Optic Neuritis Mimicking as Idiopathic Intracranial Hypertension in a Child: A Case Report

Muhammad R Abdullah; Rahma I Mustikasari

doi:10.28932/jmh.v8i2.12685

Authors

Muhammad R Abdullah Department of Ophthalmology, Universitas Airlangga- Soetomo Academic General Hospital-Universitas Airlangga Hospital Surabaya
Rahma I Mustikasari Department of Pediatric, Universitas Airlangga- Soetomo Academic General Hospital Surabaya- Universitas Airlangga Hospital Surabaya

DOI:

https://doi.org/10.28932/jmh.v8i2.12685

Keywords:

child, optic neuritis, sudden visual loss, idiopathic intracranial hypertension, steroid

Abstract

Sudden visual loss in a child can be caused by optic neuritis or idiopathic intracranial hypertension (IIH), the latter being strongly associated with obesity. This report aims to describe a pediatric case with overlapping clinical features of optic neuritis and IIH, highlighting a diagnostic and therapeutic challenge. An 11-year-old girl presented with sudden bilateral visual loss. Right eye vision was light perception, while left eye vision was hand movement. A neuroophthalmic examination confirmed optic disc edema and increased retinal nerve fiber layer thickness on an optical coherence tomography scan. Her body mass index was in the obese range. Treatment initially involved a high-dose intravenous steroid injection for optic neuritis. MRI scans were normal, but after three days of treatment, there was only minimal improvement. Acetazolamide was then added for two weeks due to suspicion of IIH. After oral steroid continuation for three months, there was significant visual improvement. Follow-up showed good visual acuity. This case underscores the importance of recognizing optic neuritis as the primary cause of acute visual loss in children, even in the presence of confounding features such as obesity.

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