Bilateral optic neuritis with macular edema in a young female: A case report

Abstract

A 20 year old female, presented with history of swelling of right cheek since 2 weeks associated with fever and rash, blurring of vision in both eyes since 7 days which was sudden in onset and painless. Dilated fundoscopic examination of right eye showed disc edema with hyperemia with macular edema. Left eye showed disc edema with hyperemia, splinter hemorrhage on the disc and macular edema. This case posed a diagnostic challenge as clinically, it did not typically fit into the diagnosis of optic neuritis as the pupil reactions were normal, absence of afferent pupillary defect. However, there was rapid therapeutic response with intravenous injection of Dexamethasone, which improved the visual acuity from <1/60 to 6/6 in about a week. Keyword: Post viral optic neuritis, Macular edema, Anterior ischemic optic neuropathy