Carol Amburn/Region 5

Papillitis—Optic Neuritis

Definition—Papillitis/Optic Neuritis is an inflammation of the optic nerve, the bundle of nerve fibers in the eye that transmits visual information to your brain.

 Develops due to an autoimmune disorder triggered by a viral infection

 Pain and temporary vision loss

 May be an indication of multiple sclerosis, condition resulting in inflammation and damage to nerves in your brain and spinal cord.

 Most recover from a single episode of optic neuritis

 Treatment with steroid medication may speed vision recovery

Symptoms—Usually affects one eye, although it may occur in both eyes simultaneously.

 Pain—worsened by eye movement

 Visual loss—should it occur, develops over the course of a day to two weeks

 Loss of color vision—color of objects, particularly red ones, temporarily appear “washed out” or less vivid than normal

Causes—Optic neuritis in young adults is believed to happened when the immune system attacks myelin covering the optic nerve, resulting in inflammation and damage

 Multiple Sclerosis  Neuromyelitis Optica

 Infections—Bacterial infections, including Lyme disease, cat scratch fever and syphilis, or viruses such as HIV, hepatitis B and herpes

 Cranial Arteritis

 Diabetes

 Drugs—One of these drugs is ethambutol (Myambutol), which is used to treat tuberculosis

Risk Factor

 Age—Often affects young adults ages 20 to 45 years. Average onset is about 30 years. Occurs less frequently in older people or children

 Sex—Women are twice as likely to develop optic neuritis

 Race—Optic neuritis occurs more in white

 Genetic mutations—May increase risk of developing optic neuritis or multiple sclerosis

Test and Diagnosis—Definitive diagnosis should be determined by an ophthalmologist.

 Ophthalmoscopy—Bright light is shined into the eye examining the structure at the back of the eye.

 Pupillary Light Reaction Test—Determines how pupils respond to bright light. Pupils affected by optic neuritis don’t constrict as well as healthy eyes do when stimulated by light  Visually Evoked Potentials Test—Records brain’s responses to visuals

 Magnetic Resonance Imaging (MRI) scan

 Blood Test

Treatment and Drugs

 Intravenous Steroids

 Oral Steroids

 Plasma Exchange Therapy—Used when steroid therapy has failed and severe vision loss persists

References

1. Dictionary of Eye Terminology 5th Ed., Barbara Cassin and Melvin L. Rubin, MD, Editor, 2006. Gainesville: FL, pg 200.

2. Ophthalmology made ridiculously simple 4th Ed., Stephen Goldberg, M.D. and William Trattler, M.D., 2008 Miami: FL pg 38.

3. http://www.healthscout.com/ency/68/413/main.htm/

4. http://www.mayoclinic.com/health/optic-neuritis/DS00882

5. http://www.wrongdiagnosis.com/p/papillitis/intro.htm