CIBA Vision Ophthalmics
Digital Grand Rounds
Answer/DiscussionThis patient was diagnosed with Ischemic Optic Neuropathy (ION). This condition typically presented with a pale swollen disk, occasional flame hemorrhages eminating from the disk. Vision loss is severe. The condition can be separated into Arteritic ION and N-arteritic ION. Patients with Arteritic ION tend to be old, and have associated headache, jaw pain, scalp tenderness and possible muscle and joint pain. Non-arteritic patients have little symptomatology other than the vision loss, and they tend to be younger. If Arteritic ION is suspected, a temporal artery biopsy and sed rate should be ordered. Steroid treatment is advisable in Arteritic cases. Non-arteritic cases usually require simple observation, although optic nerve sheath decompression is considered in progressive cases. Getting an internist involved in these cases is a good idea.See you next time... |