Optic Neuritis Causes and Symptoms
Optic neuritis (also called optic neuropathy) is inflammation of the optic nerve, the bundle of nerve fibers which send visual information from the eye to the brain. Temporary vision loss and pain are the two main symptoms of optic neuritis. Most people who suffer an episode of this condition fully recover their vision.
Who is at risk?
Optic neuritis most commonly affects adults aged 20-45. It is less common in younger and older age groups. It is more commonly seen in Caucasians than other races and is twice as likely to develop in women than in men. Certain genetic mutations also increase the risk of developing optic neuritis.
Age: While optic neuritis can occur during any time of life, the average age of a first-time patient is 30 years. In most cases, it usually affects adults under 45 years of age.
Gender: Women are twice as likely to contract optic neuritis as men are.
Race: Optic neuritis is about 8 times more common in whites of Northern European descent than in Asians or blacks.
What is the optic nerve?
Optic nerve is a nerve located at the back of the eye which is critical for the normal functioning of your eyes. It is composed of fibers that transfer visual information in the form of signals from the nerve cells in the retina to the nerve cells in the brain.
In other words, optic nerve is the nerve that transmits impulses from the eyes to the brain. In optic neuritis, fibers of this nerve become inflamed, leading to the subsequent disturbance or interruption of this visual signaling to the brain.
Causes of optic neuritis
The optic nerve is covered by a fatty insulating layer of myelin, which is essential in two ways. First, it shields the nerve from the surrounding tissue much like the plastic outer coating does on an electrical wire. Secondly, it helps the electrical impulses travel more quickly along the nerve.
Optic neuritis usually develops as a result of an autoimmune disorder, where the body's own immune system attacks the myelin coating of the nerve. This is sometimes triggered by a viral infection. The two autoimmune conditions most commonly associated with optic neuritis are multiple sclerosis and neuromyelitis optica.
- Multiple sclerosis is a chronic, progressive and often disabling disease in which the body’s own autoimmune system attacks the myelin covering of the central nervous system. Those who suffer a bout of optic neuritis are significantly more likely to develop the disease later, especially if an MRI shows abnormal brain lesions.
- Neuromyelitis Optica (Devic's Disease) is similar to MS in that the immune system attacks the nerves, but while MS attacks the entire nervous system, Neuromyelitis Optica typically only affects the optic nerves and the spinal cord.
Optic neuritis can be also be caused by infections such as Lyme disease, cat scratch fever, toxoplasmosis, syphilis, HIV, hepatitis B, herpes and more. Such infections may also cause neuroretinitis, which is similar to optic neuritis.
Other causes include cranial arteritis, diabetes, sinusitis, and certain medications.
Symptoms of optic neuritis
Those suffering from optic neuritis in one or both eyes will likely experience the following symptoms:
Pain - Optic neuritis can cause overall soreness in the eye as well as pain that occurs during eye movement.
Loss of vision - Some people experience a severe loss of normal vision with this condition while others hardly notice any change. This vision loss can manifest in different ways including a central blind spot or peripheral vision loss. Vision typically gets worse as the body temperature rises, like during a hot shower or exercise.
Dull, washed out vision - Optic neuritis can make your vision appear dull or dim. It also often affects the perception of colors, so that they appear appear washed out or paler than normal.
What are the complications of optic neuritis?
Optic neuritis is a serious medical condition that needs to be taken care of immediately. If left untreated, optic neuritis can lead to permanent damage and loss of vision (blindness) in one or both eyes.
How is optic neuritis diagnosed?
Through vision tests: A Pelli-Robson chart measures the patient's sensitivity to contrast and an Ishihara color plate tests the patient's color vision. These results will frequently be below normal in patients with optic neuritis.
Laboratory tests: Most of the time, doctors also recommend blood tests to eliminate other possible conditions such as optic neuropathy and an analysis of the spinal fluid to rule out MS.
MRI (Magnetic resonance imaging): The purpose of the MRI, by and large, is to see if there is excessive white matter surrounding your brain as this is a predictor of multiple sclerosis.
How is optic neuritis treated?
While many patients suffering from optic neuritis recover their vision and their optic neuritis usually clears up on its own within 4-10 weeks, treatment is often required.
Medical treatment of optic neuritis consists of the following
Steroids: Standard medicine advocates the use of IV corticosteroids to treat optic neuritis. However, there is no evidence this helps improve visual acuity after one year. After intravenous steroid therapy, a doctor may additionally prescribe an oral steroid called prednisone for several weeks. Oral steroids are prescribed after intravenous steroids because studies have shown that taking oral steroids alone can result in a recurrence of optic neuritis.
Plasma exchange therapy: When steroid therapy has failed and severe vision loss persists, plasma exchange therapy may help some people recover their vision. Plasma exchange therapy is when plasma is removed from blood cells by a cell separator. The cells are then returned to the person undergoing treatment, while the plasma, which contains the antibodies, is discarded and replaced with other fluids.
Nevertheless, most of the patients undergo good recovery within the period of 6 months from the time of onset. However, better chances of recovery may only be possible when optic neuritis is not associated with any other underlying disease (such as MS).
Natural hints and tips to treat or prevent optic neuritis
Get adequate sunlight exposure: Get adequate exposure to sunlight. While too much exposure to the sun's harmful rays should be avoided, this in no way should stop you from taking the recommended advantages of the same. Use sunscreen and spend a reasonable time outside.
Take "eye rest": When having an acute flare of optic neuritis, your eyes will become tired more quickly. Resting the eyes frequently often helps. "Eye rest" means closing your eyes for few minutes. Also avoid watching TV / computer screen or reading any kind of material during this period of rest. You may also increase the resolution on your computer screen or use voice recognition and text reading software. These technologies help decrease eye strain and pain.
Consume a healthy, nutritious diet: You should eat a well-balanced diet full of nutrients especially multi vitamins. While all vitamins are beneficial, vitamin D and B complex are especially considered very helpful in treatment and prevention against any type of neuritis.
Visit the eye doctor regularly: As recommended, you should see your eye doctor at least once or twice a year even everything "seems" to be okay. Regular visits to the doctor or an optometrist can lead to early diagnosis and the prevention of optic neuritis escalating into full blindness.
Should I See an Eye Doctor?
It is important to see an eye doctor as soon as possible if you suspect you have optic neuritis, both to discuss treatment options and because it may be the first sign of a more serious disorder.
You should certainly contact the eye doctor if any of the following occur:
- New symptoms- you experience eye pain or a change in your vision
- Worsening symptoms - you have been diagnosed with optic neuritis and experience new bouts of pain, worsening vision or symptoms which are not improving with your current treatment
- Unusual symptoms - you have been diagnosed with optic neuritis and are experiencing symptoms other than eye pain and vision loss, especially if there is a weakening of your limbs
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