How to diagnose an optic neuropathy
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Presentation Transcript
1. How to diagnose an optic neuropathy Alfredo A. Sadun, MD, PhD
Thornton Professor of Vision
Doheny Eye Institute
Departments of Ophthalmology and Neurosurgery
Keck/USC School of Medicine, L.A., USA
3. Overview
1) History
2) Examination
3) Optic neuritis and AION
4. I. The Problem 26 y.o. male c/o 4 days of monocular visual loss
No pain or other symptoms
20/20 OD and 20/40 OS
Small central scotoma
5. Optic Neuritis?
Central Serous Maculopathy?
6. 1) History
Characterization
Pain?
Tempo
Other cranial nerves
2) Examination
3) Optic neuritis and AION
7. II. The History :Presenting Symptoms A. Optic Nerve:
darkness, clouding, smudging
colors less vibrant
if disc, altitudinal VF defect
Tempo
TOVs, monocular, 3 secs, 3min., 30min.
Acute loss
Chronic progressive
8. II. The History: Presenting Symptoms B. Macula
Blurriness and acquired hyperopia
Distortion, metamorphopsia
Trauma?
Systemic disease?
Age?
9. Examination 1) History
2) Examination
Visual acuity
Optic Nerve Triad
Fundus appearance
3) Optic neuritis and AION
10. OPTIC NERVE TRIAD APD
COLOR
BRIGHTNESS SENSE
Out of proportion to loss of VA