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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 - Treatments
• Patient Comments: Optic Neuritis - Experience
• Find a local Eye Doctor in your town
• Optic Neuritis Index

Optic neuritis is suspected in patients with characteristic eye pain and vision loss. A complete medical examination, including chemical analysis of the blood can help rule out related diseases. Tests may include visual acuity testing, pupillary testing, visual field testing, color vision testing, and visualization of the optic disc by direct and indirect ophthalmoscopy.

A person with a first episode of optic neuritis usually undergoes an MRI of the brain to look for central nervous system lesions. MRI with gadolinium enhancement may show an enlarged, enhancing optic nerve. MRI may also help diagnose multiple sclerosis by demonstrating typical abnormalities in the brain.

If a definite cause (such as infection or underlying other disease) is determined, appropriate therapy for that cause can be instituted.

In optic neuritis of undetermined cause or related to multiple sclerosis, vision often returns to normal within two to 12 weeks with no treatment but may also advance to a permanent state of partial or complete visual loss.

Treatment with steroid medications (cortisone medications such as prednisone [Deltasone, Orasone, Prednicen-M, Liquid Pred] and methylprednisolone, [Solu-Medrol]) may speed up vision recovery. Although treatment with steroids have little effect on the final visual outcome in patients with optic neuritis, patients treated initially with intravenous (IV) steroids have about one-half the risk of developing multiple sclerosis in two years as untreated patients do. This effect disappears by the third year of follow up. In addition, patients treated with IV steroids have fewer repeated attacks of optic neuritis than untreated patients.

Ophthalmologists treat patients with optic neuritis with either IV -- followed by oral steroids -- or no treatment at all. For those who are treated, the regimen typically includes three days of IV steroids, followed by about 11 days of oral steroids.

When optic neuritis is associated with MRI lesions suggestive of multiple sclerosis (MS), immunomodulator or immunosuppressive therapy may be prescribed to reduce the incidence of future attacks.