Case #21 – The Disc at Risk

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Suggested Readings S.S. Hayreh, M.B. Zimmerman. 2008. Nonarteritic: anterior Ischemic Optic Neuropathy: Clinical Characteristics In Diabetic Patients Verus Nondiabetic Patients. Ophthalmology. 115(10): 1818-1825. F.E. Cangemi, R.L. Bergen. 1980. Optic Atrophy Following Swine Flu Vaccination. Annals of Ophthalmology. 857-863. T.P. Hull, J.H. Bates. 1997. Optic Neuritis After Influenza Vaccination. Am J Ophthalmol; 124(5): 703-704. J.Z.

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References S.S. Hayreh. 2009. Ischemic optic neuropathy. Prog Retin Eye Res; 28: 34-62. A. Kawasaki, V.A. Purvin, R. Tang. 1998 Bilateral Anterior Ischemic Optic Neuropathy Following Influenza Vaccination. Journal of Neuro-Ophthalmol; 18(1): 56-59 A.J. Ballantyne, I.C. Michaelson. 1970. Textbook of the Fundus of the Eye. Longman Group Limited. S.S. Hayreh, M.B. Zimmerman. 2008. Nonarteritic

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Jerome Sherman, OD, FAAO Jerome Sherman, O.D., is perhaps optometry's most prolific writer, publishing over 650 clinical articles, research manuscripts, book chapters and two CDs. He is senior author of three books that were published in 2007, and has delivered over three thousand lectures both nationally and internationally. He has served as a

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Comments and Conclusion (cont'd) Individuals with NA-AION typically show visual field and acuity improvements up to 6 months from the initial diagnosis, but visual function improvement after that date is rare.3 41% of eyes with an initial visual acuity of ≤20/70 and 26% of eyes with moderate to severe visual field defects showed improvement within

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Comments and Conclusions Ischemic optic neuropathy is one of the leading causes of impaired vision and blindness.1 Our patient has the most prevalent form, non-arteritic anterior Ischemic optic neuropathy (NA-AION), which occurs in 10 out of 100,000 individuals over the age of 50.1 Individuals that take medications at night for hypertension, such as our patient,

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Comparison of Classical NA-AION and Our Patient NA-AION Average age of onset: 61-years-old1 A hypotensive disorder.1 73% of cases first note vision loss after awakening.1 Poor VA not initially required. 51% of cases have a VA of 20/40 or better in the affected eye at onset.1,4,5 VF defect is always present and range

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Other Etiologies of Optic Nerve Disorders V - vascular I - infectious T - trauma A - autoimmune M - metabolic I - inherited N - neurodegenerative E - endocrine S - senile V - vitamin deficiencyI - inflammatoryT - toxicA - allergicM - mass lesionsI - idiopathicN - nutritionalE -

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B-scan Ophthalmic Ultrasound of Left Eye B-scan ultrasound reveals disc elevation in the left eye only when compared to a normal.

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