visible part – optic disc (papillitis of the optic nerve) or the part of the nerve behind the eyeball (retrobulbar neuritis).
Symptoms of optic neuritis are loss of vision in the affected eye, eye pain at movement, central scotoma, and afferent pupillary defect.
Afferent pupillary defect or Marcus-Gunn pupillary reaction is an abnormal phenomenon in which the pupil reacts to light with constriction rather than dilation. This reaction is a sensitive sign of optic neuritis and other diseases that affect the afferent implementation in the visual path.
At papillitis the optic disc looks similar as in the edema of the optic disc; the difference is that the loss of vision at papillitis is the initial symptom, while at the edema of the optic disc the loss of vision occurs after a longer period of time. Besides, the edema of the optic disc is usually bilateral, while neuritis is unilateral.
At retro-bulbar neuritis eye background looks normal, so it is said that neither the doctor nor the patient can see anything.
The cause of retro-bulbar neuritis in most cases is unknown. However, with over 40% of our patients, in the next few years multiple sclerosis has developed.
In some patients with optic neuritis atrophy of the optic nerve has developed after a few weeks.
Other possible causes of optic neuritis and atrophy of the optic nerve are infection, congenital disease, vascular occlusion, tumors, trauma, and glaucoma.
Vision usually improves after several weeks, even without therapy. Steroids are often given retrobulbary or systemically. The correct procedure is to give systemic steroids, and only in cases where the testing with nuclear magnetic resonance has proven the existence of lesions or plaques in the visual nerve.