Atypical Optic Neuritis

  • Eric D. Gaier
  • Katherine Boudreault
  • Joseph F. RizzoIII
  • Julie FalardeauEmail author
  • Dean M. CestariEmail author
Neuro-Ophthalmology (A Kawasaki, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neuro-Ophthalmology


Classic demyelinative optic neuritis is associated with multiple sclerosis and typically carries a good prognosis for visual recovery. This disorder is well characterized with respect to its presentation and clinical features by baseline data obtained through the optic neuritis treatment trial and numerous other studies. Atypical optic neuritis entails clinical manifestations that deviate from this classic pattern of features. Clinical signs and symptoms that deviate from the typical presentation should prompt consideration of less common etiologies. Atypical features to consider include lack of pain, simultaneous or near-simultaneous onset, lack of response to or relapse upon tapering from corticosteroids, or optic nerve head or peripapillary hemorrhages. The most important alternative etiologies to consider and the steps towards their respective diagnostic evaluations are suggested for these atypical features.


Optic neuritis Ischemic optic neuropathy Neuromyelitis optica (NMO) Sarcoidosis Chronic relapsing inflammatory optic neuropathy Lyme borreliosis 


Compliance with Ethical Standards

Conflict of Interest

Eric D. Gaier, Katherine Boudreault, Julie Falardeau, and Dean M. Cestari declare that they have no conflict of interest.

Joseph F. Rizzo III owns equity in Bionic Eye Technologies and Visus Technologies, which are working on an implanted and portable device for the blind, respectively. Dr. Rizzo also serves as Medical Director for Neurology and Ophthalmology for Magic Leap, Inc., which is developing a head-mounted “gaming” device.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Eric D. Gaier
    • 1
    • 4
  • Katherine Boudreault
    • 1
    • 5
  • Joseph F. RizzoIII
    • 1
    • 2
    • 5
  • Julie Falardeau
    • 3
    • 6
    Email author
  • Dean M. Cestari
    • 1
    • 2
    • 5
    Email author
  1. 1.Department of OphthalmologyMassachusetts Eye and Ear InfirmaryBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Department of OphthalmologyOregon Health & Science UniversityPortlandUSA
  4. 4.Ophthalmology EducationMassachusetts Eye and Ear InfirmaryBostonUSA
  5. 5.Neuro-Ophthalmology ServiceMassachusetts Eye and Ear InfirmaryBostonUSA
  6. 6.Neuro-Ophthalmology, Casey Eye InstituteOregon Health & Science UniversityPortlandUSA

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