Optic Neuritis in Grand Rapids, Michigan

Our sight depends on the optic nerve, which carries information about shape, color, and pattern from the retina at the back of the eye to the brain. Optic neuritis is inflammation of this nerve that leads to blurred, gray, or dim vision. Symptoms can range from mild to severe, depending on how many nerve fibers are affected.

In Grand Rapids and across West Michigan, optic neuritis is an important eye and neurological condition that often requires coordinated care between eye specialists and neurologists at local health systems such as Corewell Health (formerly Spectrum Health), Trinity Health Grand Rapids, Metro Health – University of Michigan Health, and Mercy Health.

What Is Optic Neuritis?

Optic neuritis (also called retrobulbar neuritis) is inflammation of the optic nerve. The optic nerve is made up of more than one million tiny nerve fibers bundled together. Each fiber carries visual information from the eye to the brain.

When the optic nerve becomes inflamed:

  • The nerve fibers swell
  • Signals do not travel normally
  • Vision becomes blurred, gray, or dim

In most people, vision worsens over a few days rather than all at once. The peak of vision loss usually occurs about one week after symptoms begin.

Who Gets Optic Neuritis?

  • It can occur at any age, but is most common in people in their 20s–40s, especially in their 30s.
  • It is slightly more common in women.
  • It may be more likely in people who live in northern climates like Michigan, where multiple sclerosis (MS) is more common.

In up to 80% of cases, vision improves on its own over several weeks to months. However, about 20% of people may be left with some degree of permanent reduced vision.

Symptoms of Optic Neuritis

Symptoms usually affect one eye (about 70% of cases), but both eyes can be involved.

Common Symptoms

  • Blurred vision
  • Gray or washed-out vision (colors look faded)
  • Dim vision (like someone turned down the lights)
  • Pain behind the eye, especially with eye movement
  • Reduced color vision (reds may look more brown or dull)
  • Central blind spot or dark patch in the middle of vision
  • Decreased contrast sensitivity (harder to see in low light)

Symptoms may temporarily worsen when you are hot, for example:

  • After a hot shower
  • During a workout
  • In a warm room

This temporary worsening with heat is called Uhthoff’s phenomenon and is common in optic neuritis and MS.

When to See a Doctor in Grand Rapids

Seek Immediate Medical Care If You Notice:

  • Sudden or rapidly worsening vision in one or both eyes
  • Pain with eye movement
  • Colors suddenly looking washed out
  • A dark spot in the center of your vision

Contact your primary care provider, optometrist, or ophthalmologist right away. In Grand Rapids, if optic neuritis is suspected, you may be referred urgently to:

  • Corewell Health Butterworth Hospital Emergency Department
  • Trinity Health Grand Rapids Emergency Department
  • An on-call ophthalmologist or neuro-ophthalmologist

Prompt evaluation can help rule out other serious eye conditions and start appropriate treatment if needed.

Causes of Optic Neuritis

Optic neuritis can occur on its own (idiopathic) or be triggered by an underlying condition. In Grand Rapids and the broader Michigan region, common causes and associated conditions include:

Autoimmune and Demyelinating Conditions

  • Multiple sclerosis (MS) – the most common association
  • Neuromyelitis optica spectrum disorder (NMOSD)
  • MOG antibody–associated disease (MOGAD)

In these conditions, the immune system attacks the myelin sheath (the protective covering) around nerve fibers, including those in the optic nerve.

Infections

Certain infections can also cause optic neuritis, including:

  • Cytomegalovirus (CMV)
  • Hepatitis B
  • Herpes viruses (including herpes simplex and varicella-zoster)
  • HIV
  • Lyme disease (can occur in Michigan, especially in wooded or tick-prone areas)
  • Measles
  • Mumps
  • Syphilis
  • Tuberculosis
  • Paranasal sinus infections

Other Causes

  • Radiation therapy involving the head or orbit
  • Certain medications or toxins (less common)
  • Systemic autoimmune diseases (e.g., sarcoidosis, lupus)

Sometimes, no clear cause is found even after a full workup.

Optic Neuritis and Multiple Sclerosis (MS)

For some people, optic neuritis is the first symptom of multiple sclerosis. However, not everyone with optic neuritis will develop MS.

MS Risk After Optic Neuritis

  • Brain MRI scans are used to look for small spots (lesions) in the brain.
  • These lesions represent areas where myelin has been damaged.
  • If lesions are seen on MRI, the risk of developing MS within 10 years is estimated at 30–60%, depending on the number and pattern of lesions.
  • If the MRI is normal, the risk of MS is lower, but not zero.

Because Michigan and other northern states have a higher rate of MS, neurologists in Grand Rapids are particularly experienced in evaluating optic neuritis and MS risk.

Other Vision Problems Linked to MS

Besides optic neuritis, MS can cause additional eye and vision problems:

  • Diplopia (double vision) – due to weakness or poor coordination of the eye muscles
  • Nystagmus – involuntary “jumping” or jerking eye movements, horizontally or vertically
  • Difficulty focusing or tracking moving objects

If you have had optic neuritis, your eye doctor or neurologist may recommend ongoing monitoring for MS or other neurologic symptoms.

How Optic Neuritis Is Diagnosed in Grand Rapids

Because optic neuritis can mimic other eye conditions (such as ischemic optic neuropathy, which is more common in older adults), careful diagnosis is essential.

Common Tests and Evaluations

A comprehensive evaluation may include:

  • Detailed eye examination
    • Checking visual acuity (how clearly you see letters on the chart)
    • Examining the back of the eye (optic disc) with special lenses
  • Color vision testing
    • To detect reduced color sensitivity, especially for red
  • Visual field (peripheral vision) tests
    • To identify blind spots or areas of reduced vision
  • Pupil reaction tests
    • To look for a relative afferent pupillary defect (RAPD), common in optic neuritis
  • Optical coherence tomography (OCT)
    • A scan that measures the thickness of the nerve fiber layer in the retina
  • MRI scan of the brain and orbits with contrast
    • Helps confirm optic neuritis
    • Assesses for MS-related lesions and other causes of optic nerve inflammation
  • Blood tests
    • To look for infections, autoimmune diseases, or specific antibodies (e.g., NMOSD, MOGAD)
  • Lumbar puncture (spinal tap) in select cases
    • To evaluate for MS or central nervous system infections

These tests are typically available through major Grand Rapids health systems such as Corewell Health, Trinity Health Grand Rapids, Metro Health – University of Michigan Health, and Mercy Health.

Subclinical Optic Neuritis

Sometimes, a person may have demyelination of the optic nerve but no noticeable visual symptoms. This is called subclinical optic neuritis.

Even without symptoms, damage to the optic nerve can sometimes be detected by:

  • Electrical diagnostic tests (visual evoked potentials)
  • Visual field testing
  • OCT imaging

Subclinical optic neuritis is often discovered during evaluation for MS or other neurologic conditions.

Treatment for Optic Neuritis

In many cases, optic neuritis is short-lived and improves on its own over about 4–12 weeks as the inflammation settles. However, treatment may help speed recovery and manage underlying conditions.

Common Treatments

  • Intravenous (IV) corticosteroids
    • Often given over 3–5 days in a hospital or infusion center
    • Can speed recovery of vision, especially in moderate to severe cases
  • Oral corticosteroids
    • May be used after IV steroids as a taper
    • Use of oral steroids alone (without prior IV steroids) is controversial, as some studies suggest a higher risk of recurrence
  • Treatment of underlying conditions
    • Disease-modifying therapies for MS or NMOSD
    • Antibiotics or antivirals if an infection is identified
    • Management of systemic autoimmune disease if present

Even though permanent damage to the optic nerve occurs in about 85% of cases, this does not always lead to serious long-term vision loss. Many people recover good functional vision, even if detailed testing shows some residual damage.

Living With Optic Neuritis in Grand Rapids

Seasonal and Local Considerations

  • Cold Michigan winters can sometimes make MS-related symptoms (including optic neuritis) feel better compared to hot weather, but rapid temperature changes and winter illnesses (like viral infections) may trigger flares in some individuals.
  • Low sunlight exposure in winter and potential vitamin D deficiency, more common in northern states, have been linked with a higher risk of MS. Your provider may check your vitamin D level and recommend supplementation if needed.
  • If you enjoy outdoor activities around the Grand River or West Michigan trails, protect your eyes with:
    • UV-blocking sunglasses
    • Appropriate safety eyewear for sports and yard work

Importance of Regular Eye Examinations

Regular eye exams are especially important if you:

  • Have had optic neuritis in the past
  • Have been diagnosed with MS or another autoimmune condition
  • Notice any new vision changes, even if mild

Routine exams can:

  • Detect early changes in the optic nerve
  • Monitor for recurrence
  • Help coordinate care with your neurologist and primary care provider

Where to Get Help in Grand Rapids

If you think you may have optic neuritis or are experiencing sudden changes in vision, contact:

Local Healthcare Providers

  • Your GP / Primary Care Provider
  • Ophthalmologist (eye specialist)
  • Neuro-ophthalmologist (if available through local systems)
  • Neurologist, especially if MS or another neurologic condition is suspected

Major health systems in Grand Rapids that can evaluate and treat optic neuritis include:

  • Corewell Health (Spectrum Health) – Grand Rapids
  • Trinity Health Grand Rapids
  • Metro Health – University of Michigan Health
  • Mercy Health

For broader public health information and support:

  • Kent County Health Department
  • Grand Rapids Public Health resources (for infectious disease testing, immunizations, and referrals)

If you experience sudden severe vision loss, eye pain, or neurological symptoms (such as weakness, numbness, or difficulty speaking), go to the nearest emergency department immediately.

Key Points About Optic Neuritis

  • Optic neuritis is inflammation of the optic nerve that causes blurred, gray, or dim vision.
  • Symptoms usually worsen over a few days, with the peak of vision loss around one week after onset.
  • It can occur at any age but is most common in people in their 30s.
  • Inflammation causes optic nerve fibers to swell, so they cannot transmit visual signals properly.
  • Vision improves on its own in up to 80% of cases, but about 20% may have some permanent visual loss.
  • Optic neuritis can be the first sign of multiple sclerosis, but not everyone with optic neuritis develops MS.
  • Diagnosis typically includes an eye exam, visual field and color testing, and an MRI scan of the brain and orbits.
  • IV corticosteroids may be used to speed recovery in more severe cases; oral steroid use alone is more controversial.
  • Regular eye examinations and neurologic follow-up are important, especially in regions like Grand Rapids, Michigan, where MS is relatively common.