Optic Neuritis

Visual field testing will often show a central area of loss (central scotoma), but any pattern of visual field loss is possible.

How do I know if I have optic neuritis?

Patients with optic neuritis typically experience a rapid (over days) decrease in vision and/or loss of central vision. Color vision can be affected. For example, the color red may appear more brown or orange. Patients may also experience discomfort behind their eye that gets worse with movement of the eye.

Who gets optic neuritis?

Although optic neuritis can affect all ages, usually patients tend to be young (average age early 30's) and female. Optic neuritis can be found in patients with auto-immune conditions such as in multiple sclerosis and infectious diseases such as in meningitis, infection in the orbit, or infection of the sinuses.

Retrobulbar neuritis in a woman less than 50 years old - with pain on eye movement - is very characteristic of the optic neuritis seen in multiple sclerosis and a complete neurologic evaluation is necessary (see below).

How is optic neuritis treated?

Steroids (strong anti-inflammation) medication may be prescribed. If the optic neuritis is not associated with infection, the standard of care is to treat with intravenous steroids for three days and then to follow with approximately two weeks of oral Prednisone. Optic neuritis associated with Multiple Sclerosis may recur occur more frequently if oral steroids are used without first treating with intravenous steroids.

Why is a Magnetic Resonance Imaging (MRI) study necessary ?

Imaging studies are important to look at the optic nerve and also look in the brain from changes that are suggestive of multiple sclerosis.

The inflammation can give the optic nerve a smooth or ragged or thicker than normal appearance.

In optic neuritis, the optic nerve sheath enhances (looks bright) on MRI, but the size of the optic nerve is normal.