Optic Neuritis

Question 1

What is optic neuritis?

Answer 1

The inflammation of the optic nerve head (ONH)

Question 2

What are the classifications of optic neuritis (3 types)?

Answer 2

• Retrobulbar neuritis: (adults) - Inflammation BEHIND ONH
• Papillitis: (children) - swelling of ONH
• Neuroretinitis - swelling around ONH

Question 3

What are the causes of optic neuritis?

Answer 3

• Demyelination (damage to myelin sheath i.e. in multiple sclerosis. MS causes fatigue, problems with muscle movement, balance and vision)
• Viral infections, Tuberculosis (lung infection), Syphilis (practice safe sex u dirty bastard)

Question 4

What are the presentation/symptoms of optic neuritis?

Answer 4

• Unilateral
• Acute (Sudden Onset)
• Young Female Adults (18-45)
• Rapid loss of vision in one eye
• Retrobulbar or orbital pain (behind or around eye) - worse when moving the eye.

Question 5

What are the 6 signs of optic neuritis?

Answer 5

1. Central Scotoma
2. Dyschromatopsia (red/green colour defect)
3. RAPD
4. Va reduced from 6/18-6/60
5. Normal fundus appearance (only 1 in 3 show disc swelling)
6. Pale disc

Question 6

What is the management and referral for optic neuritis?

Answer 6

URGENT REFERRAL (1-2 weeks)

• Investigate underlying cause
• No treatment (potentially steroid meds)

Question 7

What is the prognosis of optic neuritis?

Answer 7

• Vision returns after 3-4 weeks (no better than 6/12)

- Optic atrophy develops after 3-4 weeks