To report a case of bilateral optic neuritis in a child after tsutsugamushi infection.

An eight-year-old boy diagnosed with tsutsugamushi infection was referred to the ophthalmology clinic at our institution. A typical eschar was detected on his right clavicle. The patient complained of severely decreased visual acuity. The initial best corrected visual acuity (BCVA) in his right eye was 0.08, and in his left eye was negative light perception. Fundus exam showed bilateral optic disc swelling and hyperemia. Optic neuritis was diagnosed after tsutsugamushi infection, and high-dose intravenous steroid therapy was initiated according to the ONTT study protocol. Twelve months after treatment, the right eye BCVA improved to 1.0, but the left eye BCVA was only 0.06.

The authors of the present study experienced a case of bilateral optic neuritis after tsutsugamushi infection with a relatively positive response to the steroid therapy.