“Mom, it’s dark in here”: a 3-year-old suddenly lost her sight

A few weeks ago, three-year-old S. Marmela was playing in the yard of her house, and suddenly she approached her mother and told her that she could not see anything. “At first I didn’t understand what she was talking about,” the mother tells Mako Health. “I asked her, ‘What does that mean?’, and she told me everything was dark and black. I was shocked, I didn’t know how to react.”

According to her, a short time later she also noticed that the fever had risen. “I didn’t wait even a moment. I ran with her to the emergency room, and after they checked her, they immediately sent us to the children’s emergency room at the Shamir Medical Center.”

At the hospital, the medical teams began to perform a series of tests in an attempt to understand what caused the sudden loss of vision. Dr. Roni Barry Berkovich, deputy director of the pediatric intensive care unit at the Shamir Medical Center, says that the girl arrived at the hospital in an unusual and complex condition. “It was an extreme case that we don’t normally encounter,” she says. According to her, at first there was some confusion about the exact diagnosis, because the diagnosis was not typical.

After consultation between pediatric intensive care, neurology, ophthalmology, pediatric and radiology specialists, the doctors came to the conclusion that S. suffers from a rare and severe inflammation of the optic nerves, which damaged the area of ​​the chiasm – the meeting point of the optic nerves in the brain. Following the diagnosis, it was decided to give her treatment that included steroids, a biological drug and antibody treatment, with the aim of stopping the inflammatory process.

“The damage to the visual system was sharp and fast and led to complete blindness”

Prof. Haim Basan, director of the Neurology and Child Development Unit at the Shamir Medical Center, explains that this is an outbreak of the immune system against the nerve sheath (myelin), a condition that may appear after an infection. “Due to the critical location, the damage to the visual system was sharp and rapid and led to total blindness. In her case, the prognosis was particularly unusual, because the damage was sudden, severe and extensive, and the brain MRI findings were also unusual and did not match the cases known to us. The girl received treatment adapted to her condition quickly, and already during the hospitalization the test results were received that confirmed that the diagnosis and treatment choice were correct.”

According to him, the symptoms of inflammation of the optic nerves may include blurring or decreased vision, pain when moving the eyes, and in some cases also convulsions, limb weakness and a change in the state of consciousness.

The treatment was successful, and within a week there was a dramatic improvement in S’s condition, and she was able to see again. “I was sure that my girl would never see again, that she had lost her sight,” says her mother. “When we realized that her sight had returned, I felt that I could finally breathe.” Now S is expected to continue follow-up with ophthalmologists and pediatric neurologists.

“It is a disease that has a treatment, and when it is diagnosed quickly, a significant recovery can be achieved, as we saw in this case,” Prof. Basan concludes. “In any case, if a sudden decrease in vision or abnormal neurological symptoms are detected in children, it is important to seek medical treatment immediately.”