title: Reversible blindness in bilateral optic neruritis associated with nasal flu vaccine.
abstract: BACKGROUND
  Various case reports have shown possible associations between optic neuritis and different vaccines.  Some of the vaccines include influenza, hepatitis B and anthrax
  
  
  OBJECTIVE
  To present evidence for a causal relationship between optic neuritis and Live Attenuated Influenza Vaccine (LAIV), administered as nasal flu vaccine.
  
  
  METHODS
  Case Report.  In a 13-year-old male with bilateral optic neuritis, detailed clinical history, neuro-ophthalmologic examination, magnetic resonance imaging, stereo-disc photos, visual field testing, ocular coherence tomography, blood tests and cerebral spinal fluid analysis were performed.
  
  
  RESULTS
  Exam findings on presentation:  BCVA: 20/CF OD; 20/LP OS.  Positive relative afferent pupil defect OD.  Unremarkable anterior segment and posterior segment exam.  No papillitis or papilledema. Global visual field defect OU based on Humphrey 30-2.  MRI: diffuse enlargement of Optic Chiasm with inflammation of distal optic nerves bilateral.  Blood cultures and CSF were negative. Patient received 3 divided doses of methyl prednisone with mild improvement of vision upon hospital discharge and marked improvement of vision at 2 month follow up.
  
  
  CONCLUSIONS
  In this child, no infectious, vascular, granulomatous, viral or immune-related cause of optic neuritis was identified. This case provides compelling evidence that supports the nasal flu vaccination as a cause of optic neuritis.
authors.forename: Courtney
authors.initials: C
authors.lastname: Crawford
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Grazko
authors.forename: William R
authors.initials: WR
authors.lastname: Raymond
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Rivers
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Munson
mesh_terms: D001766:Blindness; D005123:Eye; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage; D009900:Optic Nerve; D009902:Optic Neuritis / Q000175:diagnosis; D014792:Visual Acuity
chemical_list: D007252:Influenza Vaccines