Certain signs and symptoms are commonly seen in patients with optic neuritis.
Pain – may precede onset of visual symptoms or occur concurrently:
(1) periocular
(2) pain on eye movement
Vision – may affect one or both eyes:
(1) progressive visual loss over a few days (usually less than 1 week) followed by spontaneous improvement
(2) spontaneous sparks or flashes of light in vision (photopsia) associated with eye movement
(3) visual sensation with eyes closed and in absence of light (phosphene)
Changes in vision usually seen in recovery phase:
(1) fading of vision
(2) misperception of the trajectory of moving objects (Pulfrich's phenomenon)
(3) deterioration in vision with specific situations (Uhthoff's phenomenon)
History may include:
(1) multiple sclerosis
(2) previous neurological symptoms
Signs:
(1) reduced visual acuity
(2) decreased color vision
(3) reduced contrast sensitivity
(4) visual field defect (central scotoma common)
(5) relative afferent pupillary defect
Ophthalmoscopic findings:
(1) optic disc may be normal or swollen; may be flat and pale if pre-existing damage exists
(2) macula normal
(3) peripheral retina normal
(4) uveitis may be present
(5) retinal periphlebitis may be present
(6) no inflammation in vitreous or anterior chamber
