Loss of Vision in a Division I Basketball Player

We present a case report of a 20-year-old cis female division 1 collegiate basketball athlete who presented to her team physician with concerns for bilateral temporal, throbbing headache and sudden-onset, non-traumatic, right eye irritation and blurred vision. She was found to have optic neuritis and ultimately diagnosed with multiple sclerosis (MS). Although MS is the most common progressive neurologic disease of young adults there is limited research on athletes with MS. While the pathogenesis of MS remains unknown, current science identifies MS as a multifactorial condition influenced by both environmental and genetic factors. MS has a female predominance and presents most often between the ages of 20 to 45 years old. Since musculoskeletal and/or neurological symptoms are often the first sign of MS it is necessary for healthcare professionals caring for athletes to be familiar with the diagnosis, management and prognosis of MS. This case presents several key themes that aim to assist clinicians caring for athletes with MS. MS can present similar to sports-related injuries (e.g., concussions, overtraining, psychosocial stressors, musculoskeletal injuries) therefore diagnosis in the athletic population is easily missed. Without a healthcare team familiar with the immediate and future needs of the athlete, subpar preliminary and continuous treatment may result in devastating health changes and career ending consequences in athletes. Treatment goals must also align with the patient's athletic goals. Additionally, this case highlights unforeseen ethical and clinical obstacles including the repercussions of the COVID-19 pandemic that must be considered by clinicians involved in the medical care of athletes.