Visual loss as a result of primary optic nerve neuropathy after intranasal corticosteroid injection

A 25-year-old woman experienced acute visual loss after injection of methylprednisolone suspension into the concha nasalis inferioris. Results of ophthalmoscopic examinations were normal throughout the observation period, a finding not reported previously in cases of visual loss after head or neck injections. An afferent pupillary defect, which diminished as visual acuity improved, implicated otpic nerve damage, as did the visual field defect which also improved slightly. This is, to our knowledge, the first case report of acute visual loss caused by optic nerve neuropathy after injection to the head or neck.