Optic Neuritis Misdiagnosis Found To Be Common In New Study

New research suggests that optic neuritis is commonly over diagnosed, when the true diagnosis is often linked to other common problems, such as headaches or other types of eye conditions. 

In a study published this month in the medical journal JAMA Ophthalmology, researchers indicate that more than half of patients were misdiagnosed with optic neuritis when they actually had other health problems.

Researchers from a university-based Midwestern euro-ophthalmology clinic focused on patients evaluated for optic neuritis between January 2014 and October 2016. The cross-sectional study included 122 patients referred for optic neuritis evaluation.

Overall, 40% of the patients were confirmed to have optic neuritis. However, optic neuritis was misdiagnosed in 60% of the patients; roughly 73 patients.

These patients had other diagnoses, such as headaches, eye pain, functional visual loss and other optic neuropathies, including nonarteritic anterior ischemic optic neuropathy.

Researchers said the most common reason patients were incorrectly diagnosed with optic neuritis was because doctors relied on one single item from their health history to diagnosis optic neuritis. In other cases, doctors failed to consider alternative diagnoses that fit their symptoms more closely.

In 33% of cases, doctors interpreted critical aspects of a patient’s medical history  to fit the optic neuritis diagnosis, which resulted in an incorrect diagnosis. In about 32% of cases, doctors failed to consider an alternative diagnosis, resulting in over diagnosis of optic neuritis. In roughly 21% of cases, doctors interpreted the physical examination findings incorrectly as optic neuritis. In another 15% of cases, doctors misinterpreted the results of diagnostic tests as optic neuritis.

Optic neuritis is inflammation in the optic nerve, which sends information from the eye to the brain. This often causes symptoms like pain, temporary vision loss, loss of color vision, or flashing lights. However, like many other eye conditions, it may lead to permanent vision loss and should be evaluated by a doctor.

While eye pain is a common symptom of optic neuritis, researchers warned eye pain should be considered in context with other symptoms, like headaches or other problems. Those symptoms don’t always point to optic neuritis.

Misdiagnosis will cause many patients to undergo unnecessary, costly and often painful diagnostic tests, procedures and treatments for a condition they don’t have.

“Understanding pitfalls leading to overdiagnosis of optic neuritis may improve clinicians’ diagnostic process,” researchers wrote.