World MS Day – understanding optic neuritis

This Thursday, 30 May marks World MS Day; a day of global solidarity, collective action and hope to help recognise and raise awareness about multiple sclerosis and support those affected by the condition.

A complex and often unpredictable neurological condition that can manifest in various ways, MS affects the brain and spinal cord.

Among the many symptoms associated with MS, optic neuritis (ON) is one of the most common and, according to MS Australia, for 1 in 4 people the first MS symptom that they noticed.

What is optic neuritis? 

Optic neuritis is an inflammation of the optic nerve, which transmits visual information from the eye to the brain. This condition can cause a range of visual disturbances, from mild blurriness to significant vision loss. Optic neuritis can occur on its own but is often associated with multiple sclerosis, serving as an early indicator of the disease in some cases. 

Connection between optic neuritis and multiple sclerosis 

Multiple sclerosis is characterised by the immune system attacking the protective myelin sheath that covers nerve fibres, leading to inflammation and damage. It is estimated that about 50% of people with MS will experience eye-related problems at some point during their disease course, with optic neuritis being the most common. 

Symptoms of optic neuritis 

The symptoms of optic neuritis can vary but commonly include: 

  • Sudden vision loss, worsening over days 
  • Eye pain, particularly when moving the eyes 
  • Changes in colour vision - colours may appear less vivid or washed out and some people experience a significant reduction in their ability to distinguish colours 
  • Flashes of light or flickering 

Symptoms tend to peak within a few days to two weeks and then gradually improve, although recovery can take several weeks to months. 

Diagnosing optic neuritis 

An optometrist can play a crucial role in the initial detection and evaluation of optic neuritis.  

By conducting a comprehensive eye examination, an optometrist can perform the following tests and assessments to determine the presence of optic neuritis: 

  • Asking detailed questions about the onset, duration and nature of vision changes and other symptoms that may suggest optic neuritis  
  • Conducting a vision test to assess the sharpness of vision using standardised eye charts 
  • Testing for colour vision changes to reveal subtle changes in colour perception 
  • Evaluating the how the pupils respond to light, which can be indicative of optic nerve function 
  • Examining the optic nerve for signs of swelling or other abnormalities 
  • Conducting visual field tests to detect peripheral vision loss or blind spots

Next steps after an ON diagnosis 

Management and treatment of optic neuritis involves a combination of approaches to reduce inflammation, manage symptoms and address underlying conditions like MS. 

The goal is to speed up recovery, prevent complications and provide supportive care. 

Upon confirmation of an optic neuritis diagnosis, treatment typically involves high-dose intravenous (IV) corticosteroids, which may be followed by oral corticosteroids. 

Regular follow-up appointments with a neurologist and an optometrist are crucial, including periodic MRI scans to monitor MS progression (if confirmed) and visual function tests to manage any ongoing visual impairment.

A final thought 

Research into new treatments for optic neuritis and multiple sclerosis is ongoing.  

Emerging therapies include neuroprotective agents aimed at protecting nerve cells from damage, remyelination therapies designed to promote the repair of the myelin sheath and experimental stem cell therapy to repair or replace damaged nerve tissue. 

Understanding the connection between optic neuritis and MS, recognising the symptoms and seeking timely diagnosis and treatment are vital steps in managing this condition.  

With the right care and support, individuals with MS and optic neuritis can navigate the challenges of these conditions and maintain a fulfilling life. 

If you are experiencing changes to your vision or are concerned about your eyesight, you can use our Find an Optometrist search tool to schedule an appointment with your local optometrist today. 

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