Optic neuritis is most likely to present with which symptom?

• A. Eye pain worsened with movement
• B. Bilateral involvement with painless vision loss
• C. Rapid improvement over days
• D. Gradual peripheral vision loss without pain

Answer: (A)

Optic neuritis involves inflammation of the optic nerve, which commonly causes acute, unilateral vision loss with eye movement–related pain. The pain arises because the inflamed nerve is irritated as the eye moves, so movement worsens discomfort. This combination—acute/rapid-onset central vision loss with pain on movement—is the hallmark. Many patients also notice reduced color vision and an afferent pupillary defect, supporting optic nerve involvement. In contrast, painless bilateral vision loss, gradual peripheral field loss, or rapid recovery over just a few days are less typical for optic neuritis and point toward other conditions or different patterns of nerve disease.