Early Onset Optic Neuritis Following Measles-Rubella Vaccination
A 17-year-old male patient presented with severe reduction of vision in his right eye 7 hours after MR vaccination. On examination, visual acuity was 20/400 and 20/20 in his right and left eyes, respectively and RAPD was +2 on the right side. External ocular, slitlamp and fundus examinations were unremarkable in both eyes. A diagnosis of retrobulbar optic neuritis was made and intravenous methylprednisolone therapy as described above was offered, but the patient declined the treatment. CBC, ESR, blood chemistry, and brain and orbital MRI revealed no abnormal findings. Automated perimetry revealed extensive visual field loss sparing only the superior nasal quadrant . Four days later, visual acuity started to improve spontaneously and 2 weeks later, reached 20/20 in the affected eye. RAPD became negative and visual field testing 3 weeks later revealed significant improvement .