To present a case of simultaneous unilateral optic neuritis with bilateral uveitis as an early manifestation of demyelinating disease

Optic neuritis (ON) is the most frequent ophthalmic manifestation of multiple sclerosis (MS), occurring in ~30% of cases. In contrast, uveitis is only associated with MS in 1% of patients. Similarly, uveitis is attributed to MS in 1%–3% cases of uveitis and is associated with an increased risk of severe visual disability. We present the young girl with ocular manifestation of concurrent optic neuritis in right eye and intermediate uveitis in both eyes.

Significantly severity of uveitis was greater in right eye. She presented with profound visual loss, with visual acuity reduced to hand motion with no history and sign of same episode previously. Neurological examination and neuroimaging revealed demyelinating process in periventricular white matter. Steroid pulse therapy provided early improvement of visual acuity to 4/10.

Concurrency of these manifestation and severity of uveitis in eye with optic neuritis was remarked. The ipsilateral association between optic neuritis and uveitis in this patient with demyelinating process - suggesting multiple -sclerosis may suggest a reciprocal potentiation between optic neuritis and uveitis in multiple sclerosis.