Oh No! I Can’t See Well after Taking a Hot Shower!

Abstract

This was to report a case of a 33-year-old Malay woman who was previously diagnosed with seronegative neuromyelitis optica spectrum disorder ten years ago based on her clinical presentation, and magnetic resonance imaging (MRI) of the spine showed a long segment of the intramedullary lesion. Her diagnosis was revised to relapsing-remitting multiple sclerosis (RRMS) when she had recurrent optic neuritis with an MRI showing juxtacortical and periventricular lesions. She was started on disease-modifying treatment and was well for six years until she noticed left eye central blurred vision, especially after taking hot showers or exposure to hot weather. Ophthalmological examination revealed left eye visual acuity 6/9 with a relative afferent pupillary defect. Humphrey's visual field also showed left centrocecal scotoma. She was treated with intravenous methylprednisolone with tapering oral prednisolone, which resulted in improvement of the left central scotoma, and her visual acuity reverted to baseline.