Inflamed Optic Nerve (Optic Neuritis)

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The optic nerve allows you to see by carrying images from your eye to your brain. When the optic nerve becomes inflamed, it’s called optic neuritis. This condition can cause reduced vision or loss of vision. This serious condition requires immediate care from your doctor.

Treatment options will depend on the cause of your inflammation, but your doctor will need to develop a specific plan for you.

How Is Optic Neuritis Diagnosed?

Optic neuritis may be difficult to diagnose. Your eye may look perfectly normal. Your doctor will ask about your symptoms and medical history. A physical exam will be done. It will include a neurologic examination. You may be referred to an ophthalmologist (eye specialist) or neurologist (nervous system specialist).

Your doctor may need to test your eye function. This can be done with:

  • Tests of color vision, side vision, visual acuity, and the reaction of the pupil to light
  • Dilated eye examination
  • Visual evoked potential test (VEP)

Some additional tests your doctor may order could include:

  • Blood tests
  • Lumbar puncture to check the fluid around the brain and spinal cord
  • An MRI or optical coherence tomography (OCT) to see your internal structures.

Your doctor may also need to evaluate you for spinal cord problems. This can be done with a somatosensory evoked potentials test.

Treating Optic Neuritis at UVA Health

Talk with your doctor about the best treatment plan for you. Treatment options include:

  • Steroid medication to reduce swelling of the optic nerve.
  • Medication to treat the cause of optic neuritis.

What Causes Optic Neuritis?

In some cases, the cause of inflammation to their optic nerve might not be clear. But there are some conditions associated with an increased risk. These include:

  • Multiple sclerosis (MS) — most common cause
  • Neuromyelitis optica (NMO, Devic’s disease)
  • Autoimmune disorders, such as systemic lupus erythematosus (SLE)
  • Infection
  • Exposure to toxic substances — this may be associated with optic neuropathy (injury to the optic nerve)
  • Some medications

How Do You Get Optic Neuritis?

Factors that may increase your chance of developing optic nerve inflammation include:

  • Personal or family history of multiple sclerosis or other autoimmune disorders
  • Previous history of optic neuritis
  • Previous history of transverse myelitis (inflammation of the spinal cord)

What Are the Symptoms of Optic Neuritis?

In some people, optic neuritis may not cause any visual problems. Others may experience one or more of these symptoms:

  • Relatively sudden decrease in vision, such as blurring, darkening, or dimming of vision
  • Loss of vision in the center of, part of, or all of the visual field
  • Abnormal color vision, such as dull and faded colors
  • Pain in or around the eye, which is often made worse with eye movement

Often, the eye pain will go away on its own within a few days, and vision problems may also spontaneously improve. But others may have sustained visual impairment. For most, vision will improve over several weeks or months.