What is the recommended treatment approach for optic neuritis?

• A. Observation without treatment
• B. Start ASAP and treat underlying cause with systemic anti-inflammatory drugs
• C. Surgical decompression
• D. Antibiotics only

Answer: (B)

Inflammation of the optic nerve needs rapid suppression to protect vision and influence the course of possible demyelinating disease. The best approach is to start systemic anti-inflammatory therapy as soon as possible, typically high-dose intravenous corticosteroids (such as methylprednisolone) followed by an oral steroid taper. This regimen speeds visual recovery and is the standard treatment for optic neuritis. Options like waiting and watching, surgical decompression, or using antibiotics alone don’t address the inflammatory process driving optic neuritis and are not appropriate unless there’s a specific infectious cause or an indication for a different intervention.