Optical neuritis is inflammation of the eye nerve, where the nerve loses its protective layer called myelin. In the absence of myelin, visual signals cannot be sent properly to the brain, resulting in impaired vision, such as blurred or blurred vision. Optical neuritis can affect both adults and children. But this disorder is most often found in women aged between 20 and 40 years.
In general, optic neuritis can recover completely after treatment, although in a small number of cases there is a permanent visual impairment, such as night blindness or color blindness. for example dusk blind or color blind. And in patients with multiple sclerosis, an increase in temperature can re-trigger symptoms of optic neuritis, for example when taking a warm bath, exercise, fever, or when going to the flu.
Symptoms of Optical Neuritis
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Optical neuritis usually only attacks one eye. Symptoms include:
- Vision decreases.
- Reduced ability to see color differences.
- The viewing room narrows, the shadow on the edge is not clearly visible.
- Pain in the eyes, especially when the eyeball is moved.
- Blindness (rare).
Causes of Optical Neuritis
Inflammation and optic nerve damage are thought to be caused by an autoimmune disorder, which is a disorder of the immune system where the immune system attacks the body itself. In this disorder that is attacked by the body's immune system is the myelin membrane. Some autoimmune diseases associated with optic neuritis are multiple sclerosis and neuromyelitis optical. The percentage risk of recurrent neuritis in patients with multiple sclerosis is around 50 percent.
Besides these two autoimmune diseases, several other factors that can also cause optic neuritis are:
- Medicines, such as some types of antibiotics and quinine pills.
- Bacterial infections (for example syphilis and Lyme disease) or viral infections (for example measles, herpes, and mumps).
- Other diseases, such as sarcoidosis, lupus, vascular disease, diabetes, glaucoma and vitamin B12 deficiency (very rare).
Diagnosis of Optical Neuritis
Examinations to diagnose this disorder include routine eye examinations, tests of pupillary reactions to light, and ophthalmoscopy to examine the structures behind the eyes, including the optic nerve.
Other diagnostic support tests that can be done:
- Blood tests, to check for possible optical neuromyelitis in cases of severe optic neuritis, by detecting related antibodies.
- MRI to determine the area of damage to the brain.
- Optical coherence tomography (OCT) to examine the thickness of retinal nerve fibers is often thinner in cases of optic neuritis.
- Visually evoked response test to assess the electrical conduction velocity of the optic nerve which in the case of optic neuritis usually slows down.
Treatment of optic neuritis
Optical neuritis generally resolves on its own. But to help speed healing, injections of high-dose steroids can be done. Steroid drugs can also slow the progression of multiple sclerosis. However, the use of this drug in some people causes side effects, such as weight gain, stomach upset, insomnia, and mood swings.
Another treatment for optic neuritis is intravenous immunoglobulin (IVIG), which is usually given in cases of optic neuritis that are already severe and can no longer be overcome by steroid drugs. In the case of optic neuritis due to vitamin B12 deficiency, the treatment is by administering vitamin B12 injections.
In most cases of optic neuritis, the patient's vision returns to normal within 12 months. Recurrence can occur, in patients without autoimmune disorders. However, the possibility is smaller compared to patients with multiple sclerosis or neuromyelitis optica.
Complications of Optical Neuritis
Complications that can occur due to optic neuritis are a decrease in visual acuity and blindness.
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