Early Onset Optic Neuritis Following Measles-Rubella Vaccination
A 15-year-old boy from the north of Iran experienced a mild vasovagal shock immediately after MR vaccination and was managed accordingly. Six hours after recovery, he noticed sudden and severe loss of vision in both eyes together with headache and dizziness. A local ophthalmologist was consulted who reported that visual acuity was hand motions in both eyes. There had been poor pupillary light reflexes making it difficult to determine relative afferent pupillary defect (RAPD). Extraocular and slitlamp examinations had been unremarkable but on fundus examination both discs had blurred margins. Brain and orbital MRI were normal. Similarly, complete blood count (CBC), erythrocyte sedimentation rate (ESR), blood chemistry and cerebrospinal fluid analysis were normal. Visual fields could not be performed due to severe visual loss. The patient was hospitalized two weeks later and received a 3-day course of pulse therapy with intravenous methylprednisolone (500 mg/day). His visual field is shown in . The patient was referred to our center one week later; visual acuity was 20/40 in right eye and 20/30 in left eye, ophthalmoscopy revealed +1 pallor in both optic discs and visual field testing revealed significant improvement .