Optic Neuritis

By posted on July 8, 2014 4:37PM
Optic Neuritis

Optic Neuritis

Inflammation of optic nerve; idiopathic or associated with
systemic disease; most common optic neuropathy in people
<45 years old; female preponderance.

Findings: acute unilateral visual loss (can evolve over 1st
week, then spontaneous improvement over weeks [70%
regain 20/20]), ocular pain exacerbated by eye movements,
decreased color vision and contrast sensitivity, positive
RAPD, VF defect (50% diffuse, 20% central scotoma, rarely
altitudinal), optic nerve appears normal or swollen (35%),
disc pallor late.

Other findings:
Pulfrich phenomenon: motion of pendulum appears
elliptical owing to altered depth perception from
delayed conduction in the demyelinated nerve
Uhthoff’s symptom: worsening of symptoms with heat or
exercise; present in 50% after recovery
Phosphenes: flashes of light induced by eye movements or
sound
Auditory clicks: CN 7 innervates stapedius, and patient
hears click with effective transmission.

DD: idiopathic, MS, syphilis, sarcoidosis, Lyme disease,
Wegener’s granulomatosis, systemic lupus erythematosus
(SLE), Devic’s syndrome (bilateral optic neuritis and
transverse myelitis)

Treatment:
In general, about 30% develop MS within 4 years and
38% develop MS by 10 years (risk is higher in women
than men)
Consider treating optic neuritis with IV steroids; do not
initiate treatment with oral steroids
Regardless of MRI status, there is a higher risk of
developing MS if the patient has previous neurologic
symptoms or a history of optic neuritis in the fellow eye.

Controlled High-risk Avonex Multiple Sclerosis Prevention
Study (CHAMPS): randomized trial of interferon
beta-1a (Avonex) for the prevention of MS after acute
demyelinating episode and abnormal MRI
3-YEAR RESULTS: risk of MS lower and fewer MRI
lesions in treatment group

Optic Neuritis
Optic Neuritis

Source: 

Ophthalmology Atlas(Photos of cases)

Optic Neuritis

Ophthalmology Notes

We do our best to simplify ophthalmology in Short Notes and exchange practical experiences between ophthalmologists all over the world.

Recently Published Stories

Yellow White Retinal Lesion Differential Diagnosis

Yellow White Retinal Lesion Differential Diagnosis

Yellow-white retinal lesions or deposits at the macula are caused by a wide range of conditions and can lead to vision loss. Causes of Yellow

Optic Disc Swelling

Bilateral Optic Disc Swelling for DD

Bilateral Optic Disc Swelling for DD By Dr.Ahmed Ali What do you think about these photos of a young male

Macular edema in Retinal vein occlusion

Macular edema in Retinal vein occlusion

Macular edema in Retinal vein occlusion By Dr.Ahmed Saleh‎  Macular edema in vein occlusion Is there any protocol to treat?

Operculated Retinal Tear

Operculated Retinal Tear

Operculated Retinal Tear By Dr. Ameen Marashi‎ 35 years old complaining from floaters .What is your Diagnosis and Management? By

Retinal Capillary Haemangioma

Retinal Capillary Haemangioma

Retinal Capillary Haemangioma By Dr.Ameen Marashi‎ Young female What is your Diagnosis ? By Dr.Ahmad Ateya haemangioma By Dr.Ameen Marashi Treated

Retinal Ischeamia

Retinal Ischeamia

 Retinal Ischeamia By Dr.Ameen Marashi‎ Describe what you see and what is your approach ?!! By Dr.Reena Sorokhaibam Capillary non

Age Related Macular Degeneration ( ARMD without CNVM )

Age Related Macular Degeneration ( ARMD without CNVM )

Age Related Macular Degeneration ( ARMD without CNVM ) By Dr.Ameen Marashi‎ This 73 years old patient suffers from reduced

Causes of Papilledema

Causes of Papilledema

Causes of Papilledema Papilledema is an optic disc swelling that is secondary to elevated intracranial pressure. In contrast to other causes

Choroidal Nevus

Choroidal Nevus

Choroidal Nevus By Dr.Ameen Marashi‎ This patient has been followed up for many years because of this appearance with VA

Retinal Diseases Signs In One Picture

Retinal Diseases Signs In One Picture

Retinal Diseases Signs In One Picture Bone spicule pigments (BSP): are a hallmark of retinitis pigmentosa (RP)   Chorioretinal Atrophy: