Optic Neuritis

Optic Neuritis

Optic neuritis is visual disturbance due to inflammation of the eye nerve (optic nerve). This condition, which often occurs in people with multiple sclerosis , is characterized by blurred vision in one eye and pain in the eye.

The optic nerve functions to carry light signals from the eye to the brain so that a person can see. If the optic nerve is inflamed, infected, or damaged, the sufferer cannot see clearly.

Optic neuritis can occur in adults or children, but most often affects women aged 20-40 years. Optic neuritis usually affects only one eye, but in some cases it can affect both eyes.

Causes of Optic Neuritis

The exact cause of optic neuritis is not known with certainty. However, it is suspected that inflammation and damage to the optic nerve are caused by an autoimmune disorder , which is a condition when the immune system attacks the body's own cells.

In optic neuritis, the body's immune system attacks the covering of the optic nerve, which is called myelin. When myelin is damaged, nerve signals from the eyes cannot be sent properly to the brain. This causes the sufferer to experience visual disturbances.

Autoimmune diseases associated with optic neuritis include:

  • Multiple sclerosis
    This disease causes the immune system to attack the myelin sheaths in the brain and spinal cord. Not only people with multiple sclerosis are at risk of developing optic neuritis, people with optic neuritis are also at risk of developing multiple sclerosis .
  • Neuromyelitis optica
    Neuromyelitis optica causes inflammation of the optic nerve and spinal cord. Although similar to multiple sclerosis , this disease does not cause brain nerve damage like multiple sclerosis .

Apart from these two autoimmune diseases, there are several other factors that are also at risk of causing optic neuritis, namely:

  • Use of quinine pills
  • Bacterial infections (for example , syphilis and Lyme disease) or viral infections (for example, measles, herpes , and mumps )
  • Other diseases, such as sarcoidosis, lupus, arteritic optic neuropathy , diabetes, glaucoma , and vitamin B12 deficiency

Optic Neuritis Symptoms

Optic neuritis is characterized by visual disturbances, such as:

  • Blurred vision in one eye
  • The field of vision is narrowed or the peripheral vision is not clear
  • Some colors appear dimmer than
  • Pain when the eye is moved
  • There was a flash of light in the eye

In rare cases, visual disturbances can also lead to blindness .

When to see a doctor

Impaired vision is a serious condition. Consult a doctor if you experience the symptoms of optic neuritis as mentioned above, especially if accompanied by the following complaints:

  • Pain and blurred vision get worse
  • Symptoms do not improve after treatment
  • Tingling or numbness in the arms and legs

Diagnosis of Optic Neuritis

As a first step, the doctor will ask about the symptoms experienced by the patient and examine the patient's eyes. Some eye examinations performed by doctors are:

Visual acuity examination

In this examination, the doctor will ask the patient to look and say the numbers or the alphabet that are placed at a certain distance. This test aims to measure the patient's visual acuity.

Visual field examination

Visual field tests can help doctors determine the patient's eye ability to see objects that are at the edge of the field of view. This test can be done using various methods, either manually or with the help of special tools.

Pupil reaction test to light

In this test, the doctor shines a flashlight into the eye to see how the pupils respond to bright light. The pupils of patients with optic neuritis do not shrink as small as those of a healthy eye when exposed to bright light.

Ophthalmoscopy

Ophthalmoscopy examination aims to examine the optic nerve plate. If the plate is swollen, it is likely that the patient has optic neuritis.

Ophthalmoscopy uses a special tool called an ophthalmoscope. The ophthalmoscope will help the ophthalmologist to shine a light on the eye and see the structures inside the patient's eyeball.

Ophthalmologists can also perform an optical coherence tomography (OCT) examination to check the thickness of the retinal nerve fibers and a visual evoked response test to assess the speed of electric current from the optic nerve. The nerve fibers in people with optic neuritis are thinner than normal people and the flow of electricity tends to slow down.

Apart from the above examinations, there are other tests that can be done to find out the risk factors for causing optic neuritis, namely:

  • Blood test, to check for the possibility of neuromyelitis optica in people with optic neuritis, by detecting antibodies in the blood
  • An MRI scan , to determine areas of damage to the brain that are the cause of multiple sclerosis

Optic Neuritis Treatment

Optic neuritis generally heals on its own within 4–12 weeks without specific treatment. However, depending on the patient's condition, an ophthalmologist can provide certain treatments to help speed healing, including:

  • Corticosteroids
    Doctors can inject high doses of corticosteroid drugs to treat optic neuritis while slowing and reducing the risk of developing multiple sclerosis .
  • Immunoglobulin injections (IVIG)
    Another treatment for optic neuritis is immunoglobulin injections (IVIG). This treatment is usually given to patients with optic neuritis who are already severe and can no longer be treated by cortico
  • Vitamin B12
    Patients with optic neuritis due to vitamin B12 deficiency can be treated with vitamin B12 injections .

In optic neuritis that is triggered by other conditions, such as diabetes , the doctor will treat that condition.

The patient's vision can generally return to normal within 12 months. Although vision has returned to normal, visual disturbances due to optic neuritis can recur, including in patients without autoimmune disorders. However, the chances are smaller than those with multiple sclerosis or neuromyelitis optica .

Optic Neuritis Complications

Complications that can occur due to optic neuritis include:

  • Permanent damage to the optic nerve resulting in blindness
  • The risk of developing deep vein thrombosis (DVT), pulmonary embolism , and urinary tract infections, in patients with optic neuritis due to neuromyelitis optica
  • Complications due to side effects of treatment, for example decreased endurance due to corticosteroids so that sufferers are susceptible to infection

Prevention of Optic Neuritis

It is difficult to prevent optic neuritis, because this condition is an autoimmune disease. Therefore, to maintain healthy eyes and vision, do regular checks to the doctor.

People under the age of 40 are recommended to have their eyes checked every 2 years. Meanwhile, people over the age of 40 need to have routine eye examinations every 1-2 years.

As previously mentioned, people with optic neuritis are also at risk of developing multiple sclerosis . Therefore, patients with optic neuritis are usually advised to get interferon injections and routine control to prevent multiple sclerosis .

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