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ALL / Ophthalmology

Optic neuritis

Optic neuritis

Causes
  • multiple sclerosis: the commonest associated disease
  • diabetes
  • syphilis

Features
  • unilateral decrease in visual acuity over hours or days
  • poor discrimination of colours, 'red desaturation'
  • pain worse on eye movement
  • relative afferent pupillary defect
  • central scotoma

Investigation
  • MRI of the brain and orbits with gadolinium contrast is diagnostic in most cases

Management
  • high-dose steroids
  • recovery usually takes 4-6 weeks

Prognosis
  • MRI: if > 3 white-matter lesions, 5-year risk of developing multiple sclerosis is c. 50%
+PassMedicine Notes
Causes
  • multiple sclerosis: the commonest associated disease
  • diabetes
  • syphilis
Features
  • unilateral decrease in visual acuity over hours or days
  • poor discrimination of colours, 'red desaturation'
  • pain worse on eye movement
  • relative afferent pupillary defect
  • central scotoma
Investigation
  • MRI of the brain and orbits with gadolinium contrast is diagnostic in most cases
Management
  • high-dose steroids
  • recovery usually takes 4-6 weeks
Prognosis
  • MRI: if > 3 white-matter lesions, 5-year risk of developing multiple sclerosis is c. 50%


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