Binocular Optic Neuritis in an Eight-Year-Old Boy Due to COVID-19 Infection

Optic neuritis or inflammation of the optic nerve is a frequent cause of acute optic nerve damage in children and adults. Optic neuritis can occur in association with some viruses, such as influenza and mumps viruses. At the end of 2019, a novel coronavirus, known as COVID-19, spread throughout the world. Coronavirus is known to cause optic neuritis in animal models, and several adult cases have been reported up to now, as well. However, to date, no case of optic neuritis has been reported in children with COVID-19.

The patient was an eight-year-old boy referred to our center, complaining of sudden bilateral and progressive blurring of vision with right-eye preference. He had a history of severe headache for three days in the previous two weeks and slight mood disturbance. On physical examination, bilateral disk swelling and significant loss of vision were detected in his both eyes. Magnetic resonance imaging (MRI) of the brain showed bilateral maxillary sinus thickening with mild optic nerves enlargement with slightly hyperintense T2 and mild post-contrast enhancement. No pathologic finding was seen in the brain, and cerebrospinal fluid and other immunologic tests were normal. Due to the patient’s history of headache and outbreak of COVID-19, a nasopharyngeal reverse transcription-polymerase chain reaction (RT-PCR) test for COVID-19 was requested, and a positive result was obtained, confirming the diagnosis of COVID-19 infection. The optic neuritis was treated with pulsed methylprednisolone and the patients’ vision improved.

In this article, we reported an eight-year-old child with optic neuritis and headache in the context of COVID-19. No case of optic neuritis has been reported in children with COVID-19.