An 11-year-old girl developed sudden visual loss in her left eye, prec
eding subacute myelitis by 9 months. Multifocal lesions in the central
nervous system were demonstrated by magnetic resonance imaging. Altho
ugh unilateral blindness is unusual, the clinical findings predominant
ly involving the optic nerve and spinal cord were consistent with the
diagnosis of neuromyelitis optica (NMO). This case provides additional
evidence to support the view that NMO is a variant of multiple sclero
sis.