What's the Connection Between MS and Optic Neuritis?

Written by Robin Madell | Published on December 11, 2013
Medically Reviewed by George Krucik, MD, MBA on December 11, 2012

If you have MS, you may be at risk. Find out why.

First Sign

Your optic nerve is responsible for transmitting images from your eyes to your brain. If the nerve becomes inflamed, it results in a condition called optic neuritis. This can cause vision loss, seeing flickering lights, and other symptoms.

For many people, optic neuritis is the first sign of MS. And according to the National Multiple Sclerosis Society (NMSS), the condition affects 66 percent of people with multiple sclerosis (MS).

What’s Your Risk?

Optic neuritis often occurs in connection with an autoimmune disorder such as MS. If you have an autoimmune disorder, other factors that increase your risk of optic neuritis include:

  • being a woman. According to the Mayo Clinic, women have double the chance of developing the condition compared to men.
  • being 20-40 years old. The average age for the start of optic neuritis is about 30 years old.
  • being white. White people are more likely to develop optic neuritis.
  • genetics. Some people have genetic mutations that increase their chance of optic neuritis.

How Do You Know If You Have It?

Your doctor can recommend a number of tests to help diagnose optic neuritis.

If your doctor suspects optic neuritis, they will likely refer you to an eye specialist, called an ophthalmologist. Common tests used to diagnose the condition include:

  • ophthalmoscopy, which examines your optic disk for swelling
  • pulpillary light reaction test, which tests how your pupils respond to light
  • MRI scan, which allows for better viewing of your optic nerve
  • visual response test to detect optic nerve damage

Watching for Relapse

If you have MS, you may experience a flare-up or relapse—also called an “exacerbation.” When this happens, you may notice that your symptoms worsen, or that you have new symptoms.

Relapse may occur if your optic nerves becomes inflamed and affects your vision. If this happens, you might only notice one symptom, or the relapse may have multiple symptoms.

For example, if you have inflammation in different parts of your central nervous system, then you may have an optic neuritis episode as well as other symptoms, like fatigue or balance problems.

Progression and Treatment

It’s impossible to predict if optic neuritis will progress to MS, according to the American Academy of Ophthalmology (AAO). But, since optic neuritis is often the first sign of MS, it’s important to get an accurate diagnosis.

If you are diagnosed with optic neuritis, it may present a window of time for your doctor to try to prevent or delay MS. However, some experts recommend delaying MS treatment unless brain lesions are visible on an MRI.

An ophthalmologist or neurologist is the best person to advise you on possible progression from optic neuritis to MS. Your doctor can help you make treatment decisions.

Preventive Measures

If your symptoms don’t get better on their own, some medications may help speed your sight recovery. Steroids are commonly used to treat optic neuritis, and they help reduce optic nerve inflammation.

Steroids may be given intravenously or in pill form. In cases of severe vision loss, your doctor may recommend another treatment called plasma exchange therapy.

If your risk is high for developing MS due to optic neuritis, certain injectable medicines might help with MS prevention as well. Medications commonly used to prevent MS include Interferon beta-1a and interferon beta-1b.

What’s the Prognosis?

According to the Mayo Clinic, if you have only one bout of optic neuritis, you will likely get your vision back. In fact, the condition often improves within a year without treatment.

If you have optic neuritis but don’t have MS, you may have vision problems in the future, but your prognosis for improved long-term vision is better than if you do have MS.

However, if you experience the condition and also have MS, you may be more likely to experience recurring symptoms of optic neuritis.

Look for Signs

Optic neuritis symptoms are the first signs of multiple sclerosis in as many as 20 percent of people with MS, according to the Mayo Clinic.

If you have eye pain, experience loss of vision, or see flashing lights, see a doctor right away. Fast action can help prevent permanent vision loss or other serious health problems.

If you notice new symptoms such as a change in how well you can see, seek medical help. Also be aware of worsening symptoms if you already have optic neuritis, especially if your symptoms aren’t responding to treatment.

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