clinical features

Last reviewed 06/2023

The clinical features of optic neuritis are divided into symptoms and clinical signs: Commonly symptoms are:

  • variable loss of central vision which usually recovers within 2-6 weeks
  • dull aching pain in the region of the eye, aggravated by movement, especially elevation

On examination:

  • visual field defect - most commonly a central scotoma
  • loss of colour vision
  • relative afferent pupillary defect
  • reduced visually-evoked response

Ophthalmoscopically:

  • the optic disc normal in retrobulbar neuritis
  • in papillitis, the disc may be swollen, with blurred margins and filling of the physiologic cup; the disc is hyperaemic with distension of retinal veins. The surrounding retinal oedema may be extensive and flame shaped haemorrhages may be observable on the surface of the disc and the adjacent retina.