THE Frequency of Isolated Optic Neuritis in Cases of Visual Impairment

Optic Neuritis in Cases of Visual Impairment


  • Waqas Arshad Department of Neurology, Central Park Medical College, Lahore, Pakistan
  • Imad Ud Din Department of Neurology, Central Park Medical College, Lahore, Pakistan
  • Safia Bano King Edward Medical University Lahore, Pakistan
  • Waqar Ali Department of Medicine, Central Park Medical College, Lahore, Pakistan
  • Ayesha Azmat Department of Emergency, Mayo Hospital, Lahore, Pakistan
  • Asif Hanif University Institute of Public Health, The University of Lahore, Lahore, Pakistan



Optic Neuritis, Visual Acuity, Visual Impairment


Visual impairment can result from various conditions of eye as well as neural pathways that are responsible to transmit visual inputs to the brain. One of the most common of these diseases is termed as optic neuritis which is basically an inflammatory disorder and effects the optic nerve. Objective: To find the frequency of the isolated optic neuritis among subjects with visual impairment. Method: We conducted an analytical cross-sectional study in the Department of Neurology at the Mayo Hospital. Total 93 subjects fulfilling the inclusion criteria were taken into the study for data collection. All cases underwent visual acuity assessment using Snellen's and near vision charts. Ishihara chart was used to assess color vision along with a fundoscopic examination. Isolated optic neuritis was defined as the presence of one or more of three defects on assessment, i.e., relative afferent pupillary, visual field, and the color vision defect. Results: The mean age of patients was 45.45 ± 14.42 years. There were 53.8% male and 46.2% female cases, with a higher male-to-female ratio. Isolated optic neuritis was diagnosed in 24.7% of cases of vision impairment. Conclusions: Isolated optic neuritis was diagnosed in almost one-quarter of the patients (24.7%). So, patients presenting with visual impairment must be screened for isolated optic neuritis as optic neuritis is easily distinguished from other diseases affecting the optic nerve by using Snellen's chart and near vision chart and fundoscopic examination and eventually can prevent permanent blindness.


Costello F. Vision Disturbances in Multiple Sclerosis. Semin Neurology. 2016 Apr; 36(2): 185-95. doi: 10.1055/s-0036-1579692.

Thapa R, Bajimaya S, Paudyal G, Khanal S, Tan S, Thapa SS, et al. prevalence and causes of low vision and blindness in an elderly population in Nepal: the Bhaktapur retina study. BMC Ophthalmology. 2018 Dec; 18(1): 1-10. doi: 10.1186/s12886-018-0710-9.

Zhang X, Li EY, Leung CK-S, Musch DC, Tang X, Zheng C, et al. prevalence of visual impairment and outcomes of cataract surgery in Chaonan, South China. PloS One. 2017 Aug; 12(8): 1-13. doi: 10.1371/journal.pone.0180769.

Bourne R, Steinmetz JD, Flaxman S, Briant PS, Taylor HR, Resnikoff S, et al. Trends in Prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study. The Lancet Global Health. 2021 Feb; 9(2): e130-e43.

Verma R, Gupta M, Chaudhari TS. Neurogenic vision loss: Causes and outcome. An experience from a tertiary center in Northern India. Journal of Neurosciences Rural practice. 2014 Oct; 5(4): 340-8. doi: 10.4103/0976-3147.139971.

Bermel RA and Balcer LJ. Optic neuritis and the evaluation of visual impairment in multiple sclerosis. CONTINUUM: Lifelong Learning in Neurology. 2013 Aug; 19(4): 1074-86. doi: 10.1212/01.CON.0000433282.00221.7e.

Al-Louzi O and Saidha S. Chapter 12 - Pathophysiology of Optic Neuritis A2 - Minagar, Alireza. Multiple Sclerosis. San Diego: Academic Press 2016. doi: 10.1016/B978-0-12-800763-1.00012-9.

Toosy AT, Mason DF, Miller DH. Optic neuritis. Lancet Neurology. 2014 Jan; 13(1): 83-99. doi: 10.1016/S1474-4422(13)70259-X.

Burton EV and Greenberg BM, Frohman EM. Optic neuritis: A mechanistic view. Pathophysiology. 2011 Feb; 18(1): 81-92. doi: 0.1016/j.pathophys.2010.04.009.

Piccolo L, Woodhall M, Tackley G, Juryńczyk M, Kong Y, Domingos J, et al. Isolated new onset' atypical'optic neuritis in the NMO clinic: serum antibodies, prognoses, and diagnoses at follow-up. Journal of Neurology. 2016 Feb; 263(2): 370-9. doi: 10.1007/s00415-015-7983-1.

Osborne B and Balcer L. Optic neuritis: pathophysiology, clinical features and diagnosis. 2018. [Last Cited: 28th Sep 2021]. Available at:

Yoo YJ, Hwang J-M, Yang HK. Differences in pupillary light reflex between optic neuritis and ischemic optic neuropathy. PloS One. 2017 Oct; 12(10): 1-14. doi: 10.1371/journal.pone.0186741.

De la Cruz J and Kupersmith MJ. Clinical profile of simultaneous bilateral optic neuritis in adults. British Journal of Ophthalmology. 2006 May; 90(5): 551-4. doi: 10.1136/bjo.2005.085399.

Optic Neuritis Study Group. The clinical profile of optic neuritis: experience of the Optic Neuritis Treatment Trial. Archives of Ophthalmology. 1991 Dec; 109(12): 1673-8. doi: 10.1001/archopht.1991.01080120057025.

Murray CJ, Barber RM, Foreman KJ, Ozgoren AA, Abd-Allah F, Abera SF, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet. 2015 Nov; 386(10009): 2145-91.

Kassebaum NJ, Arora M, Barber RM, Bhutta ZA, Brown J, Carter A, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct; 388(10053): 1603-58.

Stevens GA, White RA, Flaxman SR, Price H, Jonas JB, Keeffe J, et al. Global Prevalence of vision impairment and blindness: magnitude and temporal trends, 1990–2010. Ophthalmology. 2013; 120(12): 2377-84. doi: 10.1016/j.ophtha.2013.05.025.

Stunkel L, Kung NH, Wilson B, McClelland CM, Van Stavern GPJJo. Incidence and causes of overdiagnosis of optic neuritis. Jama Ophthalmology. 2018; 136(1): 76-81. doi: 10.1001/jamaophthalmol.2017.5470.

Bourne RR, Jonas JB, Flaxman SR, Keeffe J, Leasher J, Naidoo K, et al. prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe: 1990–2010. British Journal of Ophthalmology. 2014 May; 98(5): 629-38. doi: 10.1136/bjophthalmol-2013-304033.

Wilhelm H and Schabet M. The diagnosis and treatment of optic neuritis. Deutsches Ärzteblatt International. 2015 Sep; 112(37): 616. doi: 10.3238/arztebl.2015.0616.

Rath EZ. Visual Loss in Neuro-Ophthalmology. InCauses and Coping with Visual Impairment and Blindness. IntechOpen. 2018 Sep. doi: 10.5772/intechopen.80682.

Langer-Gould A, Brara SM, Beaber BE, Zhang JL. The incidence of clinically isolated syndrome in a multi-ethnic cohort. Journal of Neurology. 2014 Jul; 261: 1349-55. doi: 10.1007/s00415-014-7349-0.



DOI: 10.54393/pjhs.v4i03.548
Published: 2023-03-31

How to Cite

Arshad, W., Ud Din, I., Bano, S., Ali, W. ., Azmat, A. ., & Hanif, A. (2023). THE Frequency of Isolated Optic Neuritis in Cases of Visual Impairment: Optic Neuritis in Cases of Visual Impairment. Pakistan Journal of Health Sciences, 4(03), 194–197.



Original Article