الفهرس 
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Abstract
Most ophthalmologists will encounter optic neuritis in the course of their
practice. The disease behaves very differently in children versus adults. The
ONTT and CHAMPS trials have given us important data regarding prognosis
and management in adults, including probability of developing MS. Optic
neuritis in children, while less common, must be considered in the differential
diagnosis of subacute visual loss, especially children with bilateral impairment.
Secondary causes of optic neuritis are more common in children and an
investigation should be performed to assess for associated disease states. In both
populations, the ophthalmologist will play a central role in the diagnosis,
treatment, and management of these patients, whether it is an isolated case of
optic neuritis or the initial presentation of a long-term struggle with MS. With
the advent of immunomodulating therapy to minimize both the subsequent
incidence and severity of MS, early diagnosis and appropriate management by
the ophthalmologist has become even more critical. It is widely accepted that in
children, attacks of optic neuritis usually occur following a febrile illness, tend
to affect both eyes, are frequently associated with swollen discs, improve
rapidly, and have a low conversion rate to multiple sclerosis (MS)[
6,24,37,25,26, 36,65]. On the other hand, optic neuritis in adults is usually
unilateral, predominantly affects the retrobulbar portion of the optic nerve, and
presents a high conversion rate to MS [95, 96]. The largest reported series of
cases of pediatric optic neuritis are summarized in Table 11 [3- 6, 21, 22, 24- 26,
28-30, 38, 65]. This table includes the presumably idiopathic cases and excludes
those reportedly due to infection, neoplastic disease, and vasculitis. It also
combines cases that are reported in more than one series [24, 26, 38]. A total of
346 cases are reported in these series with a mean age of 9.8 years (range: 1-17
years). 61% of the reported cases were female, but female prevalence varied
from 41% to 81% in these series. In the present series 65% were female.