Walsh & Hoyt: Optic Neuritis from Viral and Bacterial Diseases

Parainfectious optic neuritis typically follows the onset of a viral or, less often, a bacterial infection by 1 to 3 weeks. It is more common in children than in adults andis thought to occur on an immunologic basis, producing demyelination of the optic nerve. The optic neuritis may be unilateral, but it is often bilateral. The optic discs may appear normal or swollen. Swelling of the peripapillary retina may be observedin patients with anterior optic neuritis. If a star figure composedof lipidexud ates develops in the macula of the affectedeye, the condition is calledneuroretinitis (discussed later). If there is evidence of optic disc swelling but no evidence of optic nerve dysfunction, and the intracranial pressure is normal, the inflammation is assumedto be ffecting the periphery of the nerve andis calledperioptic neuritis or optic perineuritis (discussed later).