Ischemic optic neuropathy
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Through Bleeding
When ION occurs in patients below the age of 50 years old, other causes should be considered, such as juvenile diabetes mellitus, antiphospholipid antibody-associated clotting disorders, collagen-vascular disease, and migraines. Rarely, complications of intraocular surgery or acute blood loss may cause an ischemic event in the optic nerve.
Presentation
Anterior ION presents with sudden, painless visual loss, developing over hours to days.
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Diagnosis
Examination findings usually include decreased visual acuity, a visual field defect, color vision loss, a relative afferent pupillary defect, and a swollen optic nerve head. Posterior ION occurs arteritic, nonarteritic, and surgical settings. It is characterized by acute vision loss without initial disc edema, but with subsequent optic disc atrophy.
Management
Although there is no recognized treatment that can reverse the visual loss, upon recent reports, optic nerve health decompression may be beneficial for a select group of patients with a gradual decline in vision due to ION.