Table 1.

Clinical features of typical acute demyelinating optic neuritis.

Patient characteristics

Young age [20–50 years]

Sex ratio 3 female: 1 male

Symptoms

Pain [> 90%], exacerbated by eye movements, resolves within 1 week, may precede other visual manifestations

Unilateral in adult patient

Progress over a period of hours to days; usually less than 2 weeks.

Phosphenes or photopsias with eye movement

Uhthoff phenomenon

Typical signs

Impaired visual acuity [90%] [10/10 to no light perception]

Blurred vision

Dyschromatopsia [88%] [red-green axes typically]

Impaired contrast sensitivity [87–99%]

Visual field loss [69%]

Afferent pupillary defect [Marcus Gunn]

Normal optic disc [70% retrobulbar] or swelling [30% papillitis]; evolution to pallor and atrophy; haemorrhages and retinal exudates rare

Normal macula and peripheral retina

Associated lesions

Uveitis or retinal periphlebitis

Outcome

Recovery of visual acuity begins within 2 to 4 weeks and often reaches 20/20