From the Guidelines
Yes, optic neuritis can occur in just one eye. This condition, characterized by inflammation of the optic nerve, can be unilateral or bilateral, as defined in the study by 1. According to this study, optic neuritis often presents with painful visual loss, but can also be painless. The primary differential consideration includes multiple sclerosis, neuromyelitis optica, neuromyelitis optica spectrum, or other infectious or granulomatous conditions.
Some key points to consider about optic neuritis in one eye include:
- It can be the initial manifestation of multiple sclerosis, as noted in the study by 1
- Symptoms typically include pain with eye movement, temporary vision loss, blurred vision, and changes in color perception in the affected eye
- Treatment often involves high-dose intravenous corticosteroids, followed by oral prednisone to reduce inflammation and potentially speed recovery
- Many cases resolve on their own within weeks to months even without treatment
If you experience sudden vision changes in one eye, especially with pain, seek immediate medical attention as prompt diagnosis is important. Optic neuritis often occurs due to an autoimmune response where the body's immune system mistakenly attacks the myelin sheath protecting the optic nerve, and it can sometimes be associated with multiple sclerosis or other inflammatory conditions, as discussed in the study by 1.
From the Research
Optic Neuritis in One Eye
- Optic neuritis can occur in one eye, which is referred to as unilateral optic neuritis 2.
- The diagnosis of optic neuritis is based on a constellation of symptoms and signs, including pain on eye movement in one eye and subacute visual loss 2.
- In unilateral optic neuritis, the direct pupillary light reflex is weaker in the affected eye 2.
- One-third of patients with optic neuritis have a mildly edematous optic disc, which can be a sign of the condition 2.
Treatment and Prognosis
- High-dosed intravenous methylprednisolone therapy can speed recovery from optic neuritis, but it does not improve the final outcome 2.
- The risk that a patient with optic neuritis will later develop multiple sclerosis can be assessed with an MRI scan of the brain 2.
- Corticosteroids, such as intravenous methylprednisolone, are commonly used to treat optic neuritis, but there is no conclusive evidence of benefit in terms of recovery to normal visual acuity, visual field, or contrast sensitivity 3, 4.
- Atypical forms of optic neuritis, such as those associated with neuromyelitis optica spectrum disorder (NMOSD) or myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD), may require different treatment approaches, including plasma exchange and long-term immunosuppressive therapy 5.