Optic neuritis occurs when your optic nerve — the part of your eye that transmits visual information from your eye to your brain — becomes inflamed. This inflammation can interfere with nerve signals traveling between your eyes and your brain.
Optic neuritis causes painful eye movements and vision loss, often occurring alongside conditions such as sarcoidosis, neuromyelitis optica, MOG antibody-associated disease, multiple sclerosis, and other autoimmune disorders. UPMC neurology experts partner with neuro-ophthalmology specialists to provide advanced care for optic neuritis.
On this page:
What Is Optic Neuritis?
Optic neuritis occurs when your optic nerve — the part of your eye that transmits visual information from your eye to your brain — becomes inflamed. This inflammation can prevent nerve signals from traveling between your eyes and your brain.
Optic neuritis often occurs alongside conditions such as multiple sclerosis and other autoimmune disorders, causing pain and vision loss.
Neuritis can be:
- Bilateral — Affecting both eyes and more often seen in neuromyelitis optica and MOG antibody-associated disease.
- Unilateral — Affecting one eye and more often seen in multiple sclerosis.
How common is optic neuritis?
Optic neuritis is a relatively uncommon condition. Researchers estimate that about five to six new cases occur per 100,000 people each year in the U.S.
What causes optic neuritis?
Optic neuritis occurs when inflammation causes damage to your optic nerve.
Inflammation can be caused by:
Autoimmune and inflammatory disorders
- Unilateral optic neuritis often occurs in people with multiple sclerosis. In some cases, optic neuritis can be the first sign of multiple sclerosis.
- Bilateral optic neuritis is linked to neuromyelitis optica and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).
- Other autoimmune conditions, including sarcoidosis, Bechet’s disease, and granulomatosis with polyangiitis (GPA), rarely cause optic neuritis
Infections
Viral, bacterial, fungal, and parasitic infections that may cause optic neuritis include:
- Aspergillosis.
- Candidiasis.
- Cytomegalovirus.
- Herpes.
- HIV.
- Lyme disease.
- Measles and other childhood viruses.
- Syphilis.
- Toxoplasmosis (from cats) and toxocariasis (from dogs).
- Tuberculosis.
- Varicella-zoster virus (causes chickenpox and shingles).
- West Nile virus, malaria, and other mosquito-transmitted infections.
Drugs and toxins
Some drugs and toxins are linked to optic nerve injury, including:
- Alcohol.
- Antibiotics and medications to treat infections.
- Anticancer medications.
- Heart rhythm disorder medications.
- Malaria medications.
- Tobacco and nicotine.
Other causes
Other causes of optic nerve injury may include:
- Compression of your optic nerve.
- Low levels of vitamin B12.
- Problems with blood flow to your eyes.
- Uncontrolled diabetes.
Optic neuritis risk factors
Risk factors for optic neuritis include:
- Being between the ages of 20 and 40.
- Being female.
- Having an autoimmune disorder such as lupus or sarcoidosis.
- Having multiple sclerosis, neuromyelitis optica, or MOG antibody-associated disease.
How can I prevent optic neuritis?
You may not be able to prevent optic neuritis, but you may be able to lower your risk by:
- Avoiding tobacco products and recreational drugs.
- Eating a balanced, healthy diet rich in vitamins and minerals.
- Getting fast treatment for infections.
- Limiting alcohol use.
- Managing chronic conditions, including autoimmune disorders and diabetes.
- Taking medications according to your doctor’s recommendations.
What Are the Signs and Symptoms of Optic Neuritis?
Symptoms of optic neuritis may include:
- Blurry vision.
- Color vision loss.
- Eye pain that worsens with eye movement.
- Vision loss in part of your field of vision, such as the center.
When should I see a doctor about my optic neuritis symptoms?
If you have symptoms of optic neuritis, you should schedule an appointment with your doctor as soon as possible or go to an emergency room or Urgent Eye Care Clinic, such as at UPMC Mercy. Getting early treatment can reduce your risk of long-term vision issues. Depending on the cause, your doctor may refer you to a neuro-ophthalmologist, neurologist, or rheumatologist for additional treatment.
How Do You Diagnose Optic Neuritis?
To diagnose optic neuritis, your provider will perform an eye examination and review your symptoms and medical history. Your doctor may also order tests to confirm your diagnosis or rule out other problems.
What to expect during your visit
During your visit, your doctor will:
- Ask you about your symptoms.
- Order tests.
- Perform an eye exam.
- Review your medical history.
Tests to diagnose optic neuritis
Tests to diagnose optic neuritis may include:
- Blood and urine tests — Checks for abnormalities and rules out other conditions.
- Cerebral spinal fluid analysis (spinal tap or lumbar puncture) — Involves inserting a needle into your lower back to collect a sample of cerebrospinal fluid (CSF) for analysis in a lab.
- Magnetic resonance imaging (MRI) — Takes images of your brain and spine using contrast dye to look for damaged or abnormal areas.
- Optical coherence tomography (OCT) — An imaging test that uses reflected light to create images of structures in the back of your eye.
- Vision tests — A complete exam to assess visual acuity, color vision, pupil reflexes, and the overall health of your eyes.
- Visual evoked potential (or response) (VEP or VER) — Measures electrical activity in the brain in response to visual stimuli, to check how well your eyes, optic nerve, and visual pathways are working.
- Visual field examination — A test that measures your peripheral vision.
Optic neuritis prognosis
In most cases, symptoms of typical optic neuritis improve within six months. Optic neuritis caused by conditions such as neuromyelitis optica takes longer to resolve, causes more severe symptoms, and may lead to permanent vision problems.
Because optic neuritis may be associated with multiple sclerosis and other autoimmune conditions, your doctor may refer you to another medical specialist for ongoing monitoring and treatment.
Is optic neuritis curable?
Optic neuritis typically improves with treatment, but it may sometimes lead to permanent eye damage.
How Do You Treat Optic Neuritis?
The goals of optic neuritis treatment are to resolve symptoms and reduce the risk of permanent vision damage.
Treatment options may include:
Medications
Your doctor may recommend high-dose intravenous (IV) or oral steroid medications to reduce inflammation of your optic nerve. After your initial treatment, your doctor may prescribe lower-dose oral steroids.
Treatment of underlying conditions
If you have an underlying condition that is causing your optic neuritis, your doctor may recommend other treatments, including:
- Antibiotics for bacterial infections.
- Antiviral medications for herpes and other viral conditions.
- Plasma exchange to remove damage-causing antibodies from your blood.
Clinical trials
You may be eligible to participate in a clinical trial studying new treatments for optic neuritis. Your doctor will let you know if you qualify for a clinical trial.
Why Choose UPMC for Optic Neuritis Care?
When you choose UPMC for optic neuritis care, you will receive:
- Multidisciplinary care — Our team of neurologists and neuro-ophthalmology experts will work together to develop a customized treatment plan that reduces your risk of complications.
- Access to advanced clinical trials — Our team participates in national multicenter clinical trials evaluating new treatment options, allowing you to contribute to research that advances care for neuro-ophthalmologic disorders.
- Seamless, ongoing treatment — If you are diagnosed with optic neuritis, our team will develop a follow-up care plan that includes ongoing monitoring and symptom management as needed.
