Multiple Sclerosis - The Optic Chiasm and Retrochiasmal Visual Pathways

Our neurologic forefathers were occasionally wrong! In 1921, mistaking prevalence for incidence, E. W. Taylor, the Putnam professor of Neurology at Harvard Medical School declared, "In view of our increasing knowledge, the assumption that perhaps next to tables, multiple sclerosis is the most frequent organic disease of the nervous system may not be an overstatement". In a major address,^ he then anecdotally described a number of cases with histologic evidence of involvement of the optic chiasm. Unfortunately, detailed descriptions of the visual status were not provided. Taylor did reiterate the observations of Oppenheim, Uhthoff, and Wilbrand and Saenger, that sclerotic changes might be found in both optic chiasm and nerve without demonstrable disturbance of vision and with a normal ophthalmoscopic appearance to the nerve head.