Treatments and drugsBy Mayo Clinic staff
Optic neuritis usually gets better on its own. In some cases, steroid medications are used to treat optic neuritis, because they help reduce inflammation in the optic nerve. Possible side effects from steroid treatment include weight gain, mood changes, stomach upset and insomnia. If you receive steroids, your treatment may involve:
- Intravenous steroids. You'll likely receive steroid therapy by vein (intravenously) for a few days. Intravenous steroid therapy may accelerate vision recovery, but it doesn't appear to affect the ultimate extent to which you'll recover vision you may have lost.
- Oral steroids. After intravenous steroid therapy, your doctor may prescribe an oral steroid called prednisone for about two weeks.
In instances in which steroid therapy has failed and severe vision loss persists, a treatment called plasma exchange therapy may help some people recover their vision.
Preventing multiple sclerosis
If you have optic neuritis and you appear to have a high risk of developing multiple sclerosis based on your MRI results, you may benefit from drugs that help prevent multiple sclerosis. These drugs include interferon beta-1a (Avonex, Rebif) and interferon beta-1b (Betaseron). These injectable drugs are used to prevent or delay the development of multiple sclerosis in people with optic neuritis who have two or more brain lesions evident on MRI scans.
The prognosis following optic neuritis is generally good. Most people regain close to normal vision within 12 months after an episode of optic neuritis.
People with multiple sclerosis or neuromyelitis optica may have a greater risk for recurrent attacks of optic neuritis. People without any underlying conditions also may have recurrent optic neuritis. But, these people generally have a better long-term prognosis for their vision than do people with multiple sclerosis or neuromyelitis optica.
- Balcer LJ. Optic neuritis. The New England Journal of Medicine. 2006;354:1273.
- Clark D, et al. Optic neuritis. Neurologic Clinics. 2010;28:573.
- Dargin JM, et al. The painful eye. Emergency Medical Clinics of North America. 2008;26:199.
- Osborne B. Optic neuritis: Pathophysiology, clinical features, and diagnosis. http://www.uptodate.com/home/index.html. Accessed Dec. 28, 2010.
- Graves J, et al. Eye disorders in patients with multiple sclerosis: Natural history and management. Clinical Ophthalmology. 2010;4:1409.
- Riordan-Eva P. Disorders of the eyes & lids. In: McPhee SJ, et al. Current Medical Diagnosis & Treatment 2011. New York, N.Y.: McGraw-Hill Medical; 2011. http://www.accessmedicine.com/content.aspx?aID=2002. Accessed Jan. 1, 2011.
- Ropper AH, et al. Disturbances of vision. In: Ropper AH, et al. Adams and Victor's Principles of Neurology. 9th ed. New York, N.Y.: McGraw-Hill Medical; 2009. http://www.accessmedicine.com/content.aspx?aID=3631567. Accessed Jan. 1, 2011.
- Germann CA, et al. Ophthalmic diagnoses in the ED: Optic neuritis. American Journal of Emergency Medicine. 2007;25:834.
- Chan RYC, et al. Ocular toxicity of ethambutol. Hong Kong Medical Journal. 2006;12:56.
- Osborne B. Optic neuritis: Prognosis and treatment. http://www.uptodate.com/home/index.html. Accessed Dec. 28, 2010.
- Robertson DM (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 10, 2011.