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Bulgarian Review of Ophthalmology

Clinical Case of a Child with Optic Neuritis, Associated with Epstein-Barr Virus

A. Oscar, N. Andonova, G. Dimitrova


We present a clinical case of a child with bilateral papillitis, associated with EBV-infection in a 5-year-old female child, who was diagnosed and treated at the Aleksandrovska University Hospital. The initial reason for the eye-exam was a new-onset squint. On admission, she had discrete Eidon confocal scan, decreased visual acuity and bilateral edema and hyperemia of the optic disks. MRI of brain and orbits was evaluated on emergency to rule out a demyelinating or intracranial process. The child had persistent lymphadenopathy and laboratory abnormalities and tested positive for EBV serology. She was treated with intravenous corticosteroid pulse therapy and visual acuity was restored to 100%. Papillitis in children is frequently bilateral, with viral genesis and has a good prognosis. Isolated papillitis (without inflammation of other eye structures) is difficult to distinguish clinically from papilledema. When papilledema is suspected, urgent MRI has to be carried out.


optic nerve, optic neuritis, papilledema, Epstein-Barr virus

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About The Authors

A. Oscar
MU – Sofia

Department of Ophthalmology

University clinic of Eye diseases, University Hospital “Aleksandrovska”

N. Andonova
MU – Sofia

Department of Ophthalmology

University clinic of Eye diseases, University Hospital “Aleksandrovska”

G. Dimitrova
MU – Sofia

Department of Ophthalmology

University clinic of Eye diseases, University Hospital “Aleksandrovska”