Optic neuritis is an inflammation of the optic nerve that causes a sudden loss of vision, often accompanied by pain during eye movements. It is a neuro-ophthalmic condition that requires prompt diagnosis, as it may be the first manifestation of a nervous system disorder.
What is optic neuritis
The optic nerve transmits images from the retina to the brain. When it becomes inflamed, signal transmission is disrupted — and vision deteriorates, sometimes over the course of several hours or days. Most often one eye is affected, less often both. The condition may occur on its own or be associated with demyelinating and infectious processes.
Causes
- demyelinating diseases — primarily multiple sclerosis, as well as neuromyelitis optica (NMOSD) and MOG-associated disease;
- viral and bacterial infections;
- autoimmune and systemic inflammatory diseases;
- toxic effects of certain substances and medications;
- in some patients the cause cannot be identified (idiopathic neuritis).
Symptoms
- sudden decrease in visual acuity in one eye;
- pain in or behind the eye that worsens with eye movements;
- impaired colour perception — colours appear dull, «washed out»;
- reduced image contrast and brightness;
- appearance of a spot or «veil» in the centre of the visual field;
- sometimes — flashes of light during eye movements.
Why this is a neuro-ophthalmic condition
Optic neuritis lies at the border of ophthalmology and neurology. It may be the first sign of multiple sclerosis or another nervous system disorder even before neurological symptoms appear. That is why it is important not just to record the loss of vision, but to assess the condition of the optic nerve and visual pathways comprehensively. This is the task of a neuro-ophthalmologist — a doctor who works at the intersection of ophthalmology, neurology and neurosurgery.
Diagnosis
The examination aims to confirm the diagnosis and identify the cause:
- testing of visual acuity and colour perception;
- assessment of the pupillary response and detection of a relative afferent pupillary defect (RAPD);
- computerised perimetry (visual field testing);
- ophthalmoscopy and OCT of the optic nerve head;
- visual evoked potentials;
- MRI of the brain and orbits — to detect demyelination;
- if needed — laboratory tests and a neurologist’s consultation.
Treatment
The approach depends on the cause and severity. In many cases anti-inflammatory therapy is used under a doctor’s supervision; if a systemic disease is identified, specialised physicians are involved. Early consultation is crucial: timely diagnosis and treatment improve the chances of preserving vision and detecting a nervous system disorder in time.
When to seek care urgently
Seek help immediately if vision suddenly declines in one or both eyes, pain appears behind the eye during eye movements, or part of the visual field is lost. The earlier the diagnosis is made, the more options there are to preserve visual function.
At the German Eye Clinic, diagnosis and follow-up for optic neuritis are provided by a neuro-ophthalmologist, Doctor of Medical Sciences. You can book a consultation by phone at 0 800 507 670 or via the «Neuro-ophthalmologist consultation» service page.
