Understanding mindset of optic neuritis patients can be helpful in delivering care

Issue: November 25, 2009

SAN FRANCISCO — After diagnosis and treatment of optic neuritis, patients often need follow-up that helps manage their mindset of the disorder, a speaker said here.

"Now that your patient's vision is improving, she's finished her steroids, how does she feel? Terrible," Fiona E. Costello, MD, FRCP, said here at the joint meeting of the American Academy of Ophthalmology and the Pan-American Association of Ophthalmology. "Most of the patients, 1 month after they present to you, are terrified. Not because their vision is bad — their vision is better. But they were a person who started with subacute onset vision loss, they came in, they thought they had a problem with their contact lens, and now they're being told that they may have a progressive neurologic condition."

Dr. Costello highlighted key symptoms, clinical mimics, most appropriate investigations and treatment management options of optic neuritis for the general ophthalmologist.

She recommended that optic neuritis cases be referred to a neuro-ophthalmologist when necessary. Specialists can help oversee long-term follow-up, as well as counsel optic neuritis patients.

Optic neuritis often affects women – and less commonly men – in their most productive years. Just as Dr. Costello mentioned, they arrive in your office healthy and fit and become increasingly anxious and depressed as they learn about the multiple sclerosis connection.

In the last decade, the availability of information on the Internet has completely altered how doctors communicate with their patients. Many patients become increasingly alarmed as they surf the net and visit blogs and chat rooms. We need to help educate patients on the good sources of web-based information and to avoid some of the sites with inaccurate jargon and inappropriate yet costly herbal “remedies.”

– Kimberly P. Cockerham, MD, FACS
OSN Neurosciences Board Member