Poor Vision – What is Optic Neuritis?

Poor Vision – What is Optic Neuritis?

Optic Neuritis is probably one of the top 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 the colors you can see to become more dull/gray/desaturated. Optic Neuritis can also cause you to completely lose vision in an eye, cause pain, make you see flashes of light/flickering or develop a “dark spot” called a scotoma in the center of your visual field (everything you can see while you focus your eyes on a single object. This includes your peripherals or the very sides of what you can see). Right before I was diagnosed with MS my vision started deteriorating rapidly and 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.

So 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. 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.

Now, 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 coarse 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%” but 90% is better than 30% 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 but instead just the blurry vision. Now 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 another issues that an optometrist may not be able to detect.

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. 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 but I am honestly not sure if it 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 all together 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?

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Comments

View Comments (48)
  • Jahand44
    2 years ago

    I had optic neuritis in my left eye last fall, mainly a gray cloudy area and was soon diagnosed with MS. Did steroids and eye cleared. Now have same thing in the right eye but mainly when out in sun or exercising. Not sure if I want to do the steroids if this is going to be a common symptom for me. No pain and doesn’t bother me all the time. Any suggestions from someone who has lived with this longer. Love reading about this symptom but I find as with all MS symptoms everyone so different. I am on Gilenya with no side effects and in 3.5 months my lesions are reduced significantly.

  • Matt Allen G author
    2 years ago

    Well, most MY vision problems are due to a lesion/atrophee in the brain instead of the optic nerve BUT I can still say (because I have so many symptoms that come and go so often) that I don’t do steroids every time, you have to sort of learn and gauge for yourself when it is bad enough that you really need them, everyone is different but for starters I would maybe ask yourself if it is bad enough that it interferes with your ability to function and get stuff done or if it can be worked through. There is no real guide, just one of those things you have to learn to determine, maybe even contact your doctors each time at first to get a professional opinion.

  • gmc
    3 years ago

    After extensive research, I finally found information that sunglasses help relieve some residual issues of optic neuritis. This was a tremendous help to me and my optometrist verified dark lens should help by slowin the light. I wish all who suffer from it could be told.

  • Jahand44
    2 years ago

    I wear sunglasses when out and my gray cloud still occurs. Any certain color or suggestions about a better type of lens?

  • Matt Allen G author
    3 years ago

    glad that helps! I think everyone is just a bit different, not everyone will benefit (I think) but definitely worth a try!

  • 1gre00f
    3 years ago

    I have not looked into this very much, but i am confused. I have been told by my neuro and ophthalmologist that if my vision is improved by glasses then it isn’t related to optic neuritis, because it would be the lens that is being treated by the glasses. ??? Also I have frequent headaches that mainly involve eye movement. Is the type of “eye pain” associated with ON?

  • Matt Allen G author
    3 years ago

    That is not true, I have no idea why they would tell you that? Most people I know with MS wear glasses to try to fix the problem optic neuritis has caused. As far as pain with eye movement? That is interesting, not sure if that is ON or a migraine type headache?

  • Jeany
    3 years ago

    I’ve had what they call Haradas Vogt Syndrome in bilateral eyes about 30 years ago. It has reoccurred about 6 times in my life unilateral. I always get treated with oral steroids. But the last time I had a new symptom of double vision then diagnosed in 2013 with MS.

  • Matt Allen G author
    3 years ago

    Do they think it is related? How miserable,

  • Matt Allen G author
    3 years ago

    Wow, so sorry I have not been replying! I have not been getting comment alerts so I just thought no one was interested in what I have had to say lately but looks like that is not the case!

  • 16c1co4
    3 years ago

    I have bilateral optic neuritis. I sometimes use IV steroids but try to avoid it as one of my new side effects is a cataract from using steroids. I will only use steroids if it is significant.

  • Matt Allen G author
    3 years ago

    I too only use them when absolutely necessary but for different reasons. So far it’s worked out OK for me,

  • Lisa
    3 years ago

    my opthomologist says i have atrophy (damage) in my optic nerve which is due to MS but is not reversible. i hope to keep it from getting worse but the only treatment is ms meds which i already take. i also have cataracts which i am going to have surgery on in the hopes that at least something will improve. i am scared of totally losing my vision.
    anyone else have atrophy?

  • Matt Allen G author
    3 years ago

    I think that is pretty normal, most MS issues are not 100% reversible, there is always a little damage left behind that MAY get worse over time. My vision seems to get worse at a rate that requires me to get stronger lens every year but everyone is different!

  • Elena
    3 years ago

    My first symptom was ON 40 years ago when I was 16. No doctor knew what it was. Everything in my right eye was purple !

  • Choose Health
    3 years ago

    I had reoccurring optic neuritis for 8 years it one go back and forth from one eye to another. I have not had a flare in 2 years now since following Dr. Wahls Paleo diet. My neurologist was shocked how well both of my eye nerves have healed. Food is the best medicine I have found.

  • nepatternmaker
    3 years ago

    my first relapse about 4 years ago that I knew something was wrong left me with a bilateral peripheral cutout. Both eyes, identically. Eye doctor thought maybe a mini-stroke. The cut out healed almost 100%, but left me with blurred vision. Second relapse in June 2015, blurred my vision much worse. It recovered some, but my vision in both eyes is 20/200, functionally blind. The MS dx followed soon after and explained the symptoms that made no sense. Interesting part is I’m 50. The article says these symptoms are more common in pediatric MS. Unfortunately, we are all different. I would love to have my vision back, but probably not going to happen.

  • Matt Allen G author
    3 years ago

    Yes, I suppose that is an odd point; it’s more common than something that is EXTREMELY common because O/N is a typical first symptom of MS regardless of age.

  • LHONpoince
    3 years ago

    Many people get a diagnosis of Optic Neuritis then lose vision in the second eye and don’t know why. Eventually they may get diagnosed with LHON, Leber’s Hereditary Optic Neuropathy, a rare genetic disorder that causes sudden, painless loss of central vision first in one eye, then the other. My son was initially diagnosed with ON and treated with steroids, but when the first eye didn’t recover and the second eye suddenly lost vision, they started looking for other diagnoses. A good neuro-ophthalmologist should be able to make the diagnosis. There’s info about it at http://www.LHON.org.

  • Shelli
    3 years ago

    I called it “Picasso Vision”. I had it for about 5 weeks and before I was diagnosed with MS.

  • Goldilocks
    3 years ago

    This article is so helpful to me. I have eye issues as many have described in their comments and in the article. Most of my eye issues are with my left eye. The most bizarre was when I woke up about 2 months ago and I only saw black and white in that eye.My right eye was normal. I was trying to wrap my brain at to what was happening and it was back to normal colour not much longer after it started. I still have on and off colour issues with that left eye but I felt like I was in the Twight Light Zone with the black and white issue.

  • Matt Allen G author
    3 years ago

    I have yet to experience that but it seems like a common issue, deficits in one eye (bilateral) which makes sense, we have two optic nerves (one for each eye) so a lesion on one would not affect the other

  • SuperTonya3
    3 years ago

    My eye only recovered maybe 20%. I have a large scotoma in the center of my vision and the colors I can see are dull/gray/desaturated. Everything is very blurry and none of my issues can be corrected by glasses. (I have glasses but the lens on my bad eye is literally just clear glass.) It’s been five years now so there will be no further recovery unless repair therapy is found.

  • Matt Allen G author
    3 years ago

    That is what scares me about my vision; it gets progressively worse and vision is important to me so my only hope is they develop a therapy to reverse damage…

  • Darlene
    3 years ago

    Hello! I was diagnosed with MS August 3-2015. As I’m learning about MS I am thinking I may have had it for about 16-17 yrs.. I haven’t been diagnosed with optic neuritis, but I have had issues with my eyes that make me wonder if those issues are related to MS. yrs. ago I experienced a lot of pain when I moved my eyes from side to side. It was too painful to walk down a grocery aisle and look from side to side. I have had extremely sharp stabbing pain in my eye, usually the same side. It is fleeting thank God, but very painful. I have had experiences of blurry vision, like the Vaseline over your eye example. I have dry eyes so I have attributed it to that, but now I wonder. Has anyone had similar experiences that the Dr. has attributed to MS. Thank You in advance for any insight into my post!

  • Matt Allen G author
    3 years ago

    I can’t say I have really had pain but it is common so I would definitely ask your doctor about it, have you tried steroids for it?

  • Carole
    3 years ago

    My ON was very similar to yours. However, my residual slightly blurred vision is not able to be corrected by lenses. The blur worsens when I’m overheated or very tired. Thankful my left eye functions an compensates for problems with right eye.

  • Matt Allen G author
    3 years ago

    Heat and fatigue make my vision so blurry in a matter of minutes! Luckily, aside from when it’s hot or I am tired, the glasses help a lot but it has got to the point where I never really feel like I am wearing “the right” prescription…

  • Bogeydog
    3 years ago

    Thank you!!!!
    People have looked at me strangely whenever I describe my previous symptoms as “losing the color vision in my right eye”. When I say I saw black and white out of one eye and color out of the other, they think I’m nuts!! Or lying. And when I describe getting my color vision back but it looks “like I’m wearing sunglasses- a bit darker”, I get the same looks. Finally an article that describes it perfectly!!! So grateful to read I am not alone! I was diagnosed 27 years ago. My motto is, “I have MS but MS doesn’t have me!! :~}

  • Matt Allen G author
    3 years ago

    I think it’s hard for people to understand something THEY can’t see,

  • Tripping on Air
    3 years ago

    I have optic neuritis and it sucks. Sometimes it helps to laugh. So I wrote this
    http://alicetrippingonair.blogspot.com/2015/08/the-10-advantages-of-being-legally-blind.html?spref=bl

  • mascha
    3 years ago

    I had blurry vision a good year before things went wrong.The night before I had a very bad headache and painfull eye.The next morning I woke up and had lost my vision.I could only see slightly.During the day it got worse and lost all vision in one eye.I got IV infusion for 3 days and prednison for a few days after.My vision got back to about 75%. I have not had any more check ups since 3 yrs ago when it occurred.when stressed it gets painfull and seems vision less sharp.Thanks for your explanation.

  • Matt Allen G author
    3 years ago

    I have never completely lost my vision; I had a blind spot in my left eye but I learned to work with it until it “went away”, totally blind would scare me

  • Rich
    3 years ago

    I’m now 69 and was “formally” diagnosed with MS in 2009. In 2002, we were returning from the fireworks on July 4th. Joking about bumper stickers and license plate we saw. Part way home I commented about a smear in my left eyeglass lens. It was like there was Vaseline smeared on it. Got home and took them to clean them and said OOPPS, not the glasses. Next day our family clinic DR. took a look and referred my to Ophthalmologist, ordered a couple of MRI’s and a field of vision test. The following Monday, I was with the head of the Ophthalmology dept at the states University hospital. Looked at the eyes and previous tests and agreed with the previous doctor. His diagnosis was PION, (posterior ishemic optic neuritis). He didn’t give my an RX or anything, except to hand me a sheet about PION. Told me to read it and if any questions, he would answer them. I said, “Doc, if I could read this, I wouldn’t be here.” Since then, I get a yearly eye exam. My neuros or family MD’s haven’t done anything to help my vision.

  • Matt Allen G author
    3 years ago

    Not even steroids? How unhelpful…

  • jim
    3 years ago

    I’m with you, Rich. That’s exactly what happened to me nd how I describe it to folks; like Vaseline was smeared on the bottom of my glasses, even though I wasn’t wearing glasses! I was diagnosed with NAION, nonarteritic anterior optic neuritis.
    Funny thing is, my neurologist says it may, or may not , be connected to my transverse myelitis. I’m no doctor, but the fact that they both occurred within weeks of each other is all the proof I need.
    Regards,
    Jim Nolan

  • Princeton
    3 years ago

    I had optic neuritis in 1970. I first got MS in 1961. It was after a traumatic experience. It was very painful. To avoid the pain when I moved my head or my eyes, I had to close one eye. Vision deteriorated. It was like a window shade had been drawn but from the bottom up. Things were black unilaterally in my left eye. I was being treated at Duke university with oral steroids and things cleared up in three months. I was left with a blind spot but I quickly adapted and seem to have no further problems. When I am very stressed now my eye is painful but very briefly.

  • Matt Allen G author
    3 years ago

    I had/have a blind spot in my left eye as well. I also adapted but luckily I haven’t really had issues with eye pain (knock on wood)!

  • Jeany
    3 years ago

    I am a 53 year old female. I was only diagnosed in 2013 after having a second episode. The first was in 2010 but at that time I was told it was Lymes. Strangly enough around 35 years ago when I was only 18 I was diagnosed with an eye disorder called “Voght Haradas Syndrome”. It cause pain, blurry vision, color vision issues, side vision issues, etc. I was treat with prednisone. This syndrome has re-occured multiple times (like every 3 years). I tend now to wonder if this was the begining of my MS.

  • Matt Allen G author
    3 years ago

    I would be willing to bet that was the first bit of MS, it sounds like it but I guess we will never know huh?

  • Elizabeth S.
    3 years ago

    I developed optic neuritis in my right eye 5 yrs ago. Tried heavy doses of steroids both orally and IV with very little to no improvement. Ended up blind in the right eye. Can basically only see very,very dark shadows & faint grey images out of that eye now. I know there has been some research with a new protein in regards to treating optic neuritis so I am hopeful that one day I might regain some of my vision back in that eye. In the meantime I have accepted the blindness and not being able to drive because of it & poor depth perception & decreased field of vision in the left eye. I am just grateful for the vision I have in my L eye and pray that I don’t wake up one day with optic neuritis in it. For now it is what it is and life goes on

  • Matt Allen G author
    3 years ago

    I can only hope you will find some form of improvement, vision is so important to me, I don’t know what I would do if I lost it!~ I already have oscillopsia and that is all I can bare!

  • mclara
    3 years ago

    if you take oral prednisone for a long stretch of time (I was on it for 4 1/2 years to keep optic neuritis under control) watch out for cataracts. The cataracts tend to be on the aggressive side. This was a side effect that was a surprise. Finally off oral and do daily steroid eye drops every day.

  • Matt Allen G author
    3 years ago

    Wow, 4.5 year??? I thought the 6 months I was on them was a long time!

  • ONFrequentFlyer
    3 years ago

    I am an ON “frequent flyer”. I have had it 6 times this YEAR alone. As I type, I am recovering from the 6th bout.

    May I suggest that red is never a good color to use (especially in an ON post), it is incredibly hard to see when you are flaring with this.

    That said. I can handle all my symptoms, but the neuritis scares the bejesus out of me. One day I’m going to wake up blind in my left eye, I just know it.

    Neuritis is painful, terrifying, and lonely. You look fine, but the irony is that you can’t see.

  • Matt Allen G author
    3 years ago

    Yes, no one can SEE how “you” can NOT see, and yeah, I try to always avoid red on my own blog, I hate red anyways! haha

  • cw
    3 years ago

    Matt – very good explanation. This is what happened to me. My first ‘attack’ was in 5th grade but I wasn’t diagnosed until I was 28. Glad you were dx’d so soon. For me, at first it was only one eye but has progressed to both. Hope you are doing okay.Thanks for sharing.

  • Matt Allen G author
    3 years ago

    That must have been scary at such a young age? Thank you, you as well!

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