Optic Neuritis (cont.)
Andrew A. Dahl, MD, FACS
Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Optic neuritis facts
- What is optic neuritis?
- What causes optic neuritis?
- What are optic neuritis risk factors?
- What are symptoms of optic neuritis?
- What are signs of optic neuritis?
- What types of doctors treat optic neuritis?
- How do health-care professionals diagnose optic neuritis?
- What is the treatment for optic neuritis?
- What is the prognosis for optic neuritis?
- Is it possible to prevent optic neuritis?
- Where can I find more information on optic neuritis?
- Find a local Eye Doctor in your town
What causes optic neuritis?
The precise cause of optic neuritis is unknown, but it is thought to be a type of autoimmune disorder. The immune system is generally used by the body to fight infection by creating a reaction that combats bacteria, viruses, fungi, and other foreign proteins. In autoimmune diseases, this reaction is mistakenly directed against a normal part of the body, creating inflammation and potential damage. In the case of optic neuritis, the optic nerve becomes swollen and its function is impaired. Inflammation and destruction of the protective myelin sheath that coats and insulates the optic nerve, plus direct damage to the nerve axons results in loss of vision, which may be temporary or permanent.
Optic neuritis is frequently an indication of multiple sclerosis (MS), a disease in which the immune system attacks the myelin sheath covering nerve fibers in the brain and spinal cord, resulting in inflammation and nerve damage. Optic neuritis typically resolves initially but often recurs.
In 15%-20% of people who eventually develop multiple sclerosis, optic neuritis is their first symptom. The risk of developing multiple sclerosis following one episode of optic neuritis is approximately 50% within 15 years of any first episode of optic neuritis. Various studies have shown that approximately 50% of patients who have optic neuritis for the first time will have MRI brain and/or spinal cord abnormalities consistent with MS at the time of the initial optic neuritis.
Neuromyelitis optica is another autoimmune condition in which demyelination occurs both in the spinal cord and both optic nerves but often sparing the brain. In this infrequent condition, the patient can experience weakness or paralysis in the limbs and/or bladder and bowel dysfunction, as well as loss of vision.
Approximately one-half of initial cases of optic neuritis are presumed to be an inflammatory reaction developing one week to one month following an upper-respiratory viral infection.
There are a variety of conditions that can affect the optic nerve, causing symptoms similar to optic neuritis. These include various optic neuropathies due to infection, trauma, hereditary conditions, toxic or nutritional problems, compressive lesions of the optic nerves, and vascular diseases, including arteritic optic neuropathy, diabetes, and glaucoma. Treatment of these optic neuropathies is directed at the underlying disease.
What are optic neuritis risk factors?
Optic neuritis risk factors include trauma, hereditary conditions, toxic or nutritional problems, compressive lesions of the optic nerves, and vascular diseases, including arteritic optic neuropathy, diabetes, and glaucoma.
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