A sub-group of patients following an initial episode of optic neuritis (ON) may experience recurrent events of ON (RON) without clinical evidence of a systemic disease or other areas of central nervous system (CNS) involvement. The presence of neuromyelitis optica (NMO)-IgG in the RON group especially when associated with severe irreversible damage emphasizes the importance of testing for NMO-IgG in this group of patients. Objective evidence of damage to the visual pathways in multiple sclerosis (MS) may be found using optical coherence tomography (OCT). Average retinal nerve fiber layer thickness (RNFLT) of affected eyes in all children with ON was lower compared to the healthy controls and the other neurological disorder controls. The therapeutic prerequisite for RON entails a double target: therapy for the acute events as well as the consideration for preventive or disease-modifying therapy (DMT). Isolated episodes of ON in the pediatric population are usually treated with steroids.