The word "optic" refers to vision or to the eye. The second cranial nerve, which connects the brain and the eye, is called the optic nerve. The optic nerve carries impulses from eye's retina to the brain, which translates them into images, giving us sight. Neuritis means "inflammation of nerves." Optic neuritis, then, is an inflammation of the optic nerve. This condition is also known as "retrobulbar neuritis" when it affects the back part of the optic nerve, and "papillitis" when it affects the optic nerve head.

When optic neuritis causes the optic nerve to become inflamed or demyelinated, sight is usually affected. Optic neuritis can be caused by a number of diseases, including multiple sclerosis (MS). Optic neuritis is one of the most common symptoms of MS. In fact, about 15% of people with MS report that their first symptom was a vision problem. More than half of all patients with MS experience optic neuritis at some point during the course of their disease. Studies have also shown that 50-60% of people who experience an isolated episode of optic neuritis will eventually develop MS. When a young person with no other health problems develops optic neuritis, the cause is usually MS.

Optic neuritis usually affects only one eye, and is often painful. Symptoms are almost always temporary, lasting between 4 and 12 weeks. A variety of symptoms can occur, including:

Sensitivity to light

"Washed out" colors

Blurred vision

"Holes" (blind spots) in the visual field

Blind spot in the center of the visual field (cecocentral scotoma)

Temporary loss of vision in one eye

Red and green color distortion

Difficulty with night vision

It is possible to have a "subclinical" episode of optic neuritis, meaning that there are no observable symptoms of the condition. When there are no symptoms, the condition can be detected though the visual evoked potentials test. This painless diagnostic test measures the time it takes for nerve impulses to travel from the retina of the eye to the occipital lobe of the brain. Electrodes are placed on the scalp of the patient, who watches lights or patterns flash across a screen. The visual stimulation creates electrical impulses that travel to the brain. When optic neuritis is present the impulses travel more slowly than normal.

Optic neuritis eventually clears up on its own. Sometimes medication is given in hopes of reversing inflammation and restoring vision more quickly. Treatment usually begins with a short course of methylprednisolone (Solumedrol) administered intravenously for 3 to 5 days. This is followed by a tapered 10 to14 day course of oral steroids. The intravenous Solumedrol can be administered at home by a visiting nurse or in an outpatient facility.

References

First published October 1, 1999
Last updated May 4, 2003
Copyright © 1999 Accordant Health Services, Inc. All Rights Reserved.

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