Poor Vision: What is Optic Neuritis?
Optic neuritis is probably one of the most common symptoms experienced by those with multiple sclerosis (MS) and those who are experiencing their first attack before actually being diagnosed with MS. But what is it? Simply put, it is usually the cause of blurry vision, often requiring glasses to correct. Sometimes, it can cause an inability to see certain colors or cause the colors you can see to become more dull, gray, or desaturated.
What are some other signs of optic neuritis?
Optic neuritis can also cause you to completely lose vision in an eye, cause pain, or make you see flashes of light/flickering. It can also cause you to develop a “dark spot” in the center of your visual field called a scotoma.
Optic neuritis is often one of the first MS symptoms
Right before I was diagnosed with MS, my vision started deteriorating rapidly and I was told this was most likely due to optic neuritis. IV and oral steroids greatly improved my vision but ever since, I have needed glasses and usually have to get a new prescription about once a year.
What causes optic neuritis?
Now that we know what the symptom is, let's talk about what causes the symptom. MS attacks the central nervous system which consists of the brain, spinal cord, and the optic nerves. The optic nerves are what connect your eyes to your brain; they are what carry the signals that describe what you are seeing from your eyes to your brain. When MS attacks the protective myelin sheath around these nerves, you start to experience poor vision because the signals your eyes are trying to send to your brain don't fully make it from point A to point B.
Uniteral vs. bilateral optic neuritis
Usually, this happens in one eye (unilateral) so when you close the affected eye, everything will look slightly better than when you close your “good” eye and try to see with your affected eye. Less commonly, optic neuritis occurs in both eyes (bilateral) but this is less common except in cases of pediatric multiple sclerosis.
Treatment for optic neuritis
So, how do you treat optic neuritis? That is probably what you really want to know. Well, as I quickly mentioned above, all you can really do is treat with steroids to bring down the inflammation affecting the optic nerve(s). Usually, a 3-5 day course of IV steroids is what a neurologist will prescribe. Sometimes, this is followed by oral steroids (Prednisone) to slowly taper off the IV steroids. This may not ever bring you back to 100 percent, but 90 percent is better than 30 percent, right?
This is why most people with MS have glasses or contact lenses because at this point, they are usually needed to give you your vision back. Of course, glasses do not help with color blindness or any of the other things optic neuritis can cause - just the blurry vision. To get glasses, you simply need to see an optometrist like anyone else, but something you should also do is see a neuro-ophthalmologist to keep a more detailed medical record of your vision and to make sure you do not have other issues that an optometrist may not be able to detect.
My experience with steroid treatment
In my situation, I usually treated my episodes of optic neuritis with IV steroids and only sometimes with oral steroids. I have also done high doses of oral steroids without the IV steroids which also did the trick, but using Prednisone for long periods of time can have some very “unfavorable” side effects, such as severe acne or weight gain. Eventually, we learned that I do not really seem to have optic neuritis but instead, the part of my brain that the optic nerves connect to is damaged.
MS vision issues
Think of the optic nerves like a power cord and the outlet on the wall like the brain; my outlet is damaged instead of the power cord, but either way, the flow of electricity is not making it from my eyes to my brain. So generally, this has affected my vision in the same ways as optic neuritis would except my optic nerves are pretty healthy. I am honestly not sure if this is ultimately better or worse, although I can say I have never had an issue with colors or lights. I have also never had a scotoma, but at the same time, I have had blind spots and all sorts of other visual symptoms that are actually caused by something else altogether, so I will not get into that at the moment. For now, I simply wanted to explain what optic neuritis is since it is so common.
What has your experience with optic neuritis been like?
Do you live with any comorbidities aside from MS?