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Optic Neuritis

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What is optic neuritis?

Optic neuritis is an inflammation of the nerve that carries visual information from the eye to the brain (optic nerve).

The condition usually causes loss of vision, eye pain and trouble seeing colours normally.

Optic neuritis is most commonly seen in people with multiple sclerosis (MS), but it can be caused by other factors, such as an infection.

Sometimes, it has no identifiable cause.

See your doctor immediately if you have eye pain, start to lose your vision or notice any other changes to your eyesight.

What are the symptoms of optic neuritis?

Optic neuritis can cause loss of vision of varying severity in 1 or, more rarely, both eyes.

Loss of vision usually worsens over a few hours or days and then starts to get better in a few weeks. However, in some cases, it may take longer for your vision to improve.

Other symptoms of optic neuritis include:

  • trouble seeing colours normally — colours may not look as bright as they usually do
  • eye pain — especially when you move your eyes. This pain can vary in intensity and can start before loss of vision

Less commonly, you may notice flashes or flickers of light.

Some people with optic neuritis also find that their symptoms worsen when their body temperature rises, such as when exercising or taking a hot shower. This is more common in those with MS.

Causes of optic neuritis

Optic neuritis is most common in adults aged 20 to 40.

There are several types of optic neuritis. The most common type is known as demyelinating optic neuritis and it is usually associated with MS.

Other causes of optic neuritis include:

Rarer causes of optic neuritis include:

Sometimes optic neuritis has no identifiable cause.

How is optic neuritis diagnosed?

If you have loss of vision or any other changes to your eyesight, see your doctor.

If your doctor suspects you have optic neuritis, you will usually be referred to an eye specialist (ophthalmologist) to confirm the diagnosis.

Your doctor or ophthalmologist may diagnose optic neuritis based on your symptoms, medical history and an examination of your eyes. This examination may involve testing:

  • your peripheral (side) vision
  • the sharpness of your vision
  • how well you see colours
  • the reaction of your pupils to light

Your doctor or ophthalmologist may also examine your optic nerve by looking at the back of your eye using a light with a magnifying lens (ophthalmoscope).

You may have further tests to look for a cause of the inflammation, including:

Treatment of optic neuritis

Optic neuritis can get better on its own over a few weeks or months. In many people, there is no lasting loss of vision. However, sometimes there may be permanent vision loss.

In some cases, your doctor may prescribe steroids given through a vein, followed by steroid tablets. Steroid treatment can help speed up your recovery and reduce the chance of a recurrence.

When optic neuritis has been caused by an underlying condition, your doctor will usually focus on treating that condition.

If your doctor thinks that you may have MS, they may prescribe medicines to help slow down or prevent the condition.

What is the outlook for optic neuritis?

Optic neuritis sometimes resolves on its own and vision can return to normal (or very close to normal).

However, some people can be left with permanent vision loss or blindness.

Optic neuritis tends to happen again in around 30% of those who have had it. When it recurs, it can affect either eye.

Optic neuritis is most common in people who have or will develop MS. Around 50% of people who get optic neuritis get MS in the next 15 years.

Where can I find additional support?

Optic neuritis can be a distressing condition that impacts many aspects of your life. It can be helpful to share your experience with other people who have also had the condition. Some useful support services are listed below, but ask your doctor for further information about local support groups and services.

Optic neuritis support groups

Royal National Institute of Blind People (RNIB)

Multiple Sclerosis Trust

National Multiple Sclerosis Society

Multiple Sclerosis Foundation

Low vision explained

Colour vision deficiency (colour blindness)

Neuromyelitis optica

Multiple sclerosis

Double vision

Written on 11 August 2020

Reviewed on 11 August 2020

References

  1. Constantinescu C, Bosley T. Optic neuritis - Symptoms, diagnosis and treatment | BMJ Best Practice [Internet]. Bestpractice.bmj.com. 2019 [cited 3 September 2019]. Available here.
  2. DynaMed [Internet]. Dynamed.com. 2019 [cited 3 September 2019]. Available here.
  3. UpToDate [Internet]. Uptodate.com. 2019 [cited 3 September 2019]. Available here.
  4. UpToDate [Internet]. Uptodate.com. 2019 [cited 3 September 2019]. Available here.
  5. UpToDate [Internet]. Uptodate.com. 2019 [cited 3 September 2019]. Available here.
  6. Lowth M. Acute Optic Neuritis AON, Optic Neuritis ON information. Patient [Internet]. Patient.info. 2019 [cited 3 September 2019]. Available here.
  7. Optic Neuritis - Eye Disorders - MSD Manual Consumer Version [Internet]. MSD Manual Consumer Version. 2019 [cited 3 September 2019]. Available here.
  8. Optic neuritis [Internet]. RNIB - See differently. 2019 [cited 3 September 2019]. Available here.
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