Deaf and Mute Patient Developing Recurrent Idiopathic Bilateral Optic Neuritis: A Case for Early Treatment With Plasmapheresis?

Bilateral idiopathic optic neuritis is an uncommon presentation of optic neuritis, and the initial treatment options are limited to corticosteroids with consideration for plasma exchange therapy as second-line therapy. We present the case of a 43-year-old deaf and mute patient whose ability to communicate via American Sign Language was severely impaired by her recurrent idiopathic bilateral optic neuritis. She was treated early and aggressively with both plasma exchange and corticosteroids within days of presentation and experienced rapid improvement in her vision. Early treatment with plasma exchange should be considered in patients whose impairment presents a significant communication barrier.