• Acute to sub-acute
onset [2,8] promoting over a several hours 6 to 2 weeks [2,9,10] |
• Young adult patient with peak manifestation
between 15-50 years of age [2,3,9] |
• Females > males [2,3,9] |
• Periocular pain (90%) [2,5,16-18], especially with eye
movement [2,3,8-10,18] |
• Unilateral loss of visual acuity [2,4,8-10,18] variable in severity
(from 20/20 in 10.5% to no light perception in 3.1% [4,5,16]), or may be
bilateral usually in children often associated
with a post or para infectious demyelination [2,4,8,10] |
• Reduced contrast sensitivity [1,8,9,18] |
• Uhthoff’s phenomenon (Exercise
or heat-induced deterioration of visual symptoms) [2,5,8,18] |
• Pulfrich phenomenon (misperception
of the direction of movement of an object) [2,5,8,18] |
• Ipsilateral relative afferent pupillary defect (RAPD).
lack of the defect suggests a preexisting or concurrent optic
neuropathy in
the fellow eye [2,4,8-10,18] |
• Normal (65%) or swollen (35%) (more
common in
children) optic nerve head [2,5,9,10,18] |
• Possibility of mild uveitis [9,18] and retinal
periphlebitis [2,9,18] |
• Visual field defect [2,4,10], any type [9,18]; ranging
from commonly seen diffuse depression and central or centrocecal scotoma
[2,5,8,16], to rarely seen quadrantic [2,4,16] and altitudinal defects
[4] |
• Spontaneous visual improvement in >90% [2,3,9,18] |
• No deterioration in vision after steroids discontinuation
[2,9] |
• Pallor of the optic disc [2,11] |
• Previous history of ON or MS [9,18] |
• Reduction in vision in bright light [2] |
• Phosphenes or photopsias (spontaneous flashes of light in
vision)
provoked by eye movement [8,18] |
• Dyschromatopsia [2,8-10,18]
(any type) [2,7]*
|