[Neuro-ophthalmology--new challenges]

The diagnosis of optic neuritis is based on clinical signs and symptoms. Ancillary testing has little medical value, but is helpful to evaluate the risk of developing multiple sclerosis and for counseling the patients. In contrast to the common belief, the usual therapy with oral prednisone may be harmful. Only megadose therapy with 1000 mg methylprednisolone/day accelerates the recovery of visual function. Similar therapy is suggested in idiopathic intracranial hypertension. In patients with non-arteritic anterior ischemic optic neuropathy only optic nerve decompression sheath surgery is helpful.