SYNOPSIS In a retrospective survey of acute optic neuritis 144 cases in adults were found and, of these, 127 were reviewed, five had died of causes related to multiple sclerosis, and 12 were lost to follow-up. There was a statistically significant seasonal variation in the incidence of optic neuritis. When the life-table method of analysis was used, the probability of developing multiple sclerosis rises to 78% 15 years after an episode of optic neuritis. At review, 49 (730 %) of the 67 patients with multiple sclerosis were independent and leading active lives.While it is generally agreed that the major cause of acute optic neuritis in adults is multiple sclerosis (McAlpine, 1972), there is wide variation in the reported incidence ofmultiple sclerosis after optic neuritis. Kurland et al. (1966) found that 13% of U.S. Army servicemen with optic neuritis followed up for 12 to 18 years developed multiple sclerosis, whereas Bradley and Whitty (1968) in Oxford found that 51% of their patients later developed definite or probable multiple sclerosis. McAlpine (1964), adapting the figures published by Lynn (1959), calculated that 85% of her patients with optic neuritis followed up for at least five years had developed multiple sclerosis. Many reports include patients with other signs of multiple sclerosis at the onset of optic neuritis and therefore do not contribute to this problem.It is the purpose of this study to clarify the position as to the prognosis of patients with acute optic neuritis with regard to the later development of multiple sclerosis. The epidemiological characteristics of multiple sclerosis in Northern Ireland have been studied for many years (Allison and Millar, 1954;Millar, 1971) and this area has the advantage of a well-defined, relatively static population of 1-million with extensive neurological and ophthalmological services.

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