I am continuing on with part two of a three part series. Today we are going to look at Optic Neuritis.
What is Optic Neuritis?
Optic neuritis is an inflammation that damages the optic nerve, a bundle of nerve fibers that transmits visual information from your eye to your brain. Pain and temporary vision loss in one eye are common symptoms of optic neuritis.
Optic neuritis is an uncommon neurologic manifestation of systemic lupus erythematosus (SLE) and can be seen in about 1% of lupus patients. Optic neuritis related to lupus often causes the optic nerve to atrophy.
Interesting factoid: Signs and symptoms of optic neuritis can be the first indication of multiple sclerosis, or they can occur later in the course of MS.
- visual loss
- pain with eye movement
- photophobia – extreme sensitivity to light.
- loss of color vision
- flashing lights – seeing flashing or flickering lights with eye movements.
The exact cause of optic neuritis is unknown. It’s believed to develop when the immune system mistakenly targets the substance covering your optic nerve (myelin), resulting in inflammation and damage to the myelin.
- Infections. Bacterial infections:
- Lyme disease – Lyme disease can cause delayed neurologic symptoms similar to those seen in multiple sclerosis (MS) such as weakness, blurred vision caused by optic neuritis, dysesthesias (sensations of itching, burning, stabbing pain, or “pins and needles”), confusion and cognitive dysfunction, and fatigue.
- cat-scratch fever
- syphilis – Among patients with secondary syphilis about 18% may have neurological (including ophthalmological) signs or symptoms. Ocular involvement may be silent or present as anterior uveitis, choroiditis, interstitial keratitis, retinal vasculitis, retinitis, optic neuritis, dacryoadenitis, or scleritis.
- measles – Acute optic neuritis is a rare complication of Measles Rubella vaccination and may occur early after immunization.
- and herpes
- Other diseases. Diseases such as MS, sarcoidosis and lupus
- Drugs. Some drugs have been associated with the development of optic neuritis.
Optic neuritis may develop after vaccinations against:
- hepatitis B
The influenza vaccine is also commonly associated with optic neuritis.
Your ophthalmologist may include the following tests to diagnose optic neuritis:
- A routine eye exam.
- Ophthalmoscopy. This eye test evaluates the optic disk, where the optic nerve enters the retina in your eye.
- Pupillary light reaction test. Pupils in eyes affected by optic neuritis don’t constrict as much as those in healthy eyes do when stimulated by light.
- Magnetic resonance imaging (MRI) scan.
- Blood tests.
- Optical coherence tomography (OCT). This measures the thickness of the retinal nerve fiber layer, which is often thinner from optic neuritis.
- Visual evoked response.
Optic neuritis usually improves on its own. In some cases, steroid medications are used to reduce inflammation in the optic nerve.
Possible side effects from steroid treatment include:
- weight gain
- mood changes
- facial flushing
- stomach upset