Vision at risk

October 2009


Optic neuritis

More than a loss of vision

Volume 38, No.10, October 2009 Pages 789-793

Edward R Chu

Celia S Chen


Optic neuritis is an acute inflammation of the optic nerve that results in painful loss of vision. Patients often present to a general practitioner, and early recognition is important as treatment may improve the speed of vision recovery.


This article provides information on the signs and symptoms of optic neuritis and discusses appropriate referral, investigations and management.


Optic neuritis is the presenting symptom in up to one-fifth of people with multiple sclerosis. Diagnosis of optic neuritis is based on history and examination, therefore obtaining pertinent information and performing proper ophthalmic examination is essential. Prompt recognition and appropriate referral is important to facilitate investigations such as magnetic resonance imaging of the brain that can help predict risk in the development of multiple sclerosis.

Optic neuritis (ON) is the presence of an acute inflammation of the optic nerve that results in painful loss of vision. It is the most commonly encountered optic neuropathy in general practice,1–4 and is often associated with multiple sclerosis (MS ).3,4 Studies show that in about 15–20% of MS cases, ON was the presenting symptom and more than half of people with MS experience at least one episode of ON during their disease.5,6 The risk of developing MS can be stratified by appropriate imaging investigations at the diagnosis of ON. Therefore, early recognition is important to ensure timely referral, investigation and treatment; prompt treatment can hasten visual recovery.

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