Optic neuritis is when the optic nerve gets swollen and inflamed. The optic nerve sends messages from the eye to the brain to help you see. This swelling can cause vision loss. In optic neuritis, the optic nerve may look swollen and the blood vessels around it can look big. When optic neuritis has been there a long time, the optic nerve may look pale.
Fig. 1: Optic nerve swelling in a patient with optic neuritis.
WHAT ARE THE SIGNS OF OPTIC NEURITIS?
The main sign of optic neuritis is a sudden loss of vision in one or both eyes. Other signs of optic neuritis include:
- Pain when moving the eye
- Headaches
- Trouble seeing colors or brightness
- Loss of peripheral (side) vision
Some kids may also feel weak or numb in parts of their body. Many children with optic neuritis had a fever, flu-like illness, or shots a week or two before the problems started.
WHAT CAUSES OPTIC NEURITIS?
Doctors think optic neuritis happens when the body’s immune or defense system attacks its own optic nerve by mistake (an auto-immune problem). This can be triggered by:
- A virus
- A recent vaccine
- An infection near the optic nerve
- Other disease that affect nerves (multiple sclerosis or neuromyelitis optica)
HOW DO DOCTORS KNOW IF IT’S OPTIC NEURITIS?
A doctor can tell if there is optic neuritis by doing a full eye exam. They will check vision, pupil reactions, and color vision, and look for swelling in the optic nerve. The doctor will also ask about recent illnesses, fevers, weakness, or immunizations. The doctor might use special tests, such as:
- OCT (ocular coherence tomography) to measure swelling in the eye
- Visual field testing to check side vision
- MRI to look for inflammation the nerve and check for other brain or nerve problems
- Spinal tap to test the fluid around the brain and spine
- Blood tests to look for infections or other problems
Doctors may do tests for problems such as MOG (myelin oligodendrocyte glycoprotein) and neuromyelitis optica (aquaporin 4 or NMO). Those tests may help with diagnosis and treatment.
HOW IS OPTIC NEURITIS TREATED?
Most children with optic neuritis get better on their own. Vision usually starts to improve in a few weeks. Many kids get back to their normal vision. In some cases, doctors may give medicines (corticosteroids/steroids) to help speed up healing. Certain causes of optic neuritis (mentioned above) have their own special treatments. Some kids may treatment for a long time to make vision better and keep the problem from coming. Sadly, a small number of children do not get their vision back even with best treatments.
HOW IS OPTIC NEURITIS DIFFERENT IN CHILDREN AND ADULTS?
In children, both eyes are usually affected at the same time. In adults, often only one eye is involved. Also, kids with optic neuritis often had a recent illness or vaccine, which is less common in adults. Both children and adults with optic neuritis are at risk of getting multiple sclerosis (an autoimmune problem that affects different nerves in the body). But kids are less at risk than adults.
MORE INFORMATION ON OPTIC NEURITIS CAN BE FOUND AT:
EyeWiki
Demyelinating Optic Neuritis
Myelin Oligodendrocyte Glycoprotein (MOG) Optic Neuritis
Neuromyelitis Optica Spectrum Disorders
American Academy of Ophthalmology
North American Neuro-Ophthalmology Society
Updated: 10/2024
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