Optic Neuritis (swollen optic nerve)

Treatment   Types   Symptoms   Causes  

The optic nerve is the pathway for information to be transferred from your eyes to the visual cortex in your brain. Optic neuritis is a condition involving an inflamed or swollen optic nerve. The optic nerve is actually a collection of more than a million tiny nerve fibers performing, with each individual fiber transmitting information from each of the photoreceptors.

Next: Nutritional support, diet, & lifestyle tips for the optic nerve.

As a result of damage to the optic nerve that can take the form of swelling, compression, trauma, lesions, inflammation, etc., the brain receives incomplete information that we experience as vision loss. Central visual acuity needed for sharp, detail work. Peripheral vision, color vision, perception of movement, vision in low light, and dark adaption can all be affected.

swollen optic nerve The optic nerve is surrounded by a protective fatty layer of myelin which insulates it from the tissue around it, and helps the impulses of energy travel more quickly along the nerve. If this outer protection is degraded or damaged, then the nerve can become swollen and inflamed.

Swelling and inflammation can occur at various locations along the optic nerve which are tied to whether the condition is of short duration or more serious. Such identification can be determined by an optic MRI. Optic myelitis is the simultaneous inflammation of the optic nerve and the spinal cord.

Types of Ocular Neuritis

Optic neuritis is a kind of optic neuropathy (optic nerve atrophy) resulting in damage to the optic nerve due to any number of causes. Optic neuritis usually occurs in only one eye (mono optic neuritis). In 30% of cases both eyes are involved.

Retrobulbar neuritis is the more common form of optic neuritis. It occurs when the part of the nerve in the orbit or socket of the eye is involved. Pain is felt with eye movement or when there is pressure on the eyeball. In an eye exam, the optic disc has a normal pink appearance.

Optic papillitis refers to optic neuritis affecting the head of the optic nerve. It is also called intraocular optic neuritis. At the head of the optic nerve is the optic disc where the optic nerve connects to the retina and where there are no photoreceptors (therefore, the blind spot). In an eye exam, the color of the optic disc of papillitis appears pale. Vision impairment can range from slight to severe. Color perception is often affected. Recovery is sometimes spontaneous, but without treatment of the underlying problem, the damage may be permanent.

Neuroretinitis is the term used when the nerve fibers in the macula are involved.

Neuromyelitis optica, with a less favorable probable outcome, is also known as Devic's syndrome. This condition is characterized by inflammation and demyelination of both the optic nerve and the spinal cord.

Symptoms

Most patients notice the onset of symptoms on a specific date, contrary to some other optic nerve conditions.

  • Sudden pain occurs and worsening of vision.
  • Pain occurs on eye movement.
  • An object swinging back and forth appears to be moving in a circle (Pulfich phenomenon).
  • Vision becomes worse with an increase in body temperature, due to, for example, a hot shower (Uhthoff phenomenon).
  • Pupils adjust slowly to bright light.

The following symptoms may not be related to optic neuritis; however, if you experience one or more of these symptoms, contact your eye doctor for a complete exam as soon as possible.

  • Blurred vision
  • Decrease in visual function. This may include a decrease in sharpness and clarity of vision (visual acuity), reduced depth perception, or decrease in side (peripheral) vision. Color vision and contrast sensitivity may also be affected. These may last anywhere from a few minutes, to a few weeks, or much longer.
  • Poor constriction of the pupil in light
  • Decrease in the perception of brightness, or decrease in color in one eye versus the other
  • Flashing or flickering lights

Causes

Optic neuritis usually begins when the body's immune system attacks the optic nerve's myelin covering and the result is a swollen optic nerve, at the nerve ending at the eyeball or somewhere along the length of the optic nerve as it continues to the brain. The swollen optic nerve may be caused or triggered by:

  • Multiple sclerosis. Any condition that causes some of the protecting myelin layer of the nerve to be degraded or destroyed may be the cause. It is common for patients (43%) to experience optic neuritis episodes before being diagnosed with MS. In fact, optic neuritis is often an early indicator of MS.
  • Diabetes, causing 15% of cases with varying prognosis depending on severity.
  • Dysfunction of liver, 7%, or kidney, 11%, with varying prognosis depending on severity.
  • Ocular blood clot, causing 5% of cases.
  • Optic nerve injury, causing 4% of cases.
  • Compressive neuropathy, such as certain types of brain tumors
  • Autoimmune conditions such as lupus, HIV, Behcet's disease, or sarcoidosis
  • Viral infections such as colds, measles, mumps, chickenpox, rubella, hepatitis B, herpes, or mononucleosis
  • Fungal infections such as cryptococcosis
  • Bacterial infections such as cat scratch fever, syphilis, or Lyme disease
  • Parasitic diseases such as toxoplasmosis
  • Chemical poisoning (also see drugs that harm the eyes)
  • Vitamin B12 deficiency, essential for a healthy nervous system.
  • Other conditions such as allergies, poor digestion, or poor circulation

From a Chinese medical perspective, optic nerve swelling is often due to "stuck" Qi or energy, which can be related to poor flow of circulation, fluids, energy (and resulting nutrient deficiency) to the optic nerve, as well as heat generated in meridians such as Stomach heat due to digestive disorders. Liver (meridian) imbalances can also lead to digestive disorders as well.

In Chinese medicine, the Liver "opens to the eyes", and therefore is the primary flow of energy responsible for healthy vision. Liver imbalances resulting in "Excess Liver Heat" can result in eye inflammatory conditions (as well as glaucoma).

See vitamins & supplements to support the optic nerve

Related Conditions

There are a number of conditions that have been linked to optic neuritis. For example, "mono optic neuritis." Researchers have reported cases of very severe optic neuritis in patients with infectious mononucleosis. Optic neuritis may be a corollary condition to other common viral infections such as measles, mumps, herpes and chickenpox. Respiratory conditions including some kinds of pneumonia, some fungal infections, and conditions involving the immune system, such as lupus and sarcoidosis may be accompanied by optic swelling / neuritis resulting in loss of vision.

Research

There is now research some nutrients and their effect on optic neuritis: alpha lipoic acid, antioxidants and micronutrients. There is extensive research on other nutrients such as taurine, vitamin B12, and omega-3 fatty acids with respect to their support of optic nerve health. Based on these studies, Dr. Grossman has selected specific nutrients and products to help support the optic nerve and overall eye health. See optic neuritis research.

Sources

Medical Dictionary. Optic Neuritis. Retrieved Feb 25 2018 from https://medical-dictionary.thefreedictionary.com/ retrobulbar+optic+neuritis.
Langer-Gould A, Brara SM, Beaber BE, Zhang JL (2014). The incidence of clinically isolated syndrome in a multi-ethnic cohort. J Neurol, Jul; 261(7):1349-55.
Memon, V., Saxena, R., Misra, R., Phuljhele, S. (2011). Management of optic neuritis. Indian J Ophthalmol, Mar-Apr; 59(2):117-122.
Dahl, A.A. Optic Neuritis. Retrieved Feb 25 2018 from https://www.medicinenet.com/optic_neuritis/ article.htm#optic_neuritis_facts Ibid. Menon. (2011).
Rodriguez M, Siva A, Cross SA, O’Brien PC, Kurland LT. (1995). Optic neuritis: A population-based study in Olmsted County, Minnesota. Neurology, 45:244–50
Jin YP, de Pedro-Cuesta J, Söderström M, Stawiarz L, Link H. (1998). Incidence of optic neuritis in Stockholm, Sweden 1990-1995: I. Age, sex, birth and ethnic-group related patterns. J Neurol Sci, 159:107–14
MacDonald BK, Cockerell OC, Sander JW, Shorvon SD. (2000). The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK. Brain, 123:665–76
National Organization for Rare Disorders. Papillitis. Retrieved Feb 26 2018 from https://rarediseases.org/rare-diseases/papillitis/
Wilhelm, H., Schabet, M. (2015). The Diagnosis and Treatment of Optic Neuritis. Dtsch Arztebl Int, Sep; 112(37): 616–626

Treatment   Types   Symptoms   Causes