A 23-year-old woman complains of painless vision loss in the left eye over the past two days. She has no past medical history. This one isn’t a diagnostic dilemma, but it does come with some nice imaging.

Those of you who know me might have assumed we would see an ultrasound image of a detached retina. No, this is more classic than that in this age group. The clip below is conveniently paused at the pathology. See if you can spot it.

Optic Neuritis

The red and yellow arrows in the image above point to the optic nerves. You don’t have to be a radiologist to appreciate that they are asymmetric. The red arrows points to the pathology.

Optic neuritis is highly associated with (but not pathognomonic for) multiple sclerosis. In other words, people who develop optic neuritis often go on to develop multiple sclerosis but not always. Other causes include Lupus and side effect of medications (does ethambutol ring a bell?), and this is clearly not an exhaustive list.

Treatment at the moment seems to be high-dose intravenous steroids; but that’s a discussion with a specialist.

That’s it. Short and sweet. Enjoy the pictures.