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Ischemic Optic Neuropathy

Overview

Any time your eyes are open, your optic nerves are at work. Their job is to transmit signals to your brain from your eyes, and then the brain translates these signals into images. In most cases, the optic nerves work flawlessly. When injury or disease affects the optic nerve, ischemic optic neuropathy (ION) settles in. The end result is temporary or potential loss of vision in one or both eyes.

Types

ION encompasses many conditions caused by insufficient blood flow to the optic nerve, including:

  • Anterior ischemic optic neuropathy (AION) and posterior ischemic optic neuropathy (PION) — ION caused by a loss of blood flow to the front (AION) or rear (PION) of the optic nerve.
  • Arteritic AION and PION (A-AION & A-PION) — ION that is typically caused by giant cell arteritis, a condition that causes blood vessels in the scalp and head to swell
  • Non-arteritic AION & PION (NA-AION & NA-PION) — Cases of ION that are caused by conditions other than giant cell arteritis
  • Surgical posterior ischemic optic neuropathy — ION that is brought on as the result of surgical complications

Symptoms

  • Partial or complete loss of vision in one or both eyes that takes minutes, hours or days to develop
  • Frequent headaches and muscle aches
  • Pain when combing your hair
  • Pain when eating

Prevention

  • Making healthy lifestyle choices that help prevent or manage heart disease, diabetes and high blood pressure
  • Not smoking cigarettes

Risk Factors

  • Age (people 50 or older are at highest risk, though ION can affect anyone)
  • Diabetes
  • Elevated blood pressure
  • Glaucoma
  • Plaque build-up in the arteries
  • Smoking cigarettes
  • Swollen arteries in the head (temporal arteritis)

Diagnosis

  • Medical history, symptom review and physical examination. Diagnosis begins with discussion of symptoms and medical history, along with an examination by an ophthalmologist.
  • Blood tests. Different types of ION result in abnormal levels of certain proteins (such as C-reactive protein) and inflammation in the body. Special blood tests measure these amounts to help determine the exact type of ION present.
  • Biopsy. A small part of a blood vessel in the head is removed to determine if giant cell arteritis is present.
  • Additional Tests. If other symptoms are present and indicate underlying health conditions, testing may be performed to determine what those conditions may be.

Treatment

Medication. If ION affects a single eye, a systemic corticosteroid may prevent it from impacting the other eye. This is used when the condition is caused by temporal arteritis.

Health Management. Underlying health conditions that increase your risk for ION, such as diabetes and high blood pressure, should be managed. This may require medication or lifestyle changes.

Vision Assistance. Unfortunately, vision lost from ION cannot be restored. However, special tools and techniques enable you to make the most of your diminished vision.

Follow-up Care

  • Regular medical checkups help monitor the progress of ION. Should symptoms worsen, a change in medication or lifestyle or additional assistive devices may help maintain as much vision as possible.