eye disorders
Ischemic Optic Neuropathy
Symptoms and Signs of Ischemic Optic Neuropathy
Vision loss with both varieties of optic nerve infarction is typically rapid (over minutes, hours, or days) and painless. Some patients notice the loss on awakening. Symptoms such as general malaise, muscle aches and pains, headaches over the temple, pain when combing hair, jaw claudication, and tenderness over the temporal artery may be present with giant cell arteritis; however, such symptoms may not occur until after vision is lost. Visual acuity is reduced, and an afferent pupillary defect is present. The optic disk is swollen and elevated, and the swollen nerve fibers obscure the fine surface vessels of the optic nerve. Often hemorrhages surround the optic disk. The optic disk may be pale in the arteritic variety and hyperemic in the nonarteritic variety. In both varieties, visual field examination often shows an altitudinal and/or central defect. 