Optic Neuritis

Painful vision loss from optic nerve inflammation

Overview

Optic neuritis is inflammation of the optic nerve, which causes vision loss in one eye developing over hours to days, typically accompanied by pain that worsens with eye movement, reduced color vision, and dimming of brightness. It is most common in young adults, especially women, and is strongly associated with multiple sclerosis, of which it is often the first manifestation. Other causes include neuromyelitis optica spectrum disorder with aquaporin 4 antibodies, MOG antibody associated disease, infections, and systemic inflammatory conditions. MRI of the brain helps assess the risk of developing multiple sclerosis. The Optic Neuritis Treatment Trial, published in the 1990s, found that intravenous corticosteroids speeded visual recovery without changing long term visual outcome. Most people with typical optic neuritis recover much of their vision over weeks to months, although subtle deficits in contrast and color vision often remain, and OCT can document residual loss of retinal nerve fibers.