title: [Management of acute visual loss in children].
abstract: Acute or rapidly progressive visual loss in children needs urgent attention and treatment. It may be unilateral orbilateral. Etiology depends upon the involved areas: eye ball, optic nerve, retro-chiasmatic pathways. Psychogenic origin is quite common in school-age children, however, it has to be considered last. Unilateral visual loss may be overlooked. Acute total transitory visual loss may be due to epilepsy or to migraine. Rapidly progressive visual loss may be due to retinal disease, optic neuritis or cortical blindness. Management of visual loss depends on clinical features, associated symptoms, and aspect of the optic disc. It needs collaboration between ophthalmologist,pediatrician and neuropediatrician. Retinal hemorrhages first call to mind a traumatic origin. Swelling of the optic disc may be due to increased intracranial pressure or due to optic neuritis. When the optic disc is normal it is necessary to rule out organic diseases before establishing the diagnosis of a psychogenic vision disturbance. In emergency, brain neuroimaging is the best way to diagnose intracranial mass and visualize optic pathways.
authors.affiliation: Service de neuropédiatrie, hôpital Armand-Trousseau, Paris, France. diane.doummar@trs.ap-hop.paris.fr
authors.forename: D
authors.initials: D
authors.lastname: Doummar
authors.forename: B
authors.initials: B
authors.lastname: Roussat
authors.forename: B
authors.initials: B
authors.lastname: Pelosse
authors.forename: H Ducou
authors.initials: HD
authors.lastname: Le Pointe
authors.forename: M
authors.initials: M
authors.lastname: Iba-Zizen
authors.forename: A
authors.initials: A
authors.lastname: Roubergue
authors.forename: D
authors.initials: D
authors.lastname: Rodriguez
authors.forename: T Billette
authors.initials: TB
authors.lastname: de Villemeur
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001766:Blindness / Q000209:etiology* / Q000628:therapy*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008881:Migraine Disorders / Q000150:complications; D009902:Optic Neuritis / Q000150:complications; D011859:Radiography