Optic neuritis

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Optic neuritis means inflammation (swelling) of your optic nerve. For most people, although this can cause some problems with vision in the short term, optic neuritis normally gets better on its own and does not usually cause any lasting loss of vision. 

Optic neuritis commonly involves the central area of your vision. However, any area of your vision (your visual field) may be affected.

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Our guide has been written to give you a detailed understanding of optic neuritis and helpful advice on next steps.

How optic neuritis affects sight

Optic neuritis usually causes a reduction or loss of vision in at least one eye. For many people with optic neuritis, vision typically gets worse over a period of several days to two weeks and then begins to improve.

Optic neuritis commonly involves the central area of your vision. However, any area of your vision (your visual field) may be affected.

You may also find that your colour vision is affected. Colours, particularly reds, may appear "washed out" or less bright than usual.

When your vision is first affected it may be common to experience discomfort or pain around your eyes, which might get worse when you move your eyes. This pain should not be so great that it stops you sleeping at night.

Causes of optic neuritis

Although optic neuritis can have a few different causes, the most common cause is "autoimmune". This means that your body's defence against infection, your immune system, attacks your body's own tissue. Sometimes it may not be possible to work out what the cause of your optic neuritis is. This is called "idiopathic" optic neuritis.

Demyelinating optic neuritis

The most common type of optic neuritis is demyelinating optic neuritis, this where the protective myelin coating on your nerve fibres breaks down. This loss of the myelin coating can slow down or stop the signal being carried by the nerve to your brain. This can then affect your vision.

Optic neuritis can also be caused by other rarer conditions. These can be described as parainfectious, infectious and non-infectious optic neuritis.

Optic neuritis and multiple sclerosis (MS)

There is an association between demyelinating optic neuritis and MS. MS is a demyelinating condition that can affect any part of the central nervous system (CNS). The CNS includes the brain and spinal cord.

If you are diagnosed with demyelinating optic neuritis, your ophthalmologist may discuss the possibility that this could be linked to MS. However, it is important to remember that not everyone who has acute demyelinating optic neuritis will be diagnosed with MS or will develop MS in the future. 

Treatment for optic neuritis

Optic neuritis usually gets better on its own and normally does not cause any lasting loss of vision. With time the majority of people with optic neuritis will make a good visual recovery and will not require any treatment. However, in some situations treatment may be felt to be helpful. Treatment, if needed, is a combination of high dose intravenous and oral (tablet) steroids.

This treatment can help speed up recovery, but makes no difference to how well your vision recovers in the long term, and so the benefits need to be weighed against the negative side effects of taking a high dosage of steroids. Most people with optic neuritis do not have steroid treatment.

If you are experiencing discomfort or pain because of optic neuritis and this is very uncomfortable, your GP or ophthalmologist should be able to advise you about pain relief. It may be possible to improve things with over-the-counter painkillers. This pain or discomfort should only normally last for a few days.

Recently diagnosed

Being diagnosed with an eye condition can be very upsetting. You may find that you are worried about the future and how you will manage with a change in your vision. We’re here to support you every step of the way – just give our Helpline a call. 

You might also find it helpful to talk to our Eye Health team about your eye condition, get support from our Sight Loss Counselling service, or find out how to register as sight impaired.

Below are some guides that may be useful:

Getting emotional support

Staying in work

Making the most of your sight

You can get support with your eye condition with RNIBGet in touch

If you've got any questions, speak to us by calling our Helpline on 0303 123 9999.

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Helpful organisations

The Multiple Sclerosis (MS) Society provides information and support to anyone affected by MS, including those with suspected MS but no diagnosis.

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