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Optic neuritis is an acute inflammatory optic neuropathy. It is the most common type of optic neuropathy causing acute visual loss in young adults (peak age at 30 to 40 years), especially among women. Patients usually present with acute reduced visual acuity, pain exacerbated by eye movements, dyschromatopsia, an afferent pupil defect, and swelling of the optic nerve head. Visual field testing often reveals central, centrocecal, arcuate, altitudinal, or nasal step defects. Magnetic resonance image scanning of the brain should be ordered in all cases of acute optic neuritis for diagnostic and prognostic purposes. The brain lesions of multiple sclerosis are commonly seen as T2 ovoid high-signal white matter lesions on magnetic resonance image scans of the brain located in perivenular regions perpendicular to ventricles with variable enhancement. Other laboratory tests, such as cerebrospinal fluid analysis, serologic tests, and visual evoked potentials, add little to the workup of typicaloptic neuritis. The recommended treatment for optic neuritis is intravenous steroids. Other promising therapies include intravenous y-globulin and some interferons, but studies so far have not resulted in any new treatment guidelines. |
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eye movement,painful
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multiple sclerosis
multiple sclerosis,risk factors for
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scotoma
scotoma,central
treatment of neurologic disorder
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