Optic Neuritis

Optic neuritis is inflammatory demyelination of the optic nerve. Patients present with painful loss of vision in one eye. The visual loss gradually develops over several days and pain occurs around the orbit and with eye movement. Visual function begins to improve over several weeks and usually returns to normal by 3 months. Color vision is the last to return.

In 20-30% of optic neuritis patients, this is the first presentation of multiple sclerosis. 50% of multiple sclerosis patients have an episode of optic neuritis at some time in their disease course. Other etiologies include infections, like syphilis and Lyme, sarcoid, or autoimmune processes like lupus. MRI scanning is helpful in differentiating those patients who are more likely to go on and develop multiple sclerosis.

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