Suspected optic neuritis at the ophthalmological emergency department Case series report
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Published:
Feb 20, 2026
Keywords:
optic neuritis, Visual Evoked Potentials, VEP, Ophthalmological emergency
Main Article Content
Abstract
Introduction: Optic neuritis is damage and swelling of the optic nerve myelin, presenting with pain during eye movements, decreased visual acuity, color vision deficiency, and visual field loss. It mainly affects people aged 20–45 years, particularly Caucasian women.
The aim: Assessment of the effectiveness of optic neuritis diagnostics at the ophthalmological emergency department
Materials and methods: Analysis of 71 cases from the Emergency Department of the University Clinical Center in Katowice (January–June 2022).
Results: Eye pain was reported in 5 patients, color vision deficiency in 18, and 11 were referred for hospitalization.
Conclusions: Early diagnosis is crucial for vision preservation.
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1.
Sieńko A, Łabuś M, Maciejczyk T, Sirek S, Wyględowska-Promieńska D. Suspected optic neuritis at the ophthalmological emergency department. Ophthatherapy [Internet]. 2026Feb.20 [cited 2026May30];12(4). Available from: https://www.journalsmededu.pl/index.php/ophthatherapy/article/view/3152
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Diagnostics
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Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
Author Biographies
Antoni Sieńko, Student Scientific Club at the Department of Ophthalmology, Faculty of Ophthalmology, Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice
Tomasz Maciejczyk, Student Scientific Club at the Department of Ophthalmology, Faculty of Ophthalmology, Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice
References
1. Petzold A, Fraser CL, Abegg M et al. Diagnosis and classification of optic neuritis. Lancet Neurol. 2022; 21(12): 1120-34. http://doi.org/10.1016/S1474-4422(22)00200-9.
2. Toosy A, Mason DG, Miller DH. Optic neuritis. Lancet Neurol. 2014; 13(1): 83-99. http://doi.org/10.1016/s1474-4422(13)70259-x .
3. Koch-Henriksen N, Hyllested K. Epidemiology of multiple sclerosis: Incidence and prevalence rates in Denmark 1948–64 based on the Danish Multiple Sclerosis Registry. Acta Neurol Scand. 1988; 78(5): 369-80. http://doi.org/10.1111/j.1600-0404.1988.tb03672.x.
4. Rejdak R. Zapalenie nerwu wzrokowego – różnicowanie, diagnoza, leczenie. II Międzynarodowa Konferencja Szkoleniowa “Nowe spojrzenie na okulistykę”; 3 czerwca 2023. Kraków.
5. Morrow MJ. Ischemic optic neuropathy. Continuum (Minneap Minn). 2019; 25(5): 1215-35. http://doi.org/10.1212/CON.0000000000000767.
6. Bonnet C, Brézin AP. Uvéites, éléments d’orientation diagnostique. J Fr Ophtalmol. 2020; 43(2): 145-51. http://doi.org/10.1016/j.jfo.2019.03.038.
7. Osaguona VB, Kayoma DH. Etiology of Optic Disc Swelling in a Tertiary Care Center in Nigeria. Niger J Clin Pract. 2020; 23(12): 1690-4. http://doi.org/10.4103/njcp.njcp_333_20.
8. Du Y, Li K, Yang J et al. Disc swelling and mild initial visual acuity loss predict a better short-term visual acuity outcome in bilateral acute optic neuritis. J Clin Neurosci. 2012; 19(10): 1380-2. http://doi.org/10.1016/j.jocn.2011.10.020.
9. The clinical profile of optic neuritis. Experience of the Optic Neuritis Treatment Trial. Optic Neuritis Study Group. Arch Ophthalmol. 1991; 109(12): 1673-8. http://doi.org/10.1001/archopht.1991.01080120057025.
10. Schneck ME, Haegerstrom-Portnoy G. Color vision defect type and spatial vision in the optic neuritis treatment trial. Invest Ophthalmol Vis Sci. 1997; 38(11): 2278-89.
11. Petzold A, Wattjes MP, Costello F et al. The investigation of acute optic neuritis: a review and proposed protocol. Nat Rev Neurol. 2014; 10(8): 447-58. http://doi.org/10.1038/nrneurol.2014.108.
12. Keltner JL. Visual Field profile of optic neuritis. Arch Ophthalmol. 2010; 128(3): 330. http://doi.org/10.1001/archophthalmol.2010.16.
13. Miller DH, Newton MR, van der Poel JC et al. Magnetic resonance imaging of the optic nerve in optic neuritis. Neurology. 1988; 38(2): 175-9. http://doi.org/10.1212/wnl.38.2.175.
14. Plant GT, Sibtain NA, Thomas D. Hyperacute corticosteroid treatment of optic neuritis at the onset of pain may prevent visual loss: a case series. Mult Scler Int. 2011; 2011: 815068. http://doi.org/10.1155/2011/815068.
15. Nakamura M, Nakazawa T, Doi H et al. Early high-dose intravenous methylprednisolone is effective in preserving retinal nerve fiber layer thickness in patients with neuromyelitis optica. Graefes Arch Clin Exp Ophthalmol. 2010; 248(12): 1777-85. http://doi.org/10.1007/s00417-010-1344-7.
16. Dutt M, Tabuena P, Ventura E et al. Timing of corticosteroid therapy is critical to prevent retinal ganglion cell loss in experimental optic neuritis. Invest Ophthalmol Vis Sci. 2010; 51(3): 1439-45. http://doi.org/10.1167/iovs.09-4009.
17. Beck RW, Cleary PA, Anderson MM Jr et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992; 326(9): 581-8. http://doi.org/10.1056/NEJM199202273260901.
18. Beck RW, Gal RL. Treatment of acute optic neuritis: a summary of findings from the optic neuritis treatment trial. Arch Ophthalmol. 2008; 126(7): 994-5. http://doi.org/10.1001/archopht.126.7.994.
19. Beck RW, Cleary PA, Trobe JD et al. The effect of corticosteroids for acute optic neuritis on the subsequent development of multiple sclerosis. The Optic Neuritis Study Group. N Engl J Med. 1993; 329(24): 1764-9. http://doi.org/10.1056/NEJM199312093292403.
20. Optic Neuritis Study Group. Multiple sclerosis risk after optic neuritis: final optic neuritis treatment trial follow-up. Arch Neurol. 2008; 65(6): 727-32. http://doi.org/10.1001/archneur.65.6.727.
21. Gupta SR, Suhler EB, Rosenbaum JT. Intravenous methylprednisolone can cause an acute, vision-threatening rise in intraocular pressure. J Clin Rheumatol. 2010; 16(8): 397-8. http://doi.org/10.1097/RHU.0b013e3181ffdd4f.
22. Francois J. Corticosteroid glaucoma. Ann Ophthalmol. 1977; 9: 1075Y1080.
23. Galetta SL. The diagnosis and management of optic neuritis. (2017).
24. Atkins EJ, Biousse V, Newman NJ. The natural history of optic neuritis. Rev Neurol Dis. 2006 Spring; 3(2): 45-56
2. Toosy A, Mason DG, Miller DH. Optic neuritis. Lancet Neurol. 2014; 13(1): 83-99. http://doi.org/10.1016/s1474-4422(13)70259-x .
3. Koch-Henriksen N, Hyllested K. Epidemiology of multiple sclerosis: Incidence and prevalence rates in Denmark 1948–64 based on the Danish Multiple Sclerosis Registry. Acta Neurol Scand. 1988; 78(5): 369-80. http://doi.org/10.1111/j.1600-0404.1988.tb03672.x.
4. Rejdak R. Zapalenie nerwu wzrokowego – różnicowanie, diagnoza, leczenie. II Międzynarodowa Konferencja Szkoleniowa “Nowe spojrzenie na okulistykę”; 3 czerwca 2023. Kraków.
5. Morrow MJ. Ischemic optic neuropathy. Continuum (Minneap Minn). 2019; 25(5): 1215-35. http://doi.org/10.1212/CON.0000000000000767.
6. Bonnet C, Brézin AP. Uvéites, éléments d’orientation diagnostique. J Fr Ophtalmol. 2020; 43(2): 145-51. http://doi.org/10.1016/j.jfo.2019.03.038.
7. Osaguona VB, Kayoma DH. Etiology of Optic Disc Swelling in a Tertiary Care Center in Nigeria. Niger J Clin Pract. 2020; 23(12): 1690-4. http://doi.org/10.4103/njcp.njcp_333_20.
8. Du Y, Li K, Yang J et al. Disc swelling and mild initial visual acuity loss predict a better short-term visual acuity outcome in bilateral acute optic neuritis. J Clin Neurosci. 2012; 19(10): 1380-2. http://doi.org/10.1016/j.jocn.2011.10.020.
9. The clinical profile of optic neuritis. Experience of the Optic Neuritis Treatment Trial. Optic Neuritis Study Group. Arch Ophthalmol. 1991; 109(12): 1673-8. http://doi.org/10.1001/archopht.1991.01080120057025.
10. Schneck ME, Haegerstrom-Portnoy G. Color vision defect type and spatial vision in the optic neuritis treatment trial. Invest Ophthalmol Vis Sci. 1997; 38(11): 2278-89.
11. Petzold A, Wattjes MP, Costello F et al. The investigation of acute optic neuritis: a review and proposed protocol. Nat Rev Neurol. 2014; 10(8): 447-58. http://doi.org/10.1038/nrneurol.2014.108.
12. Keltner JL. Visual Field profile of optic neuritis. Arch Ophthalmol. 2010; 128(3): 330. http://doi.org/10.1001/archophthalmol.2010.16.
13. Miller DH, Newton MR, van der Poel JC et al. Magnetic resonance imaging of the optic nerve in optic neuritis. Neurology. 1988; 38(2): 175-9. http://doi.org/10.1212/wnl.38.2.175.
14. Plant GT, Sibtain NA, Thomas D. Hyperacute corticosteroid treatment of optic neuritis at the onset of pain may prevent visual loss: a case series. Mult Scler Int. 2011; 2011: 815068. http://doi.org/10.1155/2011/815068.
15. Nakamura M, Nakazawa T, Doi H et al. Early high-dose intravenous methylprednisolone is effective in preserving retinal nerve fiber layer thickness in patients with neuromyelitis optica. Graefes Arch Clin Exp Ophthalmol. 2010; 248(12): 1777-85. http://doi.org/10.1007/s00417-010-1344-7.
16. Dutt M, Tabuena P, Ventura E et al. Timing of corticosteroid therapy is critical to prevent retinal ganglion cell loss in experimental optic neuritis. Invest Ophthalmol Vis Sci. 2010; 51(3): 1439-45. http://doi.org/10.1167/iovs.09-4009.
17. Beck RW, Cleary PA, Anderson MM Jr et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992; 326(9): 581-8. http://doi.org/10.1056/NEJM199202273260901.
18. Beck RW, Gal RL. Treatment of acute optic neuritis: a summary of findings from the optic neuritis treatment trial. Arch Ophthalmol. 2008; 126(7): 994-5. http://doi.org/10.1001/archopht.126.7.994.
19. Beck RW, Cleary PA, Trobe JD et al. The effect of corticosteroids for acute optic neuritis on the subsequent development of multiple sclerosis. The Optic Neuritis Study Group. N Engl J Med. 1993; 329(24): 1764-9. http://doi.org/10.1056/NEJM199312093292403.
20. Optic Neuritis Study Group. Multiple sclerosis risk after optic neuritis: final optic neuritis treatment trial follow-up. Arch Neurol. 2008; 65(6): 727-32. http://doi.org/10.1001/archneur.65.6.727.
21. Gupta SR, Suhler EB, Rosenbaum JT. Intravenous methylprednisolone can cause an acute, vision-threatening rise in intraocular pressure. J Clin Rheumatol. 2010; 16(8): 397-8. http://doi.org/10.1097/RHU.0b013e3181ffdd4f.
22. Francois J. Corticosteroid glaucoma. Ann Ophthalmol. 1977; 9: 1075Y1080.
23. Galetta SL. The diagnosis and management of optic neuritis. (2017).
24. Atkins EJ, Biousse V, Newman NJ. The natural history of optic neuritis. Rev Neurol Dis. 2006 Spring; 3(2): 45-56