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Medical Author:

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is optic neuritis?
• What causes optic neuritis?
• What are symptoms of optic neuritis?
• What are signs of optic neuritis?
• How is optic neuritis diagnosed?
• What is the treatment for optic neuritis?
• What is the prognosis for optic neuritis?
• Can optic neuritis be prevented?
• Where can I find more information on optic neuritis?
• Optic Neuritis At A Glance
• Patient Comments: Optic Neuritis - Experience
• Patient Comments: Optic Neuritis - Treatments
• Find a local Eye Doctor in your town
• Optic Neuritis Index

The major symptom of optic neuritis is vision loss, frequently maximal within one or two days and varying from a small area of blurring to complete blindness. Affected individuals may also notice distorted vision, reduced color vision, loss of contrasts, and washed out or less vivid vision than normal. Loss of vision usually develops over the course of a day to two weeks and may be worsened by heat or exercise. Vision loss is usually temporary, but it may be permanent in some cases.

Most people who develop optic neuritis experience eye pain that is worsened by eye movement. Pain associated with optic neuritis usually peaks within one week and then goes away within several days.

Optic neuritis usually affects one eye, although it may occur in both eyes simultaneously. In cases where only one eye is affected, patients may be unaware of subtle visual loss or changes in the color vision until the doctor asks them to close or cover the healthy eye.

The most characteristic findings on examination include reduced visual accuracy (acuity), a measurable change in peripheral vision, decreased perception of brightness in the affected eye, and a change in color vision (often out of proportion to loss of visual acuity). A disturbance in function of the pupil (afferent pupillary defect or APD) is usually detectable if the other eye is either unaffected or involved to a lesser degree.

The head (known as the disk) of the optic nerve can easily be visualized by an ophthalmoscope. If the optic disk is swollen, the condition is called papillitis. Otherwise, it is referred to as retrobulbar neuritis. In about two-thirds of patients, inflammation is entirely retrobulbar, causing no visible changes when the physician examines the optic nerve with an ophthalmoscope. In the other one-third, there is visible swelling of the optic nerve and there may be enlargement of the blood vessels around the nerve.