optic neuritis can be recurrent

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