From Darkness to Light: A Rare Case of Visual Recovery from Absent Light Perception to 20/20 in a Young Girl with Bilateral Optic Neuritis

Abstract

Optic Neuritis is an ophthalmic emergency, characterized by sudden loss of vision, which needs immediate attention. Although steroids are the main stay of treatment, stringent diagnostic measures including an extensive serology workup and neuroimaging need to be done as to ascertain the etiology. This case report describes a young girl with bilateral severe optic neuritis, with denied perception of light in both eyes, and no systemic association. Immediate administration of methylprednisolone is the norm in such cases, and as per Optic Neuritis Treatment Trial, it is usually given for 3 days followed by oral prednisolone. In this patient, intravenous 1gram methylprednisolone was administered for 5 days, and then followed by oral prednisolone. The patient showed an excellent response with a complete recovery of vision to 20/20, which is an extremely rare phenomenon.

Bilateral Concomitant Infection of Cytomegalovirus and Varicella-Zoster Virus Retinitis in an Immunocompromised Adult

“…Improvement from NLP vision is documented in cases with inflammatory etiologies like giant cell arteritis and optic neuritis; in these cases, the resolution of severe optic nerve edema coincided with improvement from NLP vision. 14 , 15 The mechanism of vision loss in optic nerve edema is thought to be related to mechanical disruption causing nerve fiber dysfunction as a result of localized swelling. 16 Therefore, we theorize the improvement from NLP vision in this patient may be more related to the resolution of optic nerve edema versus improvement in retinitis.…”

Bilateral Concomitant Infection of Cytomegalovirus and Varicella-Zoster Virus Retinitis in an Immunocompromised Adult

“…Improvement from NLP vision is documented in cases with inflammatory etiologies like giant cell arteritis and optic neuritis; in these cases, the resolution of severe optic nerve edema coincided with improvement from NLP vision. 14 , 15 The mechanism of vision loss in optic nerve edema is thought to be related to mechanical disruption causing nerve fiber dysfunction as a result of localized swelling. 16 Therefore, we theorize the improvement from NLP vision in this patient may be more related to the resolution of optic nerve edema versus improvement in retinitis.…”

Bilateral Concomitant Infection of Cytomegalovirus and Varicella-Zoster Virus Retinitis in an Immunocompromised Adult

“…Improvement from NLP vision is documented in cases with inflammatory etiologies like giant cell arteritis and optic neuritis; in these cases, the resolution of severe optic nerve edema coincided with improvement from NLP vision. 14 , 15 The mechanism of vision loss in optic nerve edema is thought to be related to mechanical disruption causing nerve fiber dysfunction as a result of localized swelling. 16 Therefore, we theorize the improvement from NLP vision in this patient may be more related to the resolution of optic nerve edema versus improvement in retinitis.…”

Bilateral Concomitant Infection of Cytomegalovirus and Varicella-Zoster Virus Retinitis in an Immunocompromised Adult

“…Improvement from NLP vision is documented in cases with inflammatory etiologies like giant cell arteritis and optic neuritis; in these cases, the resolution of severe optic nerve edema coincided with improvement from NLP vision. 14 , 15 The mechanism of vision loss in optic nerve edema is thought to be related to mechanical disruption causing nerve fiber dysfunction as a result of localized swelling. 16 Therefore, we theorize the improvement from NLP vision in this patient may be more related to the resolution of optic nerve edema versus improvement in retinitis.…”