It seems scarcely necessary to dwell on the established facts of the optic nerve changes in multiple sclerosis. These are familiar through the statistical studies of Uhthoff1 and those who have followed him. We know that ophthalmoscopic changes in the optic discs are found in about half the cases of this disease, that visual disturbances are frequently early symptoms—sometimes preceding any other symptoms by months or years—that the visual disturbances are often of sudden onset, and, if slight, frequently remain long unprogressive, and if excessive usually improve, the course of the optic nerve changes thus differing radically from the slow, steadily progressive atrophy of tabes.
I shall take it for granted, also, that it is the custom to examine the fundus and determine the fields of vision in every case in which multiple sclerosis is suspected. Optic nerve changes, if present, will help to confirm the diagnosis. Thus ophthalmoscopic
HOLDEN WA. THE OPTIC NERVE CHANGES IN MULTIPLE SCLEROSIS.WITH REMARKS ON THE CAUSATION OF NON-TOXIC RETROBULBAR NEURITIS IN GENERAL.. JAMA. 1908;LI(2):120–124. doi:10.1001/jama.1908.25410020032002e
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