Various abnormalities of the neurovisual pathway (including optic nerve, optic chiasm, optic tracts, thalamus, optic radiations, or visual cortex) that may present with acute visual loss or defect are covered in this variant. These may include optic neuritis, which may be secondary to demyelinating disorders (multiple sclerosis, neuromyelitis optica spectrum disorders), other inflammatory, infectious, or granulomatous disorders, or unknown underlying cause (idiopathic). This variant also includes lesions involving the brain parenchyma in the region of thalamus, optic radiations, or occipital lobes, which may have acute presentation (eg, infarct, hemorrhage, inflammatory, infectious, or demyelination processes). Ocular migraine is a common cause of transient acute monocular vision loss with ipsilateral headache in adolescents. It is diagnosed based on the clinical history and examination. Imaging is performed to exclude other causes of vision loss and headache [14]. Lastly, nonorganic (psychogenic) acute vision loss is not uncommon in school age children. These are diagnosed by exclusion, based on the clinical history, inconsistent clinical examination, and negative imaging studies [15,16]. CT Head and Orbits There is no relevant literature to support the use of CT head and orbits in the initial evaluation of children with nontraumatic vision loss. CT Head CT of the head without intravenous (IV) contrast may be complementary to MRI head for a suspected brain lesion, especially if infarct or hemorrhage in the neurovisual pathway is suspected. There is no relevant literature to support the role for contrast-enhanced CT head in the initial evaluation of children with nontraumatic vision loss. CT Orbits There is no relevant literature to support the use of CT orbits in the initial evaluation of children with nontraumatic vision loss.
Orbital Imaging and Vision Loss Child. Various abnormalities of the neurovisual pathway (including optic nerve, optic chiasm, optic tracts, thalamus, optic radiations, or visual cortex) that may present with acute visual loss or defect are covered in this variant. These may include optic neuritis, which may be secondary to demyelinating disorders (multiple sclerosis, neuromyelitis optica spectrum disorders), other inflammatory, infectious, or granulomatous disorders, or unknown underlying cause (idiopathic). This variant also includes lesions involving the brain parenchyma in the region of thalamus, optic radiations, or occipital lobes, which may have acute presentation (eg, infarct, hemorrhage, inflammatory, infectious, or demyelination processes). Ocular migraine is a common cause of transient acute monocular vision loss with ipsilateral headache in adolescents. It is diagnosed based on the clinical history and examination. Imaging is performed to exclude other causes of vision loss and headache [14]. Lastly, nonorganic (psychogenic) acute vision loss is not uncommon in school age children. These are diagnosed by exclusion, based on the clinical history, inconsistent clinical examination, and negative imaging studies [15,16]. CT Head and Orbits There is no relevant literature to support the use of CT head and orbits in the initial evaluation of children with nontraumatic vision loss. CT Head CT of the head without intravenous (IV) contrast may be complementary to MRI head for a suspected brain lesion, especially if infarct or hemorrhage in the neurovisual pathway is suspected. There is no relevant literature to support the role for contrast-enhanced CT head in the initial evaluation of children with nontraumatic vision loss. CT Orbits There is no relevant literature to support the use of CT orbits in the initial evaluation of children with nontraumatic vision loss.