The College of Optometrists

hi, with what urgency would you refer a px with optic neuritis and cranial nerve palsy (possible MS) and to whom? thanks

Hi athanki,

If some one came in with sudden onset blurring

and you checked the pupils and had RAPD

and after careful questioning you were sure it was optic neuritis - then there is a risk of it being MS. It could be the sort of MS which is slow and fairly benign, or it could be progressive and debilitating.

Then a 'soon' appt would be appropriate. There is little treatment and it will get better on its own. The only point to referal is to establish the cause.

However, if you are not sure -all you know is that they have a blur, a field defect, possible pain on looking to one side and a pupil defect. Then it could be intra cranial compression or possibly an infection like sinusitis (for example). THis would would obviously urgent and many people would want this seen straight away.

There are all points between these two scenario's - so a care plan would need establishing at the time, in discussion with the px, to eliminate any other causes and find the best referal plan.

= all the best - steven