Optic Neuritis

  • Inflammation of optic nerve causing vision loss
  • Usually affects patients younger than 50 years
  • May be part of multiple sclerosis, other autoimmune disorders, or infections
  • Refer urgently any patient with acute or subacute vision loss
  • In primary demyelinating optic neuritis, high-dose intravenous methylprednisolone 1 gm for 3 days followed by oral prednisone 1 mg/kg for 11 days slightly hastens recovery, but...
  • Spontaneous total or near total visual recovery occurs in 85%, and...
  • Corticosteroid treatment does not affect final visual outcome or long term incidence of multiple sclerosis
  • In optic neuritis associated with other autoimmune disorders, corticosteroid treatment may be very effective
  • In optic neuritis associated with infections, treatment directed at those infections