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Optic Neuritis

The optic nerve is the nerve that carries visual information from the retina to the brain. Optic neuritis (ON) is when this nerve becomes inflamed and cannot carry its signal properly.

ON is most frequently associated with multiple sclerosis (MS), an autoimmune disorder causing different areas of the body to swell after the body attacks the protective layers of organs. Untreated ON can leave to more nerve damage in MS patients.

The first symptom is normally blurred or distorted vision. Some patients describe this stage as though they are looking through a dark curtain in front of their eyes. Perception of color also decreases. Red seems to be the color that disappears first, while all the rest of the colors become duller. Many patients also experience pain constantly, while some only feel it when they move their eyes in a particular direction. Vision loss is very common for patients with ON. Partial vision loss occurs in all areas of the field of view and can eventually lead to total blindness. Symptoms rise and disappear during progression. ON episodes are recurrent.

Optic papillitis is when inflammation occurs at the point where the nerve connects to the retina. Retrobulbar neuritis is when inflammation occurs where the optic nerve begins to connect to the brain. These are both specific cases of optical neuritis.

Children and adults experience different symptoms. Pain is about half as common of a symptom in children with ON than adults. Additionally, adults tend to experience symptoms in both eyes while children only experience them in one. This is interesting as the optic nerve is a paired nerve, meaning it is one nerve that connects to both eyes.

There are other causes for ON besides for MS. Other autoimmune diseases and neurological diseases have ON as a symptom. Syphilis, Lyme disease, and herpes are all infections where ON presents itself. ON is one of the primary causes of vision loss in diabetes patients. Some medications have ON as a side effect in some patients. Vitamin B deficiency can also lead to a swollen nerve.

Corticosteroid treatment is used to reduce inflammation. It can either be injected intravenously or orally. It is best to treat ON as soon as it arises, as the optic nerve cannot repair itself very well after being damaged by inflammation. This is called optic neuropathy, the permanent damage done to the nerve cells that make up the optic nerve. Once neuropathy occurs, the nerve is permanently weakened and can be prone to damage in the future.