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Optic Neuritis

Overview

Optic neuritis is an inflammation of the optic nerve that can cause sudden vision loss, eye pain, and color vision changes. It is considered an immune-mediated condition, meaning that the immune system mistakenly targets the optic nerve. While optic neuritis can occur on its own, it is frequently associated with autoimmune diseases such as multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). In some cases, optic neuritis may be the first symptom of an underlying autoimmune or demyelinating disorder.

Common Symptoms

Sudden vision loss in one eye, pain with eye movement, blurred or dim vision, reduced color perception, flashing lights (photopsia), and a decrease in visual field or peripheral vision.

Coexisting Diseases and Conditions

Optic neuritis is commonly associated with autoimmune and demyelinating diseases such as multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). It may also occur alongside systemic autoimmune diseases like systemic lupus erythematosus (SLE) and sarcoidosis, although less commonly.

Risk Factors and Prevalence

Risk factors for developing optic neuritis include being between the ages of 20 and 40, female sex, genetic predisposition to autoimmune diseases, and having a history of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), or myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

In rare cases, optic neuritis has been associated with infections such as measles, mumps, rubella, Epstein-Barr virus, and herpes viruses. Older formulations of rabies vaccine, no longer in use, were historically linked to optic neuritis.

Optic neuritis is relatively uncommon but is one of the most frequent early signs of multiple sclerosis. Studies suggest that approximately 15% to 20% of people with MS experience optic neuritis as their first clinical event.

Recent Research

Sources

  1. Sources

    1. Balcer L. J. (2001). Optic Neuritis. Current treatment options in neurology, 3(4), 389–398. https://doi.org/10.1007/s11940-001-0043-4

    2. Guier CP, Kaur K, Stokkermans TJ. Optic Neuritis. [Updated 2025 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557853/

    3. 16th EUNOS Congress: Rotterdam, The Netherlands, 3–6 June, 2024 Editors’ Introduction. (2024). Neuro-Ophthalmology, 48(sup1), 1–165. https://doi.org/10.1080/01658107.2024.2342769

    4. Bennett J. L. (2019). Optic Neuritis. Continuum (Minneapolis, Minn.), 25(5), 1236–1264. https://doi.org/10.1212/CON.0000000000000768

    5. Toosy, A. T., Mason, D. F., & Miller, D. H. (2014). Optic neuritis. The Lancet. Neurology, 13(1), 83–99. https://doi.org/10.1016/S1474-4422(13)70259-X

    6. Gise, R. A., & Heidary, G. (2020). Update on Pediatric Optic Neuritis. Current neurology and neuroscience reports, 20(3), 4. https://doi.org/10.1007/s11910-020-1024-x

    7. Benard-Seguin, E., & Costello, F. (2023). Optic neuritis: current challenges in diagnosis and management. Current opinion in neurology, 36(1), 10–18. https://doi.org/10.1097/WCO.0000000000001128

    8. Abel, A., McClelland, C., & Lee, M. S. (2019). Critical review: Typical and atypical optic neuritis. Survey of ophthalmology, 64(6), 770–779. https://doi.org/10.1016/j.survophthal.2019.06.001