This condition typically affects
patients in the 20 - 45 age group.
Central field defect
Visual acuity may be as poor as perception
Central scotoma is typical
Impaired colour discrimination (best
demonstrated with red object, the affected
eye will see the red object less
bright than the unaffected eye)
Note the red circle changes from
red in the normal eye to darker
when viewed with the eye with
Relative afferent pupillary defect of
the affected eye
Swinging light test showing left
pupillary defect. Note the dilatation
of the pupil
when the light is shone at the
Pain on eye movement especially on adduction.
Fundal examination is normal as most
cases have retrobulbar neuritis.
Refer the patient within 24 hours for
confirmation of the diagnosis
Normal or near-normal vision usually
returns within 6 weeks
As treatment does not affect the outcome,
unilateral optic neuritis is not treated by
most ophthalmologists. However,
follow-up is important as radiological investigation
may be needed to exclude compressive
lesion in cases where spontaneous recovery
fails to recur.
Optic atrophy in a patient with
a past history of optic neuritis. Optic atrophy is a late
sign. In acute optic neuritis, the
optic disc is typically normal.
to sudden visual loss