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 patients a better chance of recovery. Most children get their vision back after treatment with medication.
What Causes Optic Neuritis?
Experts think that the cause is an over-response of the immune system (that is, 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).
What are 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
How is Optic Neuritis Diagnosed?
Optic neuritis can be difficult 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.
How is Optic Neuritis Treated?
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 some 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.
