Sudden loss of vision is an ophthalmological emergency and requires immediate referral to the eye emergency department.
The treatment of optic neuritis is directed toward the underlying cause. Systemic corticosteroids are unproven except in cases of papillitis in which there is minimal evidence of collagen vascular disease or other signs of multiple sclerosis.
The majority of patients under the age of 45 years recover normal visual acuity within 2 months. Older patients recover less well and there may be evidence of optic atrophy.
If recovery is poor, a compressive lesion must be excluded, especially if both eyes are effected.
Attacks are cumulative. Significant visual loss accompanies repeated episodes of neuritis.
If a person has an episode of isolated optic neuritis, confirmed by an ophthalmologist, refer them to a consultant neurologist for further assessment (1)
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