4 Things Lupus Sufferers Need to Know About Optic Neuritis

Lupus is a serious autoimmune disease that affects organ systems throughout your body, including your eyes. Your optic nerve, the nerve that sends signals from your eyes to your brain and allows you to see, can become inflamed as a result of your lupus. This leads to a serious ocular condition, optic neuritis. Here are four things you need to know about this condition.

What are the signs of optic neuritis?

Most of the time, optic neuritis only affects one eye, but you may notice symptoms in both eyes. The main symptom is a dull, aching pain behind the affected eye. This pain tends to get worse when you move your eyes, and feels better when you rest them.

In addition to pain, vision changes are very common. Sufferers can experience a wide range of vision changes, ranging from mild annoyances like seeing flashing lights or temporary blurred vision to serious eye problems like permanent vision loss. If you notice any changes in your eyes, see your optometrist right away and be sure to mention that you have lupus.

How does lupus cause it?

About 1% of people with lupus will develop some type of disease of the optic nerve, including optic neuritis. This happens due to the effect your autoantibodies (the immune system cells that attack your healthy cells) can have on your body. These autoantibodies can bind to your healthy cells and form immune complexes; these immune complexes will then build up on your tissues and cause inflammation. This inflammation is responsible for lupus-related complications such as optic neuritis.

Lupus can also lead to vasculitis and thrombosis. Vasculitis is the inflammation of your blood vessels, and thrombosis refers to the formation of blood clots. Both of these problems are caused by your autoantibodies, and if the veins that supply your eyes are affected, you may be left with optic neuritis.

How serious is it?

Optic neuritis is a serious problem for anyone, but it's worse for people who have lupus. This is because lupus-associated optic neuritis has a worse prognosis than other types of this eye disease. About half of sufferers will be left with a central scotoma, which is a blind spot in your central vision. Your central vision refers to the field of your vision that isn't part of your peripheral vision, so a large portion of your visual field will be affected.

Central scotomas are bad enough, but they can also progress to optic atrophy. Optic atrophy refers to the wasting away of your optic nerve. Optic atrophy can destroy your peripheral vision, so if your central scotomas progress to this condition, you'll be left blind. Optic atrophy can't be cured or treated, so it's very important to get prompt treatment for conditions that could progress to it. If you're concerned that you have optic neuritis, make sure to get treatment immediately.

Can it be treated?

Optic neuritis can be treated if it's caught early enough. Your optometrist will prescribe intravenous steroids. Steroids are given to reduce the inflammation of your optic nerve and halt further damage. 

These steroids are generally given at a high dose (250 mg) four times a day; after three days of this regimen, you'll start taking oral steroids. Due to the serious complications that high doses of steroids can cause, you'll need to be admitted to the hospital for the duration of your intravenous steroid treatment. This is necessary so that doctors can monitor you for signs of complications and stop the treatment if necessary.

If you have lupus and are worried about optic neuritis, talk to resources like Dr Gary Wetmore Optometrist