Optic Nerve
Right Optic Neuritis (Papillitis)
- Usually unilateral
- Acute VL
- Pupil +
- CV +
- VF Central scotoma
- OD Unilateral swelling
Papilledema
- Bilateral
- S&S of increase ICT + Late
- Enlarged blind spot
- Bilateral Swelling
Case Study: 26-year-old Lady
- Presentation: 3-day history of blurring of vision in the right eye, progressively worse. Dull aching pain.
- Past Medical History: Episode of weakness in the Left leg 3 years ago, settled without treatment. Recurrent attacks of frontal headache. Otherwise fit and well.
- Examination:
- Vision: Right eye 1/60 (no improvement), Left eye 6/9.
- Eye: White and quiet, no abnormality noted except for a right relative afferent pupillary defect.
Fundus Examination
Diagnostic Features
- Symptoms
- Vision
- Bilaterality
- Field
Right Optic Neuritis
Differential Diagnosis
-
DD of Swollen Optic Disc
-
Papilledema: DD
-
Pseudo papilledema
-
AION:
Investigations
Ophthalmological Examination
- VA
- Pupillary response: relative afferent pupillary defect (RAPD)
- Ocular motility
- VF examination
- Fundus examination
- FA and OCT
Investigations
- CT or MRI (MS)
- Lumber puncture
Treatment
- High-dosed intravenous steroids (methylprednisolone therapy) for 3 days (in hospital).
- Followed by oral steroid for 7 days.
- Vit B 12