Optic Neuritis

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Latest Edit: Hector 2013-5-29 (EDT)

Optic neuritis, also known as retro-bulbar neuritis, is a leading cause of vision loss, which can occur acutely in hours to days, or chronically over the course of years. It can be caused by a variety of processes leading to inflammation and damage to the optic nerve.[1]

Optic Neuritis
Eye.jpg

Optic Neuritis
Causes Environmental Toxins, Smoking, Infections, Trauma
See Also Neurological Conditions, Diabetes, Multiple Sclerosis, Autoimmune Disease, Lupus, Stroke
Books Books on Neurological Conditions
Articles Articles on Neurological Conditions

Contents

Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With optic neuritis the causes are variable. A detailed assessment is required to determine which etiologic factors are contributing to optic neuropathy.

Lifestyle

  • Vitamin B12 deficiency may increase risk.[2]
  • Alcohol consumption, coupled with nutritional deficiencies, can cause optic neuritis.[2]

External

  • Trauma
  • Injury to the optic nerve caused by penetrating trauma, as well as indirect trauma from external force can cause damage and subsequent optic neuritis.[3]

Environmental

  • Exposure to several toxins including lead, methanol, organic solvents, and tobacco may increase the risk of optic neuritis.[2]

Genetics

  • Several hereditary conditions are known to cause optic neuritis including: Leber's hereditary optic neuropathy, Kjer's dominant optic atrophy, and Wolfram's syndrome.[2]

Medical Interventions

  • Prescription Medications
  • Use of several pharmaceuticals may cause optic neuritis, including: amiodarone, disulfiram, ethambutol, and isoniazid.[2]

Diagnostic Testing

A complete health history is required to rule out underlying conditions that may be contributing. Eye tests would include color vision testing, visual acuity testing and visual field testing. A thorough nerological examination, and dilated opthalmoscopy are important in identifying the etiology of optic neuropathy.[4]

  • Blood tests indicated in cases of optic neuropathy include: CBC, ANA, ESR, HIV testing, Lyme titer, mitochondrial DNA mutation testing.
  • Imaging studies indicated include: MRI of the brain and optic nerve.

Related Symptoms and Conditions

Optic neuropathy is often associated with the following conditions:[4]

Characteristics

The optic nerve caries visual information from the eye to the brain. Sudden swelling or damage to this nerve can result in destruction of the myelin sheath which insulates the nerve thus causing visual loss that is often permanent. Optic neuritis can be caused by any process leading to damage to the optic nerve, including inflammation, ischemia, toxic exposure, or anatomical damage.[2]

The following is a short summary of common optic neuropathies.

  • Glaucomatous Optic Neuropathy
  • Glaucomatous optic neuropathy occurs due to increased stress in neurons or glial cells in the retina and their subsequent destruction. Etiology of glaucomatous optic neuropathy is not completely known, although hypotheses indicating mechanical, vascular, inflammatory, oxidative, immune, and toxic processes are being explored.[5]
  • Ischemic Optic Neuropathy
  • Posterior sschemic optic neuropathy is associated with Giant Cell Arteritis, or a combination of hypotension and anemia from blood loss.
  • Anterior ischemic neuropathy is caused by vasculitis and is associated with temporal arteritis, or systemic hypotension. [5]
  • Leber's Optic Neuropathy
  • Leber's optic neuropathy is a hereditary disease caused by a mutation in mitochondrial DNA. Patients suffering from Leber's have varied presentation, and may experience loss of vision with an onset of days to weeks, or over a period of many years. [5]

Common Symptoms

The presentation of optic neuropathy is varied, and depends on underlying cause and rate of progression. Common symptoms include:[4]

  • decreased visual acuity
  • blurred vision
  • visual field defects
  • abnormal or loss of colour vision
  • progressive vision loss or dramatic vision loss in one eye over an hour or a few hours
  • changes in the way the pupil reacts to bright light
  • pain with movement of the eye

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Optic neuritis can either be an acute condition where vision often returns to normal within a couple of weeks without aggressive treatment or if there is an underlying condition that is associated with the vision loss it may be a chronic disease and requires individualized, long-term treatment and monitoring.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:[6]

  • Working with an occupational therapist or other trained professional to identify specialized furniture and appliances when visually impaired can be very useful and can decrease the stress and emotional impact associted with chronic vision loss.

Lifestyle

Lifestyle recommendations include:

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for optic neuropathy include:

References

Reviewed by Iva Lloyd, BScH, RPE, ND [1]

  1. Dains JE, Baumann LC, Sceibel P (2007) Advanced Health Assessment and Clinical Diagnosis in Primary Care 3rd ed. Mosby.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Van Stavern GP, Newman NJ (Mar 2001) Optic neuropathies: An Overview. Opthalmology Clinics of North America;14(1).
  3. Duong et al. (2008) Neuro-Ophthamology. Emergency Medicine Clinics of North America;Feb;26(1).
  4. 4.0 4.1 4.2 Ferri (2012) Ferri's Clinical Advisor, 1st ed. Section O. Optic Neuritis. Mosby.
  5. 5.0 5.1 5.2 Yanoff and Duker (2008) Opthalmology 3rd ed. Mosby.
  6. Popivker L et al. (Dec 2010) Eyes on the prize: Life goals in the context of visual disability in midlife. Rehab;24(12):1127-35.
  7. Pizzorno Joseph E, Murray Michael T (2006) Textbook of Natural Medicine 3rd ed, Elsevier.
  8. 8.0 8.1 Head K (2001) Natural Therapies for Ocular Disoders Part Two: Cataracts and Glaucoma. Alt Med Rev;6(2):141-166.
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