Dr. Hemalatha, Dr. Umadevi R. S. , Dr. Sowbhagya H N
A 40 year old male,non smoker,non diabetic,hypertensive,presented with acute painless blurring of vision in the right eye since 20days,non progressive.On ocular examination BCVA was 6/9 in Right eye,6/6 in the left eye,normal colour vision,with sluggish pupillary reaction in the right eye.
RE fundus examination revealed disc edema,luxury perfusion,peripapillary flame shaped hemorrhages,normal foveal reflex.Left disc was small,with 0.1 cup disc ratio,indicating disc at risk for NAION.RE Visual fields showed mild peripheral inferior visual field restriction.Systemic examination,blood pressure and hematological investigations were normal.
Patient managed conservatively.Hence NAION should be considered as a differential diagnosis in patients with acute painless dimunition of vision even in less than 50year old with non specific visual field restriction owing to the segmental blood supply of anterior portion of optic nerve by posterior ciliary artery and corresponding visual field defects.