[Acute visual loss in an eight-year-old girl].

BACKGROUND

There are many causes of acute visual loss in childhood. Inflammation of the optic nerve, optic neuritis, is rare. While mostly unilateral in adults, the disease often presents bilaterally in childhood. Furthermore, progression to demyelinating disease is unusual and optic neuritis has a better prognosis in childhood than in adulthood.

MATERIAL AND METHODS

We describe an 8-year-old girl who over a few days developed painful eyes and profound visual loss. She had afferent pupil defect; ophthalmoscopy showed bilateral papilloedema, characteristic of bilateral optic neuritis. Current literature and guidelines are reviewed with regards to diagnosis and treatment of optic neuritis in childhood.

RESULTS

Steroids seem to be beneficial in the treatment of optic neuritis in childhood. Following five days intravenous administration of methylprednisolone and an oral taper over five weeks, visual acuity was almost normalised in both eyes.

INTERPRETATION

After studying the literature, we started a treatment with good outcome. Although the prognosis is usually good in children even without treatment, it is important to be aware that there are cases in which treatment with steroids is recommended.