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72-year-old woman was seen in the office on 6/1/2010. She noticed sudden vision loss in the right eye about four days ago. She had cataract surgery in that eye on May 18th. Her vision was great until four days ago when her vision declined. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers. VISUAL ACUITY: Vision OD is 20/80, PH 20/25; OS is 20/25. IOP: OD 10, OS 12. SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes with an open capsule in the right eye. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is 3+ optic nerve edema with 1+ pallor. The nerve is swollen. The retinal veins are all dilated. There are no retinal hemorrhages in the macula or on the periphery. There is peripheral retinoschisis in an unusual area, which is from 8:00 o’clock around to 11:00 o’clock which tracks about 3-disc diameters posterior to the equator. OS: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. The macula and periphery look fine. OCT SCAN: The OCT scan shows optic nerve edema in the right eye with only secondary involvement of the macula and the fovea is minimally swollen. The left eye has a normal OCT scan. PHOTOGRAPHS: Photos confirm clinical findings. IMPRESSION: 1. ANTERIOR ISCHEMIC OPTIC NEUROPATHY, PROBABLY NONARTERITIC POST CATARACT SURGERY – RIGHT EYE DISCUSSION: I explained to the patient there does appear to be poor circulation of the optic nerve. She was already dilated when she came here; however, when I checked her for brightness sensitivity, she did notice that she sees about half of the brightness in the right eye than she sees out of the left eye. Even though she has no constitutional symptoms, I am going to check a sedimentation rate and C-reactive protein to completely rule out giant cell arteritis. In the meantime, I asked her to return here for check in three weeks. I agree that an aspirin a day at this point is reasonable to help protect her fellow eye and possibly even this right eye. I asked her to see you back regularly.

AIONOD_PAHA01.jpg
Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION824 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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AIONOD_PAHA02.jpg
Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION765 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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AIONOD_PAHA03.jpg
Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION1078 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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AIONOD_PAHA04.jpg
Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION1166 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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AIONOD_PAHA05.jpg
Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION571 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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AIONOD_PAHA06.jpg
Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION563 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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AIONOD_PAHA07.jpg
Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION524 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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AIONOD_PAHA08.jpg
Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION451 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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72-year-old woman was seen in the office on 6/1/2010. She noticed sudden vision loss in the right eye about four days ago. She had cataract surgery in that eye on May 18th. Her vision was great until four days ago when her vision declined. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers. VISUAL ACUITY: Vision OD is 20/80, PH 20/25; OS is 20/25. IOP: OD 10, OS 12. SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes with an open capsule in the right eye. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is 3+ optic nerve edema with 1+ pallor. The nerve is swollen. The retinal veins are all dilated. There are no retinal hemorrhages in the macula or on the periphery. There is peripheral retinoschisis in an unusual area, which is from 8:00 o’clock around to 11:00 o’clock which tracks about 3-disc diameters posterior to the equator. OS: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. The macula and periphery look fine. OCT SCAN: The OCT scan shows optic nerve edema in the right eye with only secondary involvement of the macula and the fovea is minimally swollen. The left eye has a normal OCT scan. PHOTOGRAPHS: Photos confirm clinical findings. IMPRESSION: 1. ANTERIOR ISCHEMIC OPTIC NEUROPATHY, PROBABLY NONARTERITIC POST CATARACT SURGERY – RIGHT EYE DISCUSSION: I explained to the patient there does appear to be poor circulation of the optic nerve. She was already dilated when she came here; however, when I checked her for brightness sensitivity, she did notice that she sees about half of the brightness in the right eye than she sees out of the left eye. Even though she has no constitutional symptoms, I am going to check a sedimentation rate and C-reactive protein to completely rule out giant cell arteritis. In the meantime, I asked her to return here for check in three weeks. I agree that an aspirin a day at this point is reasonable to help protect her fellow eye and possibly even this right eye. I asked her to see you back regularly.