Abstract
Background
Optic neuritis is a common cause of subacute unilateral vision loss, occurring in
1–5 per 100,000 persons per year. It is more common in Caucasians, women, and those
from countries with northern latitudes. Those aged 20–49 years are at greatest risk.
The condition arises due to inflammation of the optic nerve. Inflammation may occur
due to systemic inflammatory disorders, most commonly multiple sclerosis.
Case Report
A 21-year-old African-American male presented to our emergency department with a complaint
of painful unilateral vision loss. On examination he was found to have a relative
afferent pupillary defect and red desaturation. A bedside ultrasound suggested pseudopapilledema
suggestive of optic neuritis. He was admitted to Neurology for confirmation of and
treatment for optic neuritis. Magnetic resonance imaging confirmed optic neuritis.
The patient was treated with i.v. steroids and discharged after improvement in visual
function.
Why Should an Emergency Physician Be Aware of This?
Optic neuritis is a clinical diagnosis. The subtle historical components and examination
findings make it a diagnostic challenge for the busy emergency physician. Early diagnosis
may improve visual outcomes. Discovery of pseudopapilledema on bedside ultrasound
may be seen in optic neuritis, and is another finding that emergency physicians may
assess for in patient presenting with unilateral vision loss.
Keywords
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Article info
Publication history
Published online: June 25, 2019
Accepted:
April 22,
2019
Received in revised form:
April 7,
2019
Received:
January 29,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
