A distinctive case study of COVID-19 induced Optic Neuritis

1. A CASE OF COVID-19 INDUCED
UNILATERAL OPTIC NEURITIS
Author & Presenter:
Dr. Radha Mathur
Co-authors:
Dr. Ashish Chander, Dr. P.S. Rastogi
EP-14
Teerthanker Mahaveer Medical College & Research Centre
Moradabad, U.P.

2. INTRODUCTION
• The Coronavirus or COVID-19 has taken over the world since
Dec’19. It causes the highly transmissible SARS-CoV-2 infection.
• Lack of eye protection has causes increase in transfer of the
disease.
• Ocular manifestations range from mild conjunctivitis to severe
ocular neuropathies.
• A rare Ophthalmologic manifestation is Optic Neuritis. We aim
to report a case manifested with optic neuritis post-COVID-19
infection

3. CASE PRESENTATION
25 years, female, Home-maker
Residence- Moradabad, Uttar Pradesh
Chief complaint: Blurring of vision x left eye x 8-10 days
Pain x left eye x 8-10 days
History of presenting illness: Gradually progressive blurring of vision of the left eye since
8-10 days which was accompanied by pain
Past illness:
History of fever x 1 month back (100 ˚ -101˚F) sudden in onset, not associated with chills
and rigor, relieved after taking medication.
RT-PCR test- positive for COVID-19 ; DIAGNOSIS - Mild Symptomatic COVID-19 positive
Medical history:
Appropriate treatment for COVID-19 infection

4. GENERAL EXAMINATION
Patient was conscious and oriented
to time, place and person
CNS Exam:
Sensory exam: no areas of
paraesthesia/ hyperesthesia/ pain
Motor exam: no signs of weakness/
ataxia
Cognitive function: no h/o memory
loss, impaired attention with normal
functioning of daily activities
CVS Exam:
Normal S1, S2 heard
No murmurs present
Resp system Exam:
Normal breath sounds heard
GIT Exam
Normal bowel and bladder sounds
heard

5. OCULAR EXAMINATION
Visual Acuity: OD: 6/6
OS: 6/60, no improvement
Colour vision: Normal
Anterior segment: OD: normal
(Slit-lamp examination) OS: RAPD (grade 1)
Intraocular pressure : OD: 12 mmHg
(Non contact tonometry) OS: 11 mmHg

6. Posterior segment :
OD OS
Normal, well defined margin
of optic disc
Mild blurring of the nasal
margin of the Optic disc with
mild elevation and disc
hyperemia
Normal vessels
Normal background retina
Normal vessels
Normal background retina

7. Humphrey’s Visual Field analysis:
OD: Normal visual field
OS: inferior visual field loss
OS OS
30-2 Threshold 10-2 Threshold

8. Non-contrast MRI of brain and orbits
- No significant abnormality seen

9. DIAGNOSIS
A 25 year/ female with history of COVID-19
infection, presenting with unilateral painful,
diminution of vision, RAPD and mild blurring of
optic disc with hyperemia and disc elevation, with
inferior visual field loss was diagnosed as a case of
COVID -19 induced unilateral Optic Neuritis
OD: Emmetropia
OS: Optic Neuritis

10. MANAGEMENT
• i.v. Methylprednisolone started at 1g x 3 days
followed by
• Oral Prednisolone started at 1mg/kg, then
tapered
• Regular weekly follow-up, to monitor the
progression of the disease

11. CONCLUSION
• Multiple neuro-ophthalmic manifestations
have been described in association with
COVID-19.
• Any patient presenting with a history of high
fever/ COVID-19 positive, should undergo a
detailed Systemic, as well as Ophthalmic
examination to rule out complications.