Optic neuritis

Question 1

Optic neuritis is an inflammatory condition that affects the optic nerve. What is the incidence of this?

1 - 7000 cases per 100,000
2 - 700 cases per 100,000
3 - 70 cases per 100,000
4 - 7 cases per 100,000

Answer 1

4 - 7 cases per 100,000

Equally likely in males and females

Question 2

What age does the incidence of optic neuritis typically peak at?

1 - 10-30
2 - 20-40
3 - 30-50
4 - 60-80

Answer 2

2 - 20-40

Question 3

In typical optic neuritis, do patients typically present with unilateral or bilateral vision loss?

Answer 3

• unilateral

Question 4

Patients with typical optic neuritis typically present with unilateral vision loss. Which 2 of the following do patients normally describe?

1 - central scotoma
2 - photopsia
3 - hazy vision
4 - blurred vision

Answer 4

3 - hazy vision
4 - blurred vision

Question 5

Which of the following is NOT a key feature of typical optic neuritis?

1 - pain on eye movement
2 - bilateral vision loss
3 - relative afferent pupillary defect
4 - loss of colour vision

Answer 5

2 - bilateral vision loss

Loss is unilateral

Question 6

In patients with typical optic neuritis, does the optic disc appear abnormal or normal?

Answer 6

• typically normal

Question 7

In patients with typical optic neuritis. do they typically present with any other demyelination disease symptoms?

Answer 7

• yes

Pins and needles, poor coordination

Question 8

Which neurological condition is typical optic neuritis associated with?

1 - motor neuron disease
2 - meningitis
3 - encephalitis
4 - multiple sclerosis

Answer 8

4 - multiple sclerosis

Question 9

What scan do patients typically receive to identify the cause of the optic neuritis?

1 - MRI
2 - CT
3 - ultrasound
4 - PET

Answer 9

1 - MRI

If MS then there will be lots of white lesions

Question 10

Does the vision loss that patients with typical optic neuritis generally return?

Answer 10

• yes

Will recover slowly over 6 weeks

Steroids may speed up the recovery

Question 11

Which of the following can cause atypical optic neuritis?

1 - bacterial infection
2 - viral infection
3 - inflammatory conditions
4 - all of the above

Answer 11

4 - all of the above

Question 12

Do patients with atypical optic neuritis have the characteristic eye pain when moving the eyes?

Answer 12

• no

Question 13

Does the vision loss in patients with atypical optic neuritis return as it does in typical optic neuritis?

Answer 13

• no

Question 14

Atypical optic neuritis is associsated with a number of conditions. Match the conditions with the groups that are most at risk of these conditions as these patients are at a greater risk of developing optic neuritis?

• African Caribbeans
• Indian subcontinent
• Turkish
• Behcets
• Sarcoidosis
• Tuberculosis

Answer 14

• African Caribbeans = sarcoidosis
• Indian subcontinent = Tuberculosis
• Turkish = Behcets

These conditions must be screened for in optic neuritis as they can cause Treponema (bacteria) than can cause atypical presentation of the condition