Question: What kind of workup would you perform for optic neuritis?

Answer: When presented with suspected optic neuritis, you must think about multiple sclerosis. After a careful history and exam for other systemic neurologic deficitis, you’re first trip will be to radiology for an MRI looking for enhancing brain lesions. Depending upon the results, neurology may consider a diagnostic spinal tap.

The treatment decision becomes whether you offer the patient a three day course of IV steroids (NOT oral) or more aggresive treatment with a drug like Avonex … Neurology will often make this call.