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Optic neuritis - More than a loss of vision
Australian Family Physician, 10/05/09

Chu ER et al. – This article provides information on the signs and symptoms of optic neuritis and discusses appropriate referral, investigations and management.

• Demyelinating optic neuritis may be related to MS.
• Diagnosis is largely based on history and physical examination.
• Patients often present with vision loss and discomfort around the eye that is aggravated by eye movement.
• Clinical signs include decreased visual acuity, decreased colour vision, presence of RAPD, decreased subjective brightness and visual field abnormality. Appearance of the optic nerve head can either be swollen (papillitis) or normal.
• The characteristic white matter lesion on MRI brain is the most important predictor in the development of MS.
• Early recognition of ON is essential for prompt referral to an ophthalmologist.
• Treatment for the acute episode of ON with IV methylprednisone followed by oral prednisolone hastens the rate of vision recovery.

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