This subject has been discussed pro and Con and will continue to be an enigma until the etiology is established. Then and only in that event exacting studies and proper treatment can be instituted. At this time one does not know if the myelin destruction, frequently with subsequent damage to the axis cylinders, is from bacterial infection, toxins, poisons, or denied blood supply or whether the myelin, having a normal cycle of depletion and replenishment, i inhibited in some manner from its physiologic ability to re-form. From pathologic consideration the possibility of re-formation is hindered by the development of the glial scar or plaque and in acute cases by mesodermal infiltration.
There are certain areas confined to the central nervous system which seem to have a predilection for these demyelinating affections, and many of these areas are intimately concerned with visual and oculogyric functions, as they contain nuclei and axons
LYLE DJ. Ophthalmological Involvement in the Primary Demyelinating Diseases. AMA Arch Ophthalmol. 1959;62(2):255-259. doi:10.1001/archopht.1959.04220020081012