Hi KLou...I went blind in my right eye about 10 years ago and had no idea it was optic neuritis. I went to my family doc. who sent me to opthamologist who told me I needed to go on steroid treatment. I was reluctant because he also showed me and article in one of his text books stating that optic neuritis would go away on its own. They both strongly recommended the steroids so with reluctance I went that route...Next time I would prefer to wait it out. I felt terrible for weeks after treatment. I don't know if that was from the steroids or the MS. I wish they had sent me to my neurologist. I just did not know and did not have computer at time to find out. I find I get more info here online than anywhere. I am new to this site and I really like the format. What has been others experience with this?

I've had several bouts of optical neuritis, two of them led to complete loss of vision in one eye. I never got the steroids because the facts are that the steroids may in fact hamper recovery and damage the eyes. You'll find this research on this site if you look around.

Be cautious! Steroids cause cataracts and can lead to blindness if they are over used. I know of a person with MS that has taken so many steroids for ON that he is in fact now blind - not from the MS but as a "side effect" from all of the steroids!

Why they do not tell you this is beyond me. The fact is, you'll end up the same whether you do the steroids or not in the case of optical neuritis (ON).

I did not have mine treated. I'm back to 99% with some minor vision field loss. Nothing big at ALL. Send me a message if you have any questions.

I'm not a doc. I did have ON a long time ago, and was treated by oral steroids. I wasn't diagnosed MS then. It remains my stronger eye. A few years ago I had ON in the other eye. Now I am diagnosed wuith MS and I have had more a few relapses.

When diagnosed this time, the neuro said 5 days of IV steroids. I hate IV steroids and all those years ago oral steroids worked. I said oral steroids, she said no. She said 5 days IV steroid, I said no.

We meet in the middle with 1 day of IV steroids. I think it has been 3 years since that ON & my vision has not totally returned like it did last time. I read that the Optic Nerve is the only nerve that is entirely in the brain and the only nerve not mylenated, its exposed. So ON is damage directly to the nerve. If not treated quickly the nerve can whither & die. That must have been why she was such a pig about the faster delivery system of IV. I wish I had done, it. But I always need to know why? Doc's are usually not inclined to explain why.

So I think steroids, IV steroids are required for ON. I have read there is no difference between oral & Iv for other relapses. But for ON there is.......

Move on to what I have read about Pregnancy & Steroids. I believe & I have read that short term steroids are not harmful in Pregnancy's. Actually Steroids are naturally produced by the body to fight inflamation. The taper dose we have top do, is because the body shuts down it's own steroid production when it sees it is getting a large external source. The taper dose is to gradually reduce the external source so the body restarts it own steroid production.

I do not believe short term steroids, what we MS people use for relapses is harmful in a pregnancy. So if you get ON while pregnant you can and should be treated with steroids. The risk is the ON nerve will wither & die without steroids. It may not, but it may.
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Corticosteroids (commonly referred to as steroids) are hormones normally produced in the human body by the adrenal glands. They have a number of physiologic effects on different organ systems, but are most widely used for their anti-inflammatory actions. These steroids are different from the anabolic steroids used by athletes and others to enhance muscle development and strength.

http://www.nationalmssociety.org/about-multiple-sclerosis/treatments/medications/corticosteroids/index.aspx

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Use of Steroid Medications

Women who use steroids for acute MS exacerbations may continue to use them during pregnancy. The use of prednisone in a woman who is breastfeeding should be carefully monitored.

http://www.nationalmssociety.org/living-with-multiple-sclerosis/healthy-living/pregnancy/index.aspx

My doc has always told me if I did not take IV roids early on in a O N Flare permenat damage would occur and waiting 6 months then taking the roids would have no help inrepairing the damaged cause by ON. I waited to long one time and regret it. nnyl1 also posted to good info.

Wish all the best

I guess like everything else with MS ON is individual....back in 1997 I had what I now know was ON. I did not go to see the doctor at that time,and it did go away in a week or so with no noticeable damage. I had a recurrance of ON in 2007 and was dx'd w/MS. I received immediate treatment with Solu-Medrol and it again cleared up with little noticeable .

From the horse's mouth:

Treatment for optic neuritis
Occasionally, steroids are used for the treatment of optic neuritis. Steroids may be given either as tablets or as a drip. Clinical trials have shown that steroids can speed up the recovery of vision but they do not seem to affect how well a person recovers their sight in the long-term.

The decision about whether or not to use steroids should be made between the doctor and the person with optic neuritis. In a typical case of optic neuritis, a wait-and-see approach is reasonable. However, some people want a more rapid recovery of vision, especially if both eyes are affected.

If recovery from optic neuritis is not good, at present there is no treatment that can reverse this. Poor vision caused by optic neuritis cannot be helped with glasses or eye exercises. Future therapies to improve vision might include treatments to protect the optic nerve (neuroprotection), treatments to promote remyelination, or possibly optic nerve transplantation. All of these are experimental at present.

http://www.mssociety.org.uk/about_ms/symptoms/vision/optic_neuritis.html

I had optic neuritis a couple of times and did not receive steroid treatment and did recover my vision completely. Last fall I had it again along with other symptoms and did receive IV steroid treatment. Then in December through January I had O.N. symptoms again in my right eye instead of my left and was not treated with steroids that time, but was diagnosed with MS and started on Rebif as damage to the optic nerve was apparent to my opthalmologist and neurologist.

Neener

Management
In the past, controversy existed as to whether or not to treat patients with ON with corticosteroids. The Optic Neuritis Treatment Trial (ONTT) supports the administration of intravenous methylprednisolone sodium succinate (Solumedrol, 250 mg. every 6 hours) for three days followed by oral prednisone (1 mg/kg per day) for 11 days for the purposes of accelerating visual recovery. This therapy did not improve visual outcome after one year but was found to increase the rate at which patients recover. The ONTT also determined that the use of oral prednisone (1 mg/kg per day) alone for 14 days is contraindicated. Patients receiving this therapy had a higher rate of new attacks of ON in both the initially affected and fellow eyes than did the intravenous/oral group and placebo group.

As recorded in the three-year follow-up of patients in the ONTT, treatment with intravenous methylprednisolone followed by oral corticosteroid regimens reduced the two-year rate of development of clinical MS, particularly in patients with signal abnormalities consistent with demyelination on MRI of the brain at the time of study entry. Serious side effects of glucocorticoid therapy are infrequent. Therefore, outpatient administration of high-dose intravenous glucocorticoids may be recommended.

http://www.revoptom.com/handbook/SECT51a.HTM

It bothered me, that I remembered I read that the Optic Nerve is unique in that it lies entirely in the brain and that it was "unmylented", uncovered.I was wrong about that, but intent is correct. The ON is "unsheathed" compared to peripheral nerves.

I had to look those facts up. I just remember reading it and understanding why my doc had wanted me to do IV steroids so much but I wasn't sure how close I was to remembering the exact details right. I just interpreted it to mean there was a valid reason for doing IV steroids for ON.

I looked up in Wikipedia, the optic nerve, combined with the study that was done that ON not treated with IV steroids had a tendency to reoccur. The outcome to "that" episode was the same with IV steroids or without. But ON was not as likely to reoccur with IV steroids.

This is what I found on Wiki about the optic nerve and I was very close....functionally correct on all of it. ON should be treated with IV steroids because ON is the only nerve that lies within the brain & requires the fast delivery of IV steroids and the ON is uncovered compared to peripheral nerves and more likely to incur
permenant damage. How I remembered it is functionally accurate for my simple brain. Close???

http://en.wikipedia.org/wiki/Optic_nerve

The optic nerve is the second of twelve paired cranial nerves but is considered to be part of the central nervous system as it is derived from an outpouching of the diencephalon during embryonic development. *Consequently, the fibers are covered with myelin produced by oligodendrocytes --rather than the Schwann cells of the peripheral nervous system and are encased within the meninges.

Therefore the distinction of nerve is technically a misnomer, as the optic system lies within the central nervous system and nerves exist, by definition, within the peripheral nervous system.

The optic nerve is ensheathed in all three meningeal layers (dura, arachnoid, and pia mater) rather than the epineurium, perineurium, and endoneurium found in peripheral nerves.

*** Fiber tracks of the mammalian central nervous system (as opposed to the peripheral nervous system) are incapable of regeneration and hence optic nerve damage produces irreversible blindness.