Ischaemic Optic Neuropathy (ION)

Question 1

define

Answer 1

this is occlusion of the optic nerve head circulation (posterior ciliary arteries)

Question 2

presentation of ION

Answer 2

sudden visual loss

usually painless

Question 3

red flag

Answer 3

young patient with unilateral vision loss and loss of colour vision

Question 4

examination signs

Answer 4

swollen optic nerve, edges become fluffy with loss of well-defined border

Question 5

example of an ischaemic optic neuropathy?

Answer 5

temporal arteritis (GCA)

Question 6

define GCA

Answer 6

inflammation of middle-sized arteries, posterior ciliary arteries are affected- walls become inflamed and thickened until lumen becomes occluded

Question 7

what is GCA associated with?

Answer 7

polymyalgia rheumatica

Question 8

presentation of GCA

Answer 8

headache
jaw claudication
scalp tenderness
enlarged temporal arteries (torturous appearance)
cannot brush hair, lie on affected side, etc.
malaise
over 60

Question 9

management of GCA

Answer 9

life and sight threatening

steroids immediately