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Vision Loss Due to Optic Neuritis


What is Optic Neuritis?

Optic neuritis is an inflammatory condition characterized by damage to the protective covering (myelin sheath) that surrounds the optic nerve. This leads to acute loss of vision.


What Causes Optic Neuritis?

There are many possible causes, however it is most commonly found in those with multiple sclerosis (MS). MS is diagnosed in about 15 to 20 percent of patients that have optic neuritis. Other causes include:

  • Inflammatory diseases, such as rheumatoid arthritis, scleroderma, granulomatosis with polyangiitis[1], churg-strauss syndrome, lupus[2], Sjogrens disease[3], sarcoidosis, microscopic polyangiitis, Guillain-Barré syndrome, polymyositis/dermatomyositis, inflammatory bowel disease[4], Behcet syndrome (rare cause)[5]

  • 1-3 weeks after a viral disease, such as measles, mumps, chickenpox, influenza and Epstein-Barr virus

  • Rarely, from growth or masses pressing on the optic nerve (eg. tumor, abscess)

  • Genetic causes, such as Leber hereditary optic neuropathy, Kjer-type autosomal dominant optic atrophy

  • Toxic causes, such as drugs

  • Nutritional deficiencies

  • Radiation

  • Trauma


Symptoms of Optic Neuritis

  • Usually vision loss occurs in just one eye; if both eyes are affected usually other conditions are suspected

  • Approximately 92% of individuals have eye pain[6]

  • Central blindspot (scotoma)


Symptoms of Connective Tissue Disorders

If optic neuritis is caused by a connective tissue disorder, other symptoms that may also be found include:

  • Difficulty breathing

  • Shortness of breath

  • Breathlessness

  • Fatigue

  • Chronic cough

  • Chest discomfort or pain

  • Swelling in the fingers

  • White fingertips

  • Numb fingertips

  • Joint pain or weakness

  • Muscle weakness


Prognosis

The prognosis and outcome of optic neuritis depends on the cause. For example - after infections, most people usually regain full vision. While most patients tend to have a full recovery, some may experience persistent symptoms. These symptoms may include: vision loss, temporary flares or exacerbations (during hot showers or exercise), and colors may look washed out.

Natural Therapies and Naturopathic Support

At our clinic we complete blood testing to rule out inflammatory and autoimmune conditions. Physical exams are also usually done to help diagnose other potential causes. Blood testing is done for nutritional deficiencies and subsequent supplementation can be used to address nutritional causes. An autoimmune or anti-inflammatory diet may be created and implemented, depending on the case. There are many herbal and supplemental options that can be used to help further address an overactive immunity or high levels of inflammation.

[1] Monteiro ML, Borges WI, do Val Ferreira Ramos C, Lucato LT, Leite CC. Bilateral optic neuritis in wegener granulomatosis. J Neuroophthalmol. 2005 Mar;25(1):25-8. doi: 10.1097/00041327-200503000-00007. PMID: 15756129. [2] Theodoridou A, Settas L. Demyelination in rheumatic diseases. J Neurol Neurosurg Psychiatry. 2006 Mar;77(3):290-5. doi: 10.1136/jnnp.2005.075861. PMID: 16484634; PMCID: PMC2077679. [3] Delalande S, de Seze J, Fauchais AL, Hachulla E, Stojkovic T, Ferriby D, Dubucquoi S, Pruvo JP, Vermersch P, Hatron PY. Neurologic manifestations in primary Sjögren syndrome: a study of 82 patients. Medicine (Baltimore). 2004 Sep;83(5):280-291. doi: 10.1097/01.md.0000141099.53742.16. PMID: 15342972. [4] Gupta G, Gelfand JM, Lewis JD. Increased risk for demyelinating diseases in patients with inflammatory bowel disease. Gastroenterology. 2005 Sep;129(3):819-26. doi: 10.1053/j.gastro.2005.06.022. PMID: 16143121. [5] Kansu T, Kirkali P, Kansu E, Zileli T. Optic neuropathy in Behçet's disease. J Clin Neuroophthalmol. 1989 Dec;9(4):277-80. PMID: 2531168. [6] The clinical profile of optic neuritis. Experience of the Optic Neuritis Treatment Trial. Optic Neuritis Study Group. Arch Ophthalmol. 1991 Dec;109(12):1673-8. doi: 10.1001/archopht.1991.01080120057025. PMID: 1841573.

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