12 year old with bilateral vision loss Raed Behbehani , MD
12 year old A 12 year old with history of sudden, sequential, bilateral vision loss x 4 days. First right eye and 1 day later the left eye. No photophobia, or redness. No fever, headache or neck pain. Otherwise healthy. No allergies.
Was admitted to Amiri Hospital . CT and MRI brain was normal. Received IV steroids x 2 days with mild improvement in vision. CBC , ESR Normal. Ophthalmology consult.
VA : HM , CF 2 meters. Color vision : 0/13 OU. Pupils : sluggish OU , Right RAPD Motility : Full, orthophoric. Orbits : Normal RTR. TA : 12 mm/Hg OU. SLE : Normal anterior segment , no cells or falre.
Visual field (ConfrontationInferior altituidinal defects OU + plus dense central scotomas.
Questions What additional information in history you would like to know ? Differential Diagnosis ? Investigations ? Treatment ?
Formulation Post-vaccinial optic neuritis. LHON , infiltrative optic neuropathy, inflammatory (sarcoid), dmyelinating If no improvement with steroids LHON mutation , LP. Trial of steroids (no evidence of efficacy).