Multiple sclerosis can damage the nerves that lead to the eye, resulting in optic neuritis. Symptoms of optic neuritis include vision problems, painful eyes, and temporary vision loss.

Multiple sclerosis (MS) can cause inflammation and damage to the myelin sheath in the optic nerve. The optic nerve is where nerve fibers come together in a bundle as they exit the globe behind the eye.

This damage is called optic neuritis. Although the symptoms of optic neuritis tend to subside over time, some people may also benefit from various treatments.

Visual disturbances are among the most common symptom that people with MS have. One 2014 study showed that optic neuritis is the first symptom of MS in about 15–20% of people with the condition.

In this article, we look at the link between MS and optic neuritis, along with its symptoms, causes, treatments, and diagnosis.

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MS is a chronic condition in which the immune system mistakenly attacks the protective myelin sheath that surrounds the nerve cells. These attacks damage these cells, causing inflammation and permanent scarring in the brain, spinal cord, and other nerves.

In MS, optic neuritis occurs when the immune cells attack the healthy, protective myelin sheath that surrounds the optic nerve, mistaking them for invading cells. This causes the myelin to swell up, which can lead to optic nerve damage.

The swelling disrupts the signals between the eye and the brain, causing visual disturbances that can include double vision, blurred vision, or blind spots.

Experts are not exactly sure why optic neuritis or MS happen, though new research aims to explore the genetic and environmental factors behind the condition.

MS is a complex condition that affects people in various ways. Because of this, people with optic neuritis from MS may have different experiences.

The symptoms of optic neuritis tend to develop quickly, between a few hours and a few days. Adults tend to experience symptoms in only one eye, but severe attacks can affect both eyes. Symptoms tend to gradually disappear over time, but some people may have lingering vision problems after an episode of optic neuritis.

Symptoms of optic neuritis include:

  • blurred vision
  • eye pain, especially when moving the eyes
  • a dull, aching pain behind the eyes
  • trouble seeing to the side of the field of vision
  • dim vision
  • a perception of flashing lights, known as photopsia
  • reduced color vision, or a graying of color
  • a blind spot or blank spot in the center of vision
  • partial vision loss, which may be worse after exercise or if the air or body temperature rises

Temporary vision loss is also possible but less common.

The symptoms of optic neuritis tend to come in flares, getting worse for a short time before getting better. Symptoms may also flare up in response to hot or cold temperatures.

In many cases, symptoms will go away on their own with no specific treatment. In some cases, doctors may still recommend treatments, such as if symptoms are severe.

What are 15 symptoms of MS in females?

The symptoms of optic neuritis usually resolve without medical treatment in a few weeks or months. However, continuing to take regular MS disease-modulating medication can help.

Intravenous or oral steroid treatment may help speed up the process of recovery. A doctor may recommend them if optic neuritis affects both eyes or if symptoms are severe.

It is advisable that a person who experiences optic neuritis as a new symptom of an MS flare check in with their doctor to evaluate their current treatment method and explore new solutions.

According to the MS Society, 80% of people start to notice an improvement within 3 weeks of symptoms appearing and 90% start to recover within 5 weeks.

The inflammation from an MS attack flares up and then subsides with time. The symptoms will likely follow the same pattern. After they first appear, symptoms may worsen for a few days before gradually getting better.

The length of a symptom flare will vary in each case. Although many people will notice their symptoms go away completely within a few weeks, others may have symptoms for a year or longer after an attack.

Detecting inflammation in the optic nerve early can help a doctor devise an appropriate treatment plan to help prevent further damage.

Diagnosis typically begins with a physical exam and the doctor asking some questions about the person’s medical history, including any medications they take. After this, the doctor will likely refer the person to a specialist called an ophthalmologist.

An ophthalmologist will perform an eye exam to check for changes in:

  • visual acuity
  • color perception
  • how well a person can view things from the side of their eye

They may also shine a light into the eye to test its reaction.

If they suspect that MS is the underlying cause, the doctor may order an MRI scan. This test creates a detailed scan of the brain to help doctors identify any scarring or signs of inflammation and nerve damage.

Other diagnostic tests for optic neuritis can include:

  • blood tests to search for specific proteins in the blood
  • ophthalmoscopy to check for inflammation in the optic nerve
  • lumbar puncture, also called a spinal tap, to check the fluid in the spinal cord and brain
  • visual-evoked response test to check how quickly the optic nerve sends signals to the brain

MS is not the only cause of optic neuritis. Other possible causes include:

A thorough diagnosis is important in each case to rule out other contributing factors and discover the true underlying cause of the symptoms.

Although optic neuritis can affect anyone with MS, some people may be at a higher risk.

Research shows that optic neuritis can most often affect young females.

People with other preexisting conditions that affect the eye may also be at greater risk, including those with diabetes or Devic’s disease.

What are MS exacerbations?

Many people fully recover their vision within several weeks or months, with or without treatment, and 90% of people start to feel better within 5 weeks.

However, people with MS may have a risk of similar attacks later on. According to the MS Society, around half of people with MS who have optic neuritis will have another attack within 10 years.

As MS progresses or severe attacks occur, changes in vision may become permanent.

Managing MS and slowing its progress with medical treatment can help manage this condition.

Does MS affect life expectancy?

Here are some questions people often ask about optic neuritis and MS.

Is optic neuritis related to multiple sclerosis?

Optic neuritis commonly affects people with MS and it probably results from a similar process. While experts still need to identify the cause, both optic neuritis and MS seems to happen when an autoimmune reaction damages the myelin sheath that surrounds neurons in the optic nerve.

How long does optic neuritis last in people with MS?

Optic neuritis usually takes from a few weeks to several months to resolve, and then a person’s usual vision can return. According to the MS Society, 8 out of 10 people see an improvement within 3 weeks, and 9 out of 10 begin to recover within 5 weeks. In some cases, however, there may be long-term visions changes.

Does optic neuritis come and go with MS?

Optic neuritis can come and go with MS. About half the people with MS will eventually have had at least one optic neuritis experience in the previous 15 years.

Optic neuritis refers to inflammation in the optic nerve, and it is a common symptom in people with MS. MS is not the only cause of optic neuritis, however, and a thorough diagnosis is important in each case.

The symptoms eventually subside on their own, in most cases. However, doctors may recommend treatment to help speed recovery. It is advisable that anyone experiencing optic neuritis from MS talk with their doctor to review their treatment and make any necessary changes.