Walsh & Hoyt: Idiopathic and Primary Demyelinating Optic Neuritis

Despite remarkable advances in neuroimaging and electrophysiologic testing, the diagnosis of optic neuritis remains basically a clinical one. Nettleship (1) first described a syndrome characterized by failure of sight limited to one eye, often accompaniedby neuralgic pain about the temple and orbit andby pain in moving the eye; many recover but permanent damage and even total blindness may ensue; there is at first little, sometimes no, ophthalmoscopic change, but the disc often becomes more or less atrophic in a few weeks. Nettleship (1) also emphasizedthe tendency for the orbital pain to antedate the loss of vision and for the maximum visual fieldd efect to be central in nature. Subsequently, Parinaud(2), Uhthoff (3), Buzzard(4), andGunn (5) describedsimilar patients.