| Papillitis | |
|---|---|
| Specialty | Ophthalmology  |
Optic papillitis is a specific type ofoptic neuritis. Inflammation of theoptic nerve head is called "papillitis" or "intraocular optic neuritis"; inflammation of theorbital portion of the nerve is called "retrobulbar optic neuritis" or "orbital optic neuritis".[1] It is often associated with substantial losses invisual fields, pain on moving the globe, and sensitivity to light pressure on the globe. It is often an early sign ofmultiple sclerosis.[2]
Papillitis may have the same appearance aspapilledema. However, papillitis may be unilateral, whereas papilledema is almost always bilateral. Papillitis can be differentiated from papilledema by an afferent pupillary defect (Marcus Gunn pupil), by its greater effect in decreasing visual acuity and color vision, and by the presence of a centralscotoma. Papilledema that is not yet chronic will not have as dramatic an effect on vision. Because increased intracranial pressure can cause both papilledema and asixth nerve palsy, papilledema can be differentiated from papillitis ifesotropia and loss of abduction are also present. However, esotropia may also develop secondarily in an eye that has lost vision from papillitis. Retrobulbar neuritis, an inflamed optic nerve, but with a normal-appearing nerve head, is associated with pain and the other findings of papillitis. Pseudopapilledema is a normal variant of theoptic disk, in which the disk appears elevated, with indistinct margins and a normal vascular pattern. Pseudopapilledema sometimes occurs inhyperopic individuals.[citation needed]
Workup of the patient with papillitis includeslumbar puncture andcerebrospinal fluid analysis.B. henselae infection can be detected by serology.MRI is the preferred imaging study. An abnormal MRI is associated with a worse visual outcome.[3]
