Optic Neuritis

Question 1

What is Optic Neuritis?

Answer 1

Optic neuritis is the inflammation of the optic nerve, which can result in vision loss, often associated with conditions like multiple sclerosis.

Question 2

What are the common causes of Optic Neuritis?

Answer 2

• Multiple sclerosis (MS)
• Lyme disease
• Sarcoidosis
• Lupus
• Measles and mumps

Question 3

What are the key signs of Optic Neuritis?

Answer 3

• RAPD (Relative Afferent Pupillary Defect)
• Reduced visual acuity (VA), typically between 6/18 - 6/60
• Colour vision defect (monocular red desaturation)
• Normal ONH appearance in retrobulbar neuritis
• Temporal disc pallor in the fellow eye
• Visual field defects (altitudinal, arcuate, or central)

Question 4

What is RAPD in Optic Neuritis?

Answer 4

Relative Afferent Pupillary Defect (RAPD) occurs when the affected eye responds less to light due to optic nerve damage.

Question 5

What are the typical symptoms of Optic Neuritis?

Answer 5

• Monocular blurring of vision
• Pain on eye movement
• Coloured flashes in vision
• Diplopia (double vision)
• Frontal headaches and globe tenderness

Question 6

What visual acuity is typically seen in Optic Neuritis?

Answer 6

Reduced visual acuity between 6/18 to 6/60, though it may rarely be worse.

Question 7

What visual field defects are associated with Optic Neuritis?

Answer 7

• Altitudinal defects
• Arcuate defects
• Central visual field defects

Question 8

What is retrobulbar neuritis, and how does it affect the ONH?

Answer 8

Retrobulbar neuritis is the most common type of optic neuritis where the optic nerve head (ONH) appears normal.

Question 9

What is temporal disc pallor in Optic Neuritis?

Answer 9

It refers to the pale appearance of the optic disc in the fellow eye due to optic nerve damage.

Question 10

What are the common symptoms of pain in Optic Neuritis?

Answer 10

Pain is typically experienced with eye movement, along with frontal headaches and tenderness around the globe.

Question 11

Why is urgent referral necessary for Optic Neuritis?

Answer 11

Optic neuritis requires urgent referral to Hospital Eye Service (HES) for diagnosis and management due to its potential link to multiple sclerosis and other serious conditions.

Question 12

What is the role of corticosteroids in Optic Neuritis management?

Answer 12

Corticosteroids may reduce the risk of conversion to multiple sclerosis, but their use in treating optic neuritis is controversial and often combined with other therapies.

Question 13

What neurological condition is commonly associated with Optic Neuritis?

Answer 13

Multiple sclerosis (MS) is the most common neurological condition associated with optic neuritis.

Question 14

How does Optic Neuritis affect colour vision?

Answer 14

It typically causes a colour vision defect, often presenting as monocular red desaturation.

Question 15

What should an optometrist do when diagnosing Optic Neuritis?

Answer 15

Urgently refer the patient to the Hospital Eye Service (HES) and potentially call the eye department for triaging.

Question 16

What are the common visual symptoms reported by patients with Optic Neuritis?

Answer 16

Monocular blurring, coloured flashes, and diplopia (double vision).

Question 17

What role does eye movement play in diagnosing Optic Neuritis?

Answer 17

Patients often report pain on eye movement, which is a key symptom of optic neuritis.

Question 18

What visual field defects are common in Optic Neuritis?

Answer 18

Central defects, altitudinal defects, and arcuate defects.

Question 19

How does optic neuritis cause vision loss?

Answer 19

Inflammation damages the optic nerve, leading to reduced visual acuity, colour vision defects, and visual field loss.

Question 20

What treatment options are available for Optic Neuritis?

Answer 20

Treatment is controversial, but corticosteroids may be used alongside other treatments to reduce recurrence and the risk of conversion to multiple sclerosis.