Symptoms, signs and early course of optic neuritis

The study was an anlysis of the early course of optic neuritis based on the case histories of 185 patients, 57% of whom were females and 43% males. More than half of the patients suffered from multiple sclerosis. In 28% of the patients the etiology remained unknown. The most common initial symptom was acute decrease in visual acuity, but in 25% the onset was subacute or slow. Pain occured in 62% and preceded decrease in visual acuity in 16% of the cases. The initial attack was unilateral in 70% and bilateral in 30% of the patients. On admission, in 64% of the involved eyes, visual acuity was poor and in 73% the defect in the visual field involved the central field. The optic disc was normal in 46%, blurred and /or hyperaemic in 20%, oedematous in 23% and in 11% there was temporal or total pallor already on admission. The last finding was common in patients with bilateral optic neuritis with a slow onset. Six months after admission visual acuity was good or excellent in 56% and the visual field was normal in 45% of the involved eyes.