Role of retrobulbar dexamethasone in the treatment of optic neuritis

Optic neuritis is a disease entity characterized by, as the name clearly suggests, inflammation of the optic nerve. Over many years, the treatment of optic neuritis has been the use of steroids. The Optic Neuritis Treatment Trial laid the foundation stone for calibrating the use of steroids. However, all modalities have their own adverse effects, in terms of cost, patient compliance, adverse effects, etc. The purpose of this article is to evaluate the role of retrobulbar dexamethasone in the treatment of optic neuritis. After proper patient preparation, a neuritic cocktail of dexamethasone and lignocaine, in pretitrated amounts, is injected in the retrobulbar space. This was administered 3 times at an interval of 48 h, followed by oral prednisolone and supplemented with oral Vitamin B complex. Of 14 patients, 8 (57.1%) patients gained to a best-corrected visual acuity (BCVA) of 6/12 or more, 4 (28.5%) patients had BCVA between 6/24 and 6/18, and 2 (14.2%) patients had BCVA of 6/60. Hence, we conclude that such affordable drug combination can provide a cost-effective measure to treat optic neuritis.