• Reference Number: HEY1422-2023
• Departments: Ophthalmology Department
• Last Updated: 1 November 2023

Introduction

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is optic neuritis?

Optic neuritis is inflammation of the optic nerve. The optic nerve is a bundle of nerve fibres that carries visual information from the eye to the brain. When the optic nerve is inflamed, it can damage the myelin sheath, which is the protective coating around the nerve fibres. This damage can disrupt the transmission of nerve signals, leading to vision problems.

What are the symptoms of optic neuritis?

 The most common symptom of optic neuritis is sudden vision loss in one eye. Other symptoms may include:

• Pain in or around the eye, especially when moving the eye
• Decreased colour vision, colour appears ‘washed out.’
• Blurred vision
• Double vision
• Loss of peripheral vision

What causes optic neuritis?

 Optic neuritis is sometimes associated with other medical conditions, such as:

• Multiple sclerosis (MS)
• Systemic autoimmune diseases: Neuromyelitis optica (NMO), sarcoidosis
• Rheumatic diseases as systemic Lupus
• Viral infections, such as measles, mumps, and chickenpox
• Bacterial infections, such as syphilis and tuberculosis, lyme disease, cat scratch disease.

How is it diagnosed?

 Optic neuritis may be difficult to diagnose as your eye looks perfectly normal. Often the inside of your eye also looks normal. A few patients with optic neuritis have swelling of the optic disc (the beginning of the optic nerve) at the back of the eye. Both of your eyes will be examined and tests for colour vision, visual acuity and pupil assessment will be made. Blood tests may also be required. Based on these findings a diagnosis will be made.

What is the treatment?

 Treatment with steroid medications may speed up vision recovery although a study – The Optic Neuritis Trial (ONTT) – suggested that recovery was likely to be equal after six months whether patients were treated with steroid drugs or placebo drugs (dummy pills). Patients who were treated with a specific steroid called Methyl-Prednisolone did have a slightly quicker recovery of their vision although the final visual outcome was no better than those who were not treated. Steroid treatment is sometimes recommended for patients who have severe visual impairment, optic neuritis in both eyes, or if they have poor vision in the unaffected eye. Treatment options will be discussed with you by the ophthalmologist.

What is the prognosis for optic neuritis?

The prognosis for optic neuritis is generally good. Most people make a full recovery of their vision within a few weeks or months; however, it may not return to normal, especially if they have optic neuritis associated with an autoimmune disease.

The associated pain will normally resolve within a few days of onset but the vision may vary becoming more blurred during exercise or taking a hot bath or shower.

Do I have Multiple Sclerosis?

 Multiple Sclerosis (MS) is a disease in which the body’s immune system attacks the myelin in the brain and/or spinal cord. Optic neuritis may be the first sign of MS. Your ophthalmologist may discuss with you the risks of MS and the need for any further investigations for example brain scan.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the ophthalmology department on tel: 01482 608788.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.