Optic neuritis is swelling and inflammation of the optic nerve that can cause eye pain, visual impairment, dull colors, and/or flashing lights. Since the optic nerve carries visual information to the brain, any symptoms of optic neuritis should be checked by a doctor immediately. If a patient has just one incident, chances are good that they will fully recover. However, inflammation of the optic nerve can be the first sign of multiple sclerosis, a serious degenerative disease.
One of the dangers of this problem is that the optic nerve can lose some of its myelin. The myelin sheath is fatty tissue that protects the nerves. When the myelin sheath is compromised, the nerves can be damaged. This is one important reason to consult a doctor. Medication can help speed up recovery in many cases.
How Optic Neuritis Is Diagnosed
Optic neuritis may be considered as a diagnosis if the patient has one or more of these symptoms:
- Eye pain that is worse when the eye moves. Some people report a dull ache located behind the eye.
- Loss of vision including blurring, blind spots and distorted vision. The vision loss may become noticeable over several hours, or several days. Vision loss may be more noticeable during a hot shower, hot bath or exercise. Sometimes, the vision loss is permanent.
- Color perception can be duller. Colors appear less vivid.
- Flashing lights are reported by patients with optic neuritis.
The condition usually affects one eye at a time, but both eyes can be affected.
The doctor will conduct vision tests and examine the eye to measure the extent of the vision problem.
Since optic neuritis can have many possible underlying causes, an exam and extensive tests may be needed. The doctor may run tests to eliminate other possible causes of the symptoms, such as a stroke. If symptoms point to multiple sclerosis, an MRI might be ordered. Sometimes optic nerve swelling can be seen, but not always. Optic nerve atrophy may show as pale optic nerves. Patients who appear to be in good health may be asked to wait and see whether extensive testing is needed.
This eye problem is most common in people aged 18 through 45, but it can affect other age groups too.
Optic neuritis can be one of the causes of optic nerve atrophy.
A swollen optic nerve can have many possible causes. They generally fall into two broad categories: autoimmune disorders, and infections.
In an autoimmune disorder, the immune system attacks parts of the body. Multiple sclerosis involves attacks on the myelin sheath – optic neuritis is often a first sign. Optic neuritis is linked to other autoimmune diseases such as sarcoidosis, neuromyelitis optica, lupus, juvenile arthritis (JA) and Behcet’s disease.
Infections by viruses, funguses, and bacteria can cause optic neuritis, such as cryptococcosis, Mycoplasma pneumonia, measles, rubella, chickenpox, herpes zoster (shingles), mumps, mononucleosis, viral encephalitis, Lyme disease, meningitis, tuberculosis, upper respiratory infections, and syphilis.
Sometimes the underlying cause is not found.
In the case of autoimmune diseases, treatment for the underlying disease is key to controlling the optic neuritis.
Infectious causes of optic neuritis typically get better in 2 to 12 weeks.
Instead of waiting for it to “go away on its own,” anyone experiencing sudden vision changes or symptoms should seek immediate medical care. Untreated optic neuritis can result in nerve cell death, leading to blindness. Damage from optic neuritis can be made worse by inflammation and oxidative stress; therefore, controlling these factors can be helpful.
If an underlying cause can be identified, it should be treated.
It is common for doctors to prescribe steroids for optic neuritis. Intravenous corticosteroids can be followed by oral steroids. Unfortunately, some patients experience side effects. And, its effectiveness is in question, except for a link to multiple sclerosis: receiving IV steroids seemed to have an effect on the risk of being diagnosed with MS.1
The goal of steroids for this condition is to speed recovery and improve vision; however, the research does not back up all these goals. A recent meta-analysis of studies on steroids for optic neuritis found no conclusive improvement in vision six months after steroids started.2. A research analysis3 found that while steroids appeared to speed recovery in acute cases, the final visual outcome was unaffected. Steroids were more helpful to vision in multiple sclerosis patients who had recently developed MS. The paper concluded that the side effects of steroids had to be weighed against pain levels, amount of vision loss and/or amount of white matter brain lesions (MS).
Other Approaches to Optic Neuritis Support and Prevention
Nutritional support is important in many eye issues. The eyes, nerves, and myelin sheaths are made from nutrients; therefore, altering the diet to ensure adequate intake of nutrients can do no harm. A study4 linked poor micronutrient levels (high cadmium; low iron) to optic neuritis and associated inflammation.
Antioxidants are important. Oxidative stress also believed to be a cause or contributing factor of optic neuritis. In lab animal models reducing oxidative stress impacting cell mitochondria5 was effective in reducing damage to the optic nerve.
Drinking freshly made juice helps fill in any nutritional gaps. To support the optic nerve, juice parsley, ginger, cabbage, carrots, beets, endive, wheat grass, chlorophyll, and/or berries. Favor organic to reduce exposure to pesticides.
Blueberry juice was found to reduce inflammation in patients with juvenile arthritis, when combined with a medication, more than the medication alone.6
Jiaogulan is a Chinese medicinal plant that contains large amounts of gypenosides. A research study7 showed that gypenosides may protect the optic nerve.
Reduce or eliminate any toxins you are taking in. Avoid tobacco smoke (which contains cyanide) and ask your doctor about the side effects of any medications you are taking.
Exercise has been repeatedly shown to increase circulation and overall health. Do not neglect simple physical activity as a cornerstone for preventing any number of diseases.
Next: Learn more about support for: Optic Neuritis, Eye Fatigue, and the Optic Nerve.
- Multiple Sclerosis Risk after Optic Neuritis: Final Optic Neuritis Treatment Trial Follow-Up – The Optic Neuritis Study Group. Arch Neurol. 2008 Jun; 65(6): 727–732. doi: 10.1001/archneur.65.6.727 ↩
- Corticosteroids for treating optic neuritis. Gal RL, Vedula SS, Beck R. Cochrane Database Syst Rev. 2015 Aug 14;8:CD001430. https://www.ncbi.nlm.nih.gov/pubmed/26273799 ↩
- Curr Opin Ophthalmol. 2015 Nov;26(6):439-44. doi: 10.1097/ICU.0000000000000197.
Should patients with optic neuritis be treated with steroids? Mackay DD. https://www.ncbi.nlm.nih.gov/pubmed/26367086 ↩
- Blood plasma levels of microelements in patients with history of optic neuritis, by K. Kaźmierczak, G. Malukiewic, H. Lesiewska-Junk, A. Laudencka, M. Szady-Grad, J. Klawe, and K. Nowicki. Current Eye Research, January, 2014 Jan;39(1):93-8 ↩
- X. Qi, A.S. Lewis, et. al., Suppression of mitochondrial oxidative stress provides long-term neuroprotection in experimental optic neuritis, Investigations in Ophthalmology and Visual Science, February, 2007 ↩
- Y. Zong, et al, Blueberry Improves the Therapeutic Effect of Etanercept on Patients with Juvenile Idiopathic Arthritis: Phase III Study – https://www.naturaleyecare.com/study.asp?s_num=433 – , Tohoku Journal of Experimental Medicine, October, 2015 ↩
- K. Li, et al, Gypenosides might have neuroprotective and immunomodulatory effects on optic neuritis, Medical Hypotheses, May, 2014 ↩