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Optic Neuritis in Children

What Is Optic Neuritis?

Your optic nerve carries information from your eyes to your brain. It helps you understand what you’re seeing. When the nerve becomes inflamed, it is called optic neuritis. Optic means “eye,” and neuritis means “inflammation in the nerve.”

Optic neuritis can cause mild to severe vision loss. It is rare in children. It affects about one in 200,000 children.

Early diagnosis and treatment give the child a better chance of recovery. Most children get their vision back after treatment with medication.

Optic Neuritis Causes

Experts think that the cause is an over-response of the immune system (i.e., an autoimmune disorder). This means the body’s immune system attacks the optic nerve.

It can be sudden and can be caused by an infection (virus), inflammation, or a genetic condition. It may also be a first symptom of autoimmune diseases like lupus or multiple sclerosis (MS).

Optic Neuritis Symptoms

Symptoms can be different from child to child. Common symptoms of optic neuritis in children include:

  • Rapid and severe decrease in vision in one or both eyes
  • Headaches
  • Pain with eye movement
  • Decreased central vision (looking straight ahead)
  • Reduced ability to see colors or brightness – especially reds or greens

Optic Neuritis Diagnosis

The disorder can be challenging to notice early. A child may not be aware of a change in vision if only one eye is affected. Parents may not notice a problem until the healthy eye is covered.

A pediatric neuro-ophthalmologist is a specialist who treats problems with the optic nerve and loss of vision. To diagnose optic neuritis, this doctor may:

  • Ask about symptoms
  • Ask about recent fever, flu-like illness or vaccines one to two weeks before the change in vision
  • Perform an eye exam to test close and distant vision and change in pupil size when reacting to light
  • Measure how much a child can see to the front and sides, and ability to see color and shades of color

Other tests may include:

  • Optical coherence tomography (OCT). This eye-imaging device looks for swelling and damage to the optic nerve. A device sends light waves through the eye to create high-quality pictures of the optic nerve and eye.
  • Magnetic resonance imaging (MRI). This imaging test uses a large magnet and radio waves with contrast dye to look for areas of inflammation in the brain and spine.
  • Blood tests.
  • Spinal cord tap. The doctor removes some fluid around the brain or spinal cord to test substances in the spinal fluid.

Optic Neuritis Treatment

The goal of treatment is to find and control inflammation in the optic nerve. First, a child receives steroids through the veins to quiet the inflammation. This helps speed recovery.

In cases that are caused by an autoimmune disease, doctors may prescribe medicines that calm the immune system (called immunotherapies) to improve symptoms. They also help prevent optic neuritis from coming back.

Optic Neuritis Long-Term Outlook

With correct diagnosis and treatment, most children get all their eyesight back. However, up to 24% of children don’t fully recover their vision. This happens if there is a delay in diagnosis or in getting the right treatment.

With certain syndromes, it is possible that optic neuritis can happen again and cause more damage to the nerve. Also, some causes of optic neuritis, such as neuromyelitis optica (NMO), can create severe vision loss.

The Multiple Sclerosis and Neuroimmunology Center is home to specially trained doctors who treat optic neuritis in children. Our team is prepared to care for your child’s unique needs, from diagnosis to treatment to long-term follow-up. Receiving this well-coordinated care in one location can improve outcomes.

Last Updated 08/2021

Reviewed By Veeral Shah, MD

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For more information or to schedule an appointment, contact the Multiple Sclerosis and Neuroimmunology Center.

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