Vestibular Rehabilitation Considerations in an Uncommon Optic Neuritis: A Case Report

Abstract

Optic neuritis is an inflammatory condition that leads to inflammation and damage to the optic nerve, causing visual disturbances and pain. It is commonly associated with disorders such as multiple sclerosis and often manifests as sudden, unilateral loss of vision or blurred vision. This disorder can affect individuals of any age and may lead to decreased binocular vision, potentially resulting in difficulties with depth perception and visual coordination. Physiotherapy plays a crucial role in treating optic neuritis by addressing various aspects of the illness. We report the case of a 14-year-old male with diminution in both eyes, which was sudden in onset and painless in nature, with no history of falls, trauma, or diabetes. Magnetic resonance imaging reveals hyperintensity on short-tau inversion recovery (STIR) with mild contrast enhancement in the posterior aspects of the bilateral optic nerves (intracranial part), extending to the optic chiasm in optic neuritis. Physiotherapists employ a range of techniques to enhance the patient's overall well-being, including gaze stability exercises, eye-hand coordination exercises, and habituation exercises aimed at improving visual tracking and coordination. Additionally, physiotherapy can help reduce related symptoms such as muscle weakness, balance issues, and posture problems caused by impaired visual perception. Physical therapists endeavor to improve the quality of life for patients with optic neuritis by enhancing functional independence and contributing to a more effective approach to treatment. Notably, there was an improvement in visual scanning, spatial awareness, and eye movement control in this case.

Keywords: gaze stability exercises; neurophysiotherapy; optic neuritis; physiotherapy rehabilitation; ‏strabismus.

Figure 1. MRI of the brain

Arrow indicates hyperintensity on STIR with mild contrast enhancement in the posterior aspects of bilateral optic nerves (intracranial part) with extension till the optic chiasm in optic neuritis MRI: magnetic resonance imaging; STIR: short-tau inversion recovery

Figure 2. Post-rehabilitation MRI

MRI: magnetic resonance imaging