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Case Reports
. 2022 Sep 3;14(9):e28735.
doi: 10.7759/cureus.28735. eCollection 2022 Sep.

Bilateral Optic Neuritis and Facial Palsy Following COVID-19 Infection

Geeta Behera  1 , Pratik Gera  1 , Mary Stephen  1 , Augustine Jose  2 , Molly M Thabah  3 , Vaibhav Wadwekar  4
Affiliations
Case Reports

Bilateral Optic Neuritis and Facial Palsy Following COVID-19 Infection

Geeta Behera et al. Cureus. .

Abstract

Cases of optic neuritis have been reported following the novel coronavirus disease 2019 (COVID-19), with most being unilateral and associated with demyelinating illness. We report a case of a 22-year-old woman who presented with sudden onset painless diminution of vision in both eyes six weeks following COVID-19 infection. She also had a history of left lower motor neuron (LMN) facial palsy immediately following COVID-19 disease that recovered fully on steroids. Ocular examination and ancillary and laboratory investigations pointed to bilateral atypical optic neuritis. The patient responded well to the standard optic neuritis treatment protocol. We diagnosed her as a case of left LMN facial palsy and parainfectious bilateral optic neuritis following COVID-19. Parainfectious bilateral optic neuritis and facial nerve palsy associated with COVID-19 can occur following COVID-19 disease. Ours is the first case to report the occurrence of both in a patient.

Keywords: bilateral optic neuritis; covid-19 disease; demyelinating disease; facial palsy; sars-cov-2.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Bilateral disc edema
(A) Fundus images of the disc edema seen in both the eyes. (B) SD-OCT (RNFL analysis) images show an increased RNFL thickness. SD-OCT, spectral-domain optical coherence tomography; RNFL, retinal nerve fiber layer
Figure 2
Figure 2. (A) Overview report of visual fields showing visual field defect at presentation, with subsequent recovery on treatment in the right and left eyes. (B) MRI scan of the brain and orbit, T1 post-contrast sequence (transverse plane), showing bilateral optic nerve thickening.
Figure 3
Figure 3. VEP shows both eyes' delayed latency and sub-normal amplitude.
VEP, visual evoked potential
See this image and copyright information in PMC

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