Idiopathic bilateral optic neuritis in adult has been reported very rarely. The objective of this report is to present a case of idiopathic bilateral optic neuritis in adult and treatment responses. A nineteen year old female presented with bilateral optic neuritis. It was characterized by decreased visual acuity, painful ocular motility and sluggish pupillary reaction with Relative Afferent Pupillary Defect (RAPD) in left eye, hyperemic and generalized optic disc swelling and central scotoma in Humphrey visual field of both eyes. MRI showed diffuse thickening and irregularly outlined optic nerves of both eyes. Idiopathic bilateral optic neuritis in adults is a rare presentation. Prompt treatment with optic neuritis treatment trial (ONTT) improved the visual outcome.
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