Dr. Jeslin Johnson

Dr.VIRNA SHAH

Abstract

Lactational optic neuritis is a rare clinical entity.We report 3 cases of lactating mothers presented in

a span of 6 months with sudden painful defective vision in one eye within 3 months postpartum(PP).

Case 1 showed BCVA of 6/12,RAPD 2 & disc edema in LE, Case 2 of 5/60, RAPD 4 in RE, disc edema.MRI of both confirmed ON but no features of demyelination.Both after treatment (ONTT),vision improved to

6/6.Case 3 was different as she had ON antenatally(28 weeks of gestation),treated as per ONTT, vision

improved to 6/6. Her MRI showed demyelination.She developed the second episode at 3 months PP

post partum.BCVA in LE was 1/60, RAPD4 edema, after treatment(ONTT),vision improved to 6/6.

Pregnancy appears to be an immunoprotective period,but post partum period is immunologically prime

for immune mediated diseases. Post partum optic neuritis may be the first manifestation of multiple

sclerosis and these patients should be followed up carefully to detect early signs of demyelinating

disease.

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