In Optic neurities in children all symptoms are present EXCEPT:
B i.e. Headache and vomiting Papilloedema (not papillitis) is caused by raised intracranial pressure and it presents with headache & vomiting . Features Papillitis (Optic neuritis) Papilloedema Aetiology Inflammation of intraocular pa of optic nerve Q (or optic disc). Non inflammatory Q hydrostatic oedema of optic disc due to raised intracranial pressure Q Laterality Usually unilateral Usually bilateral Onset Sudden Q Insidious Q Loss of vision Sudden and marked Q Depressed light brightness & coloured objects appear faded (pulfrich phenomenon). Gradual Q & negligible in the initial stage Recurrent attacks of transient black out (blurred vision) Q i.e. amaurosis fugax. Pupillary reflex Sluggish and ill sustainedQ Relative afferents papillary defect (RAPD or Marcus Gunn's pupil)Q Visual acquity & pupillary reaction remain normal until optic atrophy sets in Pain Present on ocular movements Q Absent Q Tenderness Present at inseion of medial rectus and superior rectus Q Absent Q Swelling of disc Moderate (2-3 dioptres) Marked (> 3 dioptres) Q Visual field defects Central or centro-cecal scotoma Q Enlargement of blind spot Q and concentric constriction of field Posterior vitreous Fine opacities Clear
Afferent pupillary defect
Headache and vomiting
Pain on movement of eye ball
Sudden visionloss