A Practical Approach To Diagnosing And Treating Optic Neuritis.

As defined in Kanski, optic neuritis is "an inflammatory or demylinating disorder
of the optic nerve". It is typically categorized into three types:
1) papillitis
2) neuroretinitis
3) retrobulbar neuritis
The appearance of papillitis includes disc swelling, vitreous cells, and possible
hemorrhages around the disc. Typically this occurs in children. Neuroretinitis has all the
possible signs of papillitis with a macular star in addition. This is the least common of all three cases. It is typically present in end stage syphilis, and rarely associated with
demylination. Retrobulbar neuritis is the classic senario of"patient sees nothing, doctor
sees nothing" where the nerve head and retinal fiber layer appear normal. This form is
most frequently associated with demylinating disease such as multiple sclerosis. (Kanski)
The focus of discussion will be: what ideally should happen in the exam room to
diagnose and treat optic neuritis, educate the patient on their prognosis, and the chances of conversion to multiple sclerosis. Results of the Optic Neuritis Treatment Trial will also be summarized.