Ischemic Optic Neuropathy

Ischemic optic neuropathy (ION) is a condition of the eye that affects the middle-aged and elderly population, and can be potentially devastating in terms of vision loss. Known as a “stroke” of the optic nerve, it can occur suddenly and without warning. AION (anterior ischemic optic neuropathy) can affect one eye only, or it can progress and have an impact on both eyes. Ocala, FL board-certified retina surgeon Dr. Shalesh Kaushal is profoundly compassionate about offering his patients hope and compassion, as well as the best treatment options available regardless of what the diagnosis is. Because vision loss with this condition can be so sudden and so severe, it can be overwhelming for his patients who lose both their visual acuity and visual field site without warning. Dr. Kaushal recommends annual eye screenings for patients who are aging so that underlying conditions may be recognized, therefore possibly preventing sudden vision loss that a stroke can cause.

There are two types of known anterior ischemic optic neuropathy. The more serious of the two is known as the “arteritic” form, caused by a disease known as giant cell arteritis or GCA. This form can cause immediate or severe vision loss. Researchers still do not have a clear indication as to why, but this form of ION affects more women than men, most over the age of 50. The “non-arteritic” type, which is the most common form of this disease, has a better prognosis. Patients with this type often have a better outcome, often saving a big portion of their vision loss.

Ischemic optic neuropathy is one of those medical conditions that can be very unsettling because the onset is so rapid and unexpected. In fact, the vision loss itself can occur over days, hours, or minutes. Even more troubling: roughly 75% of patients report realizing the vision loss has occurred upon waking up. There is generally no pain associated with the condition and many of the symptoms, which include mild headaches, muscle aches, and minor aches and pains, can be confused with other ailments. If it is believed that someone is at risk for ION, a clinical diagnosis can be made during a physical eye exam. Many researchers believe a drop or spike in blood pressure is a factor for the onset of the non-arteritic form of ION, which is the more common type. Individuals who are ill with certain diseases may be at a higher risk.

Ischemic optic neuropathy (ION) is found based on a physical exam of the eye and a clinical diagnosis. Upon examination, it is common for eye surgeons to find that the optic disk is elevated and swollen, with on-site hemorrhaging around the retina. Immediate tests to determine the severity of the condition include a biopsy, ESR, CBC, and C-reactive protein. Ancillary testing may also be required. If it is suspected that giant cell arteritis is a part of the diagnosis, a biopsy is usually performed to quickly confirm. Blood work may also be included if the arteritic form of this condition is found to be present.

There are many reasons why it is important for annual eye exams, as well as overall good nutrition and health. While there is not an exact known cause for ION, poor nutrition can lead to a number of diseases and conditions, such as diabetes, that may be a precursor to a stroke. Sufferers of the non-artertic form of ION can recover and up to 40% regain useful vision. Treatment and overall prognosis is dependent upon the type of ION that has been diagnosed. Currently, the treatment options are limited for the arteritic variety, and patients who lose their vision to this form generally do not recover from it. Patients diagnosed with the non-arteritic variety usually begin an oral corticosteroid, which helps to treat the affected eye while protecting the other.

Ocala, FL retina surgeon Dr. Shalesh Kaushal offers the latest diagnostic advancements to help diagnose underlying eye problems, often before a major condition occurs. Patients who have certain illnesses such as diabetes, rheumatoid arthritis, sickle cell anemia, and others are more prone to certain eye conditions and should have their eyes checked regularly. We invite you to call our office for more information and to schedule your consultation.