Optic neuritis is an inflammation of the optic nerve that most often strikes young people aged 18-45. It is often accompanied by demylenation of the optic nerve. Demylenation is a loss of some of the fatty covering, called the myelin sheath, that protects the nerve and helps it conduct signals. While most people who develop optic neuritis recover their vision without treatment, a doctor must be consulted. This condition can lead to permanent damage of the optic nerve, creating partial or total blindness or holes in the visual field.
Symptoms typically include pain (in 92% of adult cases and 60% of pediatric cases). Vision changes are the other primary symptoms. Usually there is loss of all or part of the visual field. This develops between a few hours to a few days and peaks in one to two weeks. Loss of peripheral vision; dimming of color vision; blurriness; and changes in the way the pupil reacts to bright light are also seen. Optic neuritis most frequently occurs in just one eye, known as mono optic neuritis, but it can occur in both eyes.
There are many different causes of optic neuritis. The likelihood of recovery depends on cause. It is often a typical symptom of multiple sclerosis. And it is linked to some other autoimmune diseases, including sarcoidosis, neuromyelitis optica, lupus and Behcet’s disease. In these cases, the immune system mistakes the body’s own tissues as foreign and attacks them instead of attacking foreign invaders. Recovery from optic neuritis due to autoimmune disease tends to depend on the overall progression of the disease. Treating the autoimmune disease may be most effective for curing the associated optic neuritis.
Optic neuritis is also linked to a wide range of fungal, viral and bacterial infections. These include cryptococcosis, Mycoplasma pneumonia, measles, rubella, chickenpox, herpes zoster (shingles), mumps, mononucleosis, viral encephalitis, Lyme disease, meningitis, tuberculosis, upper respiratory infections, and syphilis. In these cases, it usually resolves spontaneously and completely in two weeks to three months.
About 90% of people diagnosed with optic neuritis recover most or all of their vision within six months. Around 14% experience a recurrence in the affected eye within ten years. And about 12% experience a new optic neuritis in the unaffected eye within ten years.
In order to diagnose it, a thorough medical examination is necessary to rule out possible causes. If multiple sclerosis is suspected, an MRI is also needed to see if the brain shows signs. And a complete eye exam is needed to test color vision, visual acuity, the visual field, and to examine the optic nerve. In one third of cases there is visible swelling of the optic nerve. In two thirds of cases the swelling cannot be seen. In many cases, if a patient seems otherwise healthy, a doctor may wait for a few weeks before ordering the necessary blood tests to rule out underlying causes.
Traditionally, intravenous corticosteroids have been used to speed recovery with a follow-up course of oral steroids to wean off the medication. However, studies show no improvement in the return of visual acuity with IV steroids, and oral steroids seem to increase disease recurrence. IV steroids can have numerous side effects in some patients including depression, insomnia, weight gain and elevated blood sugar.
While there is no conclusive evidence supporting alternative treatments, products that detoxify the body, reduce inflammation and correct cellular function may have some benefit. Two great inflammation reducers are fish oil and curcumin, an extract of turmeric. Fish oil can be taken in a relatively high dose of between 3-6 grams daily and curcumin can be taken in a dosage of anywhere between 200 mg and 1,000 mg daily. To improve absorption, curcumin powder or turmeric can be cooked in boiling water or boiling milk. Boil for ten minutes in water or cook in milk just until it boils. Or take curcumin tablets that includes black pepper for better absorption.
Optic neuritis should never be self-diagnosed. A physician and/or eye doctor must be consulted if any symptoms of optic neuritis appear, including pain and vision changes.