Optic Neuritis

An eye care specialist may suspect optic neuritis based on:

• Your symptoms.
• Your medical history.
• If you have (or could have) another condition that could cause optic neuritis.

An eye exam is a key part of the process. The exam will include the following:

• Visual acuity.
• Visual field.
• Ability to see color.
• Pupil reflexes.
• Slit lamp exam.

The following tests are also likely early on:

• Visual evoked potentials.
• Optical coherence tomography.

If the above checks and test results are consistent with optic neuritis, and another condition doesn’t better explain your symptoms, your eye care provider will probably refer you to a specialist. This may be a neurologist or a neuro-ophthalmologist (an eye care specialist who focuses on retinal and optic nerve issues and conditions).

Further testing

A magnetic resonance imaging (MRI) scan is a key part of diagnosing optic neuritis. The scan will involve contrast, a substance that makes tissue changes more visible on the scan. If you have optic neuritis, the affected optic nerve(s) will look brighter than a healthy optic nerve.

An MRI is important because it can detect brain lesions, which can be key indicators of MS. MRIs can also detect other lesions affecting your optic nerve and/or spinal cord, which are signs of NMO or MOGAD.

There are also several lab tests your provider might recommend. Lab testing is likely if:

• It’s possible an infection could be the cause of your optic neuritis.
• The MRI detects lesions that could mean you have MS, NMO or MOGAD.
• Your symptoms are more consistent with NMO or MOGAD than MS.

Lab tests generally include blood and urine tests for signs of infection or autoimmune antibodies (especially antibodies that indicate you have NMO or MOGAD). A spinal tap (lumbar puncture) to test your cerebrospinal fluid (CSF) can also detect signs of infection or other changes in your cerebrospinal fluid.