Optic Neuritis Damage - How permanent?

[unwiseacts]

In June of this year I was diagnosed with Optic Neuritis. This led to subsequent findings of lesions on the brain (CIS).

After a hospital stay, including an inpatient and an outpatient corticosteroid regimen, my vision bounced back. My concern is that there might be permanent damage. I did wait more than a week from the time I noticed a problem with my eye to the time I checked into the hospital (which isn't too bright, since I work at the hospital).

My ophthalmologist told me that whatever recovery my eye makes within the first 6 months after the episode is about as good as it's going to get. My neurologist said recovery can be up to a year, or in some cases, even longer. As it stands right now, I still have noticeable color desaturation in my right eye (especially with yellow and red, and everything looks as if it is slightly tinted blue), as well as persistent bluriness that tends to get worse around dusk.

My question is two-fold. First, in your experience, how much of a recovery, usually, does a person have during their first bout with ON (is it typical to make a full recovery)? Second, how long after the bout can I expect (even minor) improvement?

[Sandra M Brown, MD]

First, the delay in starting corticosteroid treatment did NOT affect the overall long term healing of the optic nerve.  This has been well established.  So don't kick yourself about that.

Second, the majority of improvement occurs in the first 6 months, but some patients notice continued mild improvement up to a year.  Difference in color perception is often the lingering permanent difference.  The vague blurry feeling is called "loss of contrast sensitivity" and cannot be corrected by changing your glasses.  There is nothing you can do to influence the course of the healing.

I'm not familiar with the acryonym CIS but I am guessing you have a diagnosis of multiple sclerosis, which can develop without obvious neurological symptoms.  If so, you may want to investigate starting immuno-modulation therapy to decrease the likelihood that you will develop actual symptoms of MS.

[unwiseacts]

Dr. Brown, thank you kindly for your response!

The term CIS, says my nerologist, means Clinically Isolated Syndrome, and is not a multiple sclerosis diagnosis. He told me that I would have to suffer another bout.

He found multiple lesions, the scariest of which surround the corpus collosum. I indeed have MS, but am waiting on the official diagnosis. In the meantime, he does want to put me on Copaxone, so I will be getting treatment to minimize future relapses.

Thank you again for your time!