Suspected optic neuritis in children. A clinical and VEP study

Optic neuritis (ON) in children may be a difficult diagnostic task when clinical picture is atypical. ON in children presents differently than in adults. Also the results of some investigations (Haitz test, contrast sensitivity test, visual field tests) are less objective in children. We presented ophthalmological and electrophysiological findings of children with suspected ON. Fourteen children (mean age 12.3 years) referred to us with suspected ON during the last two years were included in our study. In 8/14 children visual problems started suddenly, in 6/14 gradually. Visual loss ranged from 0.3-0.6, at follow up (after a couple of days) it has improved to 0.4-1.0. In 6 children optic disc abnormalities (hyperaemia. oedema of the optic disc) were found. An afferent pupillary defect was positive in 2/14 children. Pain in the affected eye was present in 4/14 children. Haitz test, visual field tests and contrast sensitivity test were normal in an, while colour vision was impaired in one child. Pattern electroretinography (PERG) was normal in all, while visual evoked potentials (VEPs) were abnormal in 3/14 children. We conclude that on clinical grounds 8/14 children remain ON suspects. On electrophysiological grounds. ON was possible in 3/14 children.