UNILATERAL RETROBULBAR NEURITIS IN A 50-YEAR-OLD FEMALE - A CASE REPORT

Formerly Published in Vol 14 No. 8 Jan. – Jun., 2026

Abstract

Introduction: Retrobulbar neuritis is an inflammation affecting the optic nerve behind the eyeball without ophthalmoscopic manifestations in the fundus. It is an uncommon neuro-ophthalmic disorder that presents with optic nerve dysfunction evidenced by profound visual loss and with no accompanying fundal signs on ophthalmoscopy to explain visual loss.

Purpose: To report a case of unilateral retrobulbar optic neuritis and its management protocols in a resource poor setting.

Case report: A 50-year-old woman presented to the eye clinic with complaints of rapidly deteriorating visual acuity of the left eye of three days duration. No associated pain on moving the eye, no headaches, no history of fever. Examination revealed a visual acuity of 6/6 in the Right eye and Light Perception with inaccurate light projection in two quadrants in the left eye. There was a Relative Afferent Pupillary Defect (RAPD) in the left eye but essentially normal fundus after ophthalmoscopy. She was hospitalized and had intravenous methylprednisolone for three days and thereafter placed on oral prednisolone tablets. The patient showed marked improvement of left visual acuity and colour sensitivity as she was on treatment which was sustained after medications were tapered and stopped.

Conclusion: Retrobulbar neuritis may present in one or both eyes and in middle age population as opposed to younger population. Good prognosis can be achieved with proper and timely management protocols.