Optic neuritis

Question 1

Optic neuritis risk factors

Answer 1

Known multiple sclerosis
Female sex
Young age

Question 2

Optic neuritis history

Answer 2

(Sub)acute unilateral painful vision loss
Flashes worse on eye movement
Reduced visual fields
Reduced colour vision

Question 3

Optic neuritis examination

Answer 3

Fundoscopy - optic nerve may show swelling or pallor
RAPD positive
Reduced Ishihara plate
May have internuclear ophthalmoplegia (in MS - slow adduction of one eye)

Question 4

Optic neuritis investigations

Answer 4

Optic neuritis - clinical diagnosis
MRI brain and orbits with gadolinium contrast
Consider CSF analysis

Question 5

Management of optic neuritis

Answer 5

IV methylprednisolone then taper with oral pred
If no MS consider regular MRI
If MS follow up with neurology