Ophthalmologic presentation of pediatric multiple sclerosis: A report of three cases

Background: Pediatric multiple sclerosis (MS) is a rare but potentially disabling inflammatory demyelinating disorder of the central nervous system. Ocular manifestations may be the initial presentation and require urgent evaluation.

Cases: We report three pediatric cases in which MS was revealed by ophthalmologic symptoms: (1) a 10-year-old boy with severe unilateral optic neuritis; (2) a 13-year-old boy presenting with left abducens nerve palsy and multiple active MRI lesions; and (3) a 13-year-old girl with decreased vision in the left eye and hyalitis, later confirmed to have white-matter demyelinating lesions.

Conclusion: Ophthalmic manifestations may be the first sign of MS in children. Prompt recognition and multidisciplinary management are crucial to prevent long-term neurological sequelae.