Does this optic neuritis patient have neuromyelitis optica? An approach to optic neuritis in the context of neuromyelitis optica

Optic neuritis is a common presentation of demyelinating disease, most often associated with multiple sclerosis, and typically associated with a relatively good recovery and prognosis. However, when optic neuritis is the heralding event of neuromyelitis optica (NMO), it is much more likely to be the start of a devastating and disabling chronic disease with a reduced lifespan. Early recognition of NMO is the best chance a patient has of avoiding life-altering disability, as relapse prevention is essentially disability prevention because this disease, unlike MS, does not really have a progressive component. The following review was written to assist the clinician, particularly the ophthalmologist, in assessing optic neuritis in evaluating and recognizing the potential NMO patient.