Optic Nerve Disorder

Introduction

Sight is one of the essential senses that allow individuals to perceive and interact with their world. When conditions that affect the eye develop, the sense of sight and vision suffers. Optic nerve disorders are among the conditions that could cause one to lose their sight (Chan, 2014). Optic nerves are involved in the transmission of impulses from the eyes to the brain. The brain decodes these impulses thereby allowing an individual to make sense of what they see (Vogel & Pascucci, 2011). Optic nerve disorders can result when the nerves suffer damage. Alternatively this disorder may develop when damage to the pathways that link the nerves to the brain occurs. The ultimate result is that one suffers either partial or total loss of vision. Optic neuritis is one of the numerous optic nerve disorders. This condition forms the subject of this essay. Among other issues, the essay explores the causes of the condition, the symptoms that patients present and the different diagnostic and treatment options available. 

Optic neuritis

Optic neuritis is a condition of the optic nerves that is characterized by the inflammation of these nerves (Toosy, Mason & Miller, 2014). This condition usually develops in patients who suffer from such conditions as neuromyelitis optica and multiple sclerosis. This condition affects different individuals differently. There are those who fully regain their vision and others who lost such aspects of sight as contrast and brightness. Patients may also be unable to identify colors correctly. In the discussion below, different aspects of this condition are explored in detail. 

Causes

The medical community is still yet to conclusively determine the exact cause of optic neuritis. However, the community has gained insights into possible causes. It is believed that the response of the immune system to threats plays a role in the emergence of this condition (Brodsky, 2010). There are instances where the immune system identifies myelin as a threat. Myelin covers the optic nerve and when it is attacked by the immune system, an individual’s optic nerves become inflamed. One of the key functions of the myelin is that it accelerates the travel of impulses to the brain. Since it is targeted by the immune system, the myelin’s capacity to perform this function is impaired. The result is that one’s vision suffers. 

It has been noted earlier that optic neuritis is mostly reported by individuals who are ailing from multiple sclerosis and neuromyelitis optica (Demaerschalk & Wingerchuk, 2015). Essentially, these conditions could cause optic neuritis. Multiple sclerosis is similar to optic neuritis in that it also results when the immune system launches attacks against the myelin. On the other hand, neuromyelitis optica is characterized by the inflammation of the spinal cord and the optic nerves (Demaerschalk & Wingerchuk, 2015). Each of these illnesses exposes one to an elevated risk of developing optic neuritis. In the discussion that follows, other risk factors are examined. 

Infections are among the factors that increase the likelihood of an individual developing optic neuritis. Such bacterial infections as syphilis and Lyme disease are among the illnesses that are risk factors (Newman, Miller & Biousse, 2008). Lupus and sarcoidosis have also been blamed for exposing individuals to the threat of developing optic neuritis. Other than these illnesses, pharmaceutical treatment has also been identified as a risk factor. There are certain medications that could see one develop the condition. These drugs include certain antibiotics and quinine.

Risk factors

There are certain realities that enhance the chances of an individual developing optic neuritis. Age is among these. Adults who are in the 20-40 age bracket are most at risk of developing this condition (“Optic Neuritis”, n.d). Gender is yet another risk factor. It is understood that women face a greater risk of developing optic neuritis. This is not to say that men need not worry. It merely means that most of the sufferers of the condition happen to be female. Race and genetic mutations are yet other factors that elevate the risk of suffering from the condition (“Optic Neuritis”, n.d). It has been observed that the condition occurs at a higher rate within the white population in the United States compared to other segments of the population such as the black community. 

Symptoms

While symptoms do not necessarily indicate that one is ailing from a certain condition, they offer insights that allow physicians to identify the condition. One of the symptoms that is associated with optic neuritis is pain in the eye (“Optic Neuritis”, n.d). Patients suffering from the condition complain that the pain worsens when they move their eyes. Vision loss is another symptom that patients present with. The vision loss is usually reported in one eye. In many cases, the vision loss is merely a reduction in the clarity of vision and it is usually temporary. However, there are cases where the loss is permanent. Patients may also lose color vision (“Optic Neuritis”, n.d). One of the effects of optic neuritis is that it alters how one perceives color. Patients are unable to fully recognize the full vividness of color. Colors appear pale and washed out. Another symptom associated with optic neuritis is flashing lights (“Optic Neuritis”, n.d). Essentially, this means that patients see flickering lights particularly when they move their eyes. They are advised to especially rush when the pain in their eyes intensifies. 

In addition to the symptoms mentioned above, it is common for patients who have developed optic neuritis to witness arcuate defects (“Optic Neuritis b”, n.d). Essentially, these defects limit their field of view. Central scotoma and nasal steps are other symptoms that patients present with. Papillitis and cecocentral scotoma are other symptoms that individuals need to keep an eye out for as they indicate that one may have developed optic neuritis (“Optic Neuritis b”, n.d). While these symptoms may appear mild, patients are advised to visit their physician when they observe that the symptoms have worsened. 

Diagnosis

There are various tools and insights that physicians can rely on to determine if a patient has developed optic neuritis. One of these tools is a simple procedure where the doctor determines the ability of the patient to identify colors (“Optic Neuritis”, n.d). Through the procedure, the doctor also examines the patient’s peripheral vision. Opthalmoscopy is another method that may be used to diagnose optic neuritis. This method is used by doctors to assess the state of the eye. The doctor uses a bright light to determine the condition of the optic disc (“Optic Neuritis”, n.d). Since optic neuritis causes the optic disk to swell, a doctor may conclude that the patient has the condition when they observe a swelling in the optic disc. 

Observing the response of the pupils to bright light is another simple technique that is used to diagnose optic neuritis. Bright light is directed at the pupil and an observation is made (“Optic Neuritis”, n.d). When it is observed that the pupils do not constrict properly, this can be taken as indication that the patient has developed optic neuritis. The methods discussed above are rather simple and easy to carry out. However, they may not provide physicians with sufficient insight to conclude that the patient is suffering from optic neuritis. This forces the physicians to resort to more complex tests and procedures. Magnetic resonance imaging (MRI) is among these tests (“Optic Neuritis b”, n.d). The MRI scan does not necessarily identify optic neuritis. Instead, it is employed to determine if one has such conditions as multiple sclerosis which is usually accompanied by optic neuritis. Blood tests and optical coherence tomography are the other sophisticated tests that may be administered as part of diagnosis. 

Treatment and management 

The primary aim of carrying out diagnosis is to identify the illness and to offer treatment. There are numerous approaches that physicians usually adopt in their treatment of optic neuritis. While it is not advised, patients may sit back and hope that the optic neuritis will improve without intervention. However, they should seek treatment. Steroids are among the drugs that are offered to patients (Acton, 2013). They address the inflammation of the nerves. Patients who are placed on steroids need to be wary of a number of side effects. These effects include stomach upsets and gaining weight. In addition to addressing nerve inflammation, the steroids also allow patients to recover their vision much quicker. Additionally, this treatment also shields a patient from developing multiple sclerosis. Plasma exchange therapy is an emerging and promising treatment for optic neuritis (Acton, 2013). It is still experimental and there is no conclusive evidence that it actually cures optic neuritis. The prognosis for optic neuritis is encouraging. Patients who receive treatment can hope to make a full recovery within 12 months. However, there is always the risk that optic neuritis may evolve into multiple sclerosis.

In conclusion, vision is one of the senses that are difficult to do without. Optic neuritis threatens the proper functioning of the visual faculties. This condition is caused by developmental and acquired factors. Most of its symptoms are observed in the eye and cause visual impairments. Patients report pain in their eyes and they are able to perceive reality clearly. Essentially, optic neuritis denies patients the opportunity to take in all the beauty and depth that nature offers. Individuals who experience any of the symptoms of this condition should urgently seek medical assistance. There are various diagnostic tools available that can be used to determine if they are actually suffering from the condition. After diagnosis, the doctor is able to administer treatment. While optic neuritis is not life-threatening, individuals need to exercise great care and work closely with their doctors. 

References

Acton, A. (Cont.). (2013). Neuritis: New Insights for the Healthcare Professional: 2013 Edition. Atlanta: ScholarlyEditions. 

Brodsky, M. C. (2010). Pediatric Neuro-Ophthalmology. New York: Springer. 

Chan, J. W. (2014). Optic Nerve Disorders: Diagnosis and Management. New York: Springer.

Demaerschalk, B. & Wingerchuk, D. (2015). Evidence-Based Neurology: Management of Neurological Disorders. Hoboken, NJ: John Wiley & Sons. 

Newman, N. J., Miller, N. R., & Biousse, V. (Eds.). (2008). Walsh and Hoyt’s Clinical Neuro-ophthalmology: The Essentials. Philadelphia: Lippincott Williams & Wilkins. 

Optic Neuritis. (n.d). Retrieved 7th December 2016 from 

http://www.mayoclinic.org/diseases-conditions/optic-neuritis/symptoms-causes/dxc-20263591  

Optic Neuritis b. (n.d). Retrieved 7th December 2016 from

https://www.mssociety.org.uk/what-is-ms/signs-and-symptoms/eyes-and-sight/optic-neuritis  

Toosy, A. T., Mason, D. F., & Miller, D. H. (2011). Optic Neuritis. The Lancet Neurology, 13 (1), 83-99. 

Vogel, W. H., & Pascucci, S. E. (2011). Our Eyes and Our Vision . Bloomington, IN: iUniverse.