DR ROHAN MADAN

Dr. REENA GUPTA, DR. CHEKITAAN SINGH, DR. NEEBHA ANAND, DR. CHAWLA URMIL

Abstract

Ocular manifestations of vit B12 deficiency are rare & only few cases of optic neuritis secondary to B12 deficiency have been published. We report a case of 23 y/o vegetarian girl who presented with acute, B/L, asymmetric, progressive vision loss associated with pain on ocular movements & pulsatile occipital headache. No history of diabetes, hypertension, TB but had chronic nephropathy from the age of 5, for which she took no regular therapy. She was diagnosed as a case of optic neuritis after a comprehensive ocular and systematic examination, complete battery of lab investigations & an MRI with contrast & VEP to confirm the diagnosis. She received pulse therapy of IV methylprednisolone followed by tapering doses of oral steroids which led to improvement of RAPD & pain on ocular movements, but her vision deteriorated.

To avoid irreversible optic nerve damage, it is of utmost importance to consider Vit B12 deficiency as a differential diagnosis & start aggressive treatment early.