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69-year-old man was seen in the office on 4/26/2012. He lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. He was seen by a retinal specialist and neuro-ophthalmologist at the time. He had blood tests done which were fine. He has been taking Plavix and aspirin. He is also taking cholesterol-lowering medications. He was coughing a lot about a week ago and noticed he had some floaters and then noticed his vision started to blur up again on the inferonasal part of the vision in the right eye. VISUAL ACUITY: Vision OD is 20/16, OS is 20/40. IOP: OD 17, OS 7. SLIT LAMP EXAM: There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is swelling on the superior pole of the optic nerve. There is a posterior vitreous separation with 2+ vitreous hemorrhage. With scleral depression, there are no retinal tears. OS: Vertical C/D ratio is 0.8. The nerve is pale. PHOTOGRAPHS: Photos of the right eye show swelling of the superior pole of the optic nerve and the photos of the left eye show atrophy of the optic nerve. IMPRESSION: 1. NONARTERITIC ISCHEMIC OPTIC NEUROPATHY – RIGHT EYE 2. OPTIC ATROPHY FROM PREVIOUS NONARTERITIC ISCHEMIC OPTIC NEUROPATHY – LEFT EYE 3. VITREOUS HEMORRHAGE – RIGHT EYE DISCUSSION: I explained to the patient that he has ischemic optic neuropathy, unfortunately, in the right eye similar to what he had in the left eye. I am hopeful this episode will be self-limiting. He is already taking the Plavix and I suggested he pump himself up to a full Plavix instead of a half Plavix, and I asked him to return for check in about a month.

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Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 355 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
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Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 279 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
na_aion_japl_042612_02a.jpg
Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 275 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
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Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 276 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
na_aion_japl_042612_04.jpg
Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 282 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
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Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 404 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
na_aion_japl_053112_06.png
Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 299 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
na_aion_japl_053112_07.png
Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 307 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
na_aion_japl_053112_08.jpg
Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 185 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
na_aion_japl_053112_09.jpg
Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 185 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
na_aion_japl_053112_10.jpg
Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 176 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
na_aion_japl_053112_11.jpg
Acute Non-arteritic Anterior Ischemic Optic Neuropathy Right Eye - Previous NA-AION left eye 161 views69-year-old man previously lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. About a week ago and noticed blurred vision in the inferonasal part of the vision in the right eye.

VISUAL ACUITY: Vision OD is 20/16, OS is 20/40
00000
(0 votes)
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69-year-old man was seen in the office on 4/26/2012. He lost vision in the left eye from nonarteritic anterior ischemic optic neuropathy in 2006. He was seen by a retinal specialist and neuro-ophthalmologist at the time. He had blood tests done which were fine. He has been taking Plavix and aspirin. He is also taking cholesterol-lowering medications. He was coughing a lot about a week ago and noticed he had some floaters and then noticed his vision started to blur up again on the inferonasal part of the vision in the right eye. VISUAL ACUITY: Vision OD is 20/16, OS is 20/40. IOP: OD 17, OS 7. SLIT LAMP EXAM: There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is swelling on the superior pole of the optic nerve. There is a posterior vitreous separation with 2+ vitreous hemorrhage. With scleral depression, there are no retinal tears. OS: Vertical C/D ratio is 0.8. The nerve is pale. PHOTOGRAPHS: Photos of the right eye show swelling of the superior pole of the optic nerve and the photos of the left eye show atrophy of the optic nerve. IMPRESSION: 1. NONARTERITIC ISCHEMIC OPTIC NEUROPATHY – RIGHT EYE 2. OPTIC ATROPHY FROM PREVIOUS NONARTERITIC ISCHEMIC OPTIC NEUROPATHY – LEFT EYE 3. VITREOUS HEMORRHAGE – RIGHT EYE DISCUSSION: I explained to the patient that he has ischemic optic neuropathy, unfortunately, in the right eye similar to what he had in the left eye. I am hopeful this episode will be self-limiting. He is already taking the Plavix and I suggested he pump himself up to a full Plavix instead of a half Plavix, and I asked him to return for check in about a month.