Walsh & Hoyt: Bilateral Optic Neuritis

In adults, bilateral simultaneous acute optic neuritis, particularly that associatedwith MS, is uncommon but well described. Adie found only one case of bilateral optic neuritis in his series of 70 adult patients, and other authors agreedwith him that both simultaneous and early consecutive cases were exceedingly rare. However, reports indicate that the incidence of bilateral simultaneous acute optic neuritis in patients with MS is 1075%. Morrissey et al. performeda retrospective analysis of the causes of bilateral simultaneous acute optic neuritis in 23 adults and found that 5 of the patients (22%) had developed clinical evidence of MS. In many of these series, the time interval between attacks in the two eyes is not stated. Bradley and Whitty (82) separated their cases into those that were unilateral (71%), those that were bilateral andsimultaneous (7%), those that were bilateral andnonsimultaneous but occurredwithin 3 months of each other (12%), andthose that occurred more than 3 onths apart (12%). These authors foundno significant differences in rate andd egree of recovery between bilateral andunilateral cases, regardless of the time interval between the attacks. The studies of Rischbieth and of Hutchinson seem to support this view.