Visual recovery in patients with optic neuritis and visual loss to no light perception

After the first episode of optic neuritis, about 85 percent of patients have improvement of vision to at least 20/40 or better. Optic neuritis, inflammation of the optic nerve, causes swelling of the optic nerve and rapid loss of vision over a period of days, but vision usually returns to normal or close to normal after the first episode. It is not known if this good prognosis is also true for patients with optic neuritis whose loss of vision progresses to the point where they can no longer perceive light. A review of 151 patients treated for optic neuritis over an eight-year period was undertaken; 15 of these patients had acute loss of vision, progressing to no light perception. Three patients were excluded from further study because of previous optic neuritis or unreliability of patient reporting. Of the 12 patients remaining, eight recovered vision of 20/40 or better; five of these had vision of 20/20 or better. Four of the patients recovered peripheral vision, but continued to have dense central scotoma (area of depressed vision within the visual field, surrounded by an area of more normal vision). These patients achieved vision of less than 20/400. Eleven of the 12 patients had abnormalities in color vision which persisted after return of vision. (Consumer Summary produced by Reliance Medical Information, Inc.)