Upcoming Events
If you have any vision problem, no matter how minor – especially if it involves eye pain – get it checked out by an optometrist or ophthalmologist. It could be optic neuritis, the inflammation of the optic nerve that can affect your vision. Optic neuritis is common in people with multiple sclerosis, says Christopher Langston, MD, a neuroimmunologist and the medical director of The Madlyn Borelli Multiple Sclerosis Center at Montefiore Nyack Hospital in Nyack, NY.
“When people think of multiple sclerosis, they usually think of symptoms like difficulty walking, imbalance, numbness and tingling. They don’t usually think about eye symptoms,” he says. “But optic neuritis can occur in people with MS, lupus and other autoimmune diseases. In some cases, it can be the first sign of MS.”
In other cases, there is no apparent cause for a person’s optic neuritis, and it is not linked with any other disease.
What is Optic Neuritis?
Optic neuritis is a swelling of the eye’s optic nerve. This nerve carries light signals from the back of the eye to the brain so you can see. If the optic nerve is swollen, damaged or infected, your vision can be affected.
A common feature of optic neuritis is blindness in either the top or bottom half of vision. It typically occurs only in one eye, Dr. Langston says. The vision loss may not affect the entire top or bottom half of the eye. “It may appear to a person that they have a smudge on their contact, except that the smudge persists even after they change the contact,” he says.
Another symptom is eye pain. “When the nerve gets swollen, it becomes painful to move the eye,” he says. “Sometimes this can result in headaches.”
The vision loss typically gets worse over days to weeks, and then slowly resolves over weeks to months. The symptoms may return when a person is stressed, sick or overheated. “All these conditions stress the optic nerve and can cause the symptoms of the original injury to come out again,” he says. “It’s important to understand that transient return of symptoms does not necessarily indicate a fresh injury.”
Diagnosis and Treatment
Optic neuritis may be diagnosed when a person comes to an optometrist or ophthalmologist with vision problems or eye pain. But in some cases, the doctor will find evidence of optic neuritis even if the person doesn’t have symptoms. “When the doctor shines a light in the eye, they may see the eye doesn’t react to light equally in both eyes. That could be a sign of optic neuritis,” Dr. Langston says.
Some people get better without any treatment. Many people need treatment to improve vision or at least keep their symptoms from getting worse. “Some people have a full recovery, but others don’t,” he says. “If optic neuritis isn’t treated, its symptoms can get worse. Getting diagnosed and treated early can help a person potentially get better faster.”
Optic neuritis is often treated with steroids to reduce inflammation.
In people with MS whose optic neuritis doesn’t respond to steroids, the optic neuritis is treated with a procedure called plasma exchange, a light form of plasmapheresis in which inflammatory molecules are filtered out of the blood.
“The expected outcome for most patients with optic neuritis is good, unless you leave it untreated,” Dr. Langston says. “Especially if you have MS or another autoimmune disease, optic neuritis can potentially blind you if the underlying cause isn’t discovered. If you have vision problems, especially if they’re accompanied by pain, it’s important to seek medical attention right away to see what’s going on and whether an underlying condition is causing them.”
For more information about the services provided at the Madlyn Borelli Multiple Sclerosis Center at Montefiore Nyack Hospital, call 845-348-8880 or visit montefiorenyack.org/multiple-sclerosis.
