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    Optic neuritis

    Retro-bulbar neuritis

    Optic neuritis is inflammation of the optic nerve. It may cause sudden, reduced vision in the affected eye.

    Causes

    The exact cause of optic neuritis is unknown.

    The optic nerve carries visual information from your eye to the brain. Suddeninflammation of this nerve can cause the optic nerve to swell. This can result in injury to the nerve fibers and some or permanent loss of vision.

    Conditions that have been linked with optic neuritis include:

    • Autoimmune diseases, including lupus, sarcoidosis, and Behcet's disease
    • Cryptococcosis, a fungal infection
    • Bacterial infections, including tuberculosis, syphilis, Lyme disease, and meningitis
    • Viral infections, including viral encephalitis, measles, rubella, chickenpox, herpes zoster, mumps, and mononucleosis
    • Respiratory infections, including Mycoplasma pneumonia and other common upper respiratory tract infections
    • Multiple sclerosis

    Symptoms

    • Loss of vision in one eye over an hour or a few hours
    • Changes in the way the pupil reacts to bright light
    • Loss of color vision
    • Pain when you move the eye

    Exams and Tests

    A complete medical examination can help rule out related diseases. Tests may include:

    • Color vision testing
    • MRI of the brain including special images of the optic nerve
    • Visual acuity testing
    • Visual field testing
    • Examination of the optic disc using indirect ophthalmoscopy

    Treatment

    Vision often returns to normal within 2to 3 weeks with no treatment.

    Corticosteroids given through a vein (IV) or taken by mouth may speed up recovery.The final vision after recovery is no different with or without steroids. Oral steroids may actually increase the chance of recurrence.

    Further tests may be needed to determine the cause of the neuritis. The condition causing the problem can then be treated.

    Outlook (Prognosis)

    People who have optic neuritis without a disease such as multiple sclerosis have a good chance of recovery.

    Optic neuritis caused by multiple sclerosis or other autoimmune diseases has a poorer outlook. However, vision in the affected eye may still return to normal.

    • Body-wide side effects from corticosteroids
    • Vision loss

    About 1 in 5 patients with a first episode of optic neuritis will developnerve problemselsewhere in the body, or will develop multiple sclerosis.

    When to Contact a Medical Professional

    Call your health care provider immediately if you have a sudden loss of vision in one eye, especially if you have eye pain.

    If you have been diagnosed with optic neuritis, call your health care provider if:

    • Your vision decreases
    • The pain in the eye gets worse
    • Your symptoms do not improve within 2 to 3 weeks

    References

    Guercio JR, Balcer LJ. Inflammatory optic neuropathies and neuroretinitis. In: Yanoff M, Duker JS, Augsburger JJ, eds. Ophthalmology. 3rd ed. Philadelphia, Pa: Elsevier Mosby; 2008:chap 9.6.

    Eze P, Sra SK, Sra KK, et al. Immunology of neurologic and endocrine diseases that affect the eye. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology on DVD-ROM - 2013 Edition. Philadelphia, Pa: Lippincott Williams & Wilkins; 2013:vol 2, chap 35.

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        Self Care

          Tests for Optic neuritis

            Review Date: 8/24/2013

            Reviewed By: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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