Optic neuritis

Optic neuritis, an inflammatory demyelination of the optic nerve.

Optic neuritis is thought to be immune-mediated and is most commonly seen in women age 20-40 Symptoms develop acutely and usually include monocular vision loss, pain with eye movement, and “washed—out" color vision.

Examination typically reveals an afferent pupillary defect (paradoxical pupillary dilation of the affected eye with the swinging—flashlight test) and central scotoma.

Funduscopy is usually normal as inflammation occurs behind the optic nerve head

Optic neuritis is strongly associated with multiple sclerosis and is frequently the heralding symptom of this condition.

As  such, patients are typically evaluated with MRI of the orbits and the brain to look for other areas of inflammation.