Optic neuropathy, or anterior ischemic optic neuropathy (AION), is a dangerous disorder that can lead to loss of vision in one or both eyes. It most typically affects adults over the age of 50, and is caused by blockages in the blood supply to the optic nerve. There are two forms of the condition, the more serious of which can lead to fatal complications. Treatment for the disorder varies with the form of illness present.
Understanding and Treating Non-arteric Optical Neuropathy
Non-arteric AION is the most common form of the disorder. It is typically associated with a number of conditions, including diabetes, high blood pressure, atherosclerosis (plaque buildup in the arteries), arteriosclerosis (hardening of the arteries), gastrointestinal ulcers and systemic low blood pressure. Non-arteric AION occurs equally in men and women. The primary symptom of this condition is vision loss.
Treatment for non-arteric AION may involve a number of different steps. Your doctor may begin by prescribing glaucoma-related medications to lower the pressure of the intraocular fluid inside your eyeball. Beta blockers such as betaxolol (Betoptic) achieve this goal by reducing the production of fluid. Alpha-agonists such as brimonidine (Alphagan) reduce intraocular fluid production and increase fluid drainage. Prostaglandin-like compounds such as bimatoprost (Lumigan) also increase drainage of fluid. All of these medications are typically administered as eye drops, and several other pressure-lowering options are also available. Consult your doctor for more information and an explanation of medication side effects.
Your doctor may also ask you to get better control of your high blood pressure. If you are not on medication for this condition, you may need to start. If you already use blood pressure medication, you may need to adjust your dosage or change to a more effective drug. While your pressure may need to come down quickly to preserve your vision, your doctor will seek to avoid the complications of lowering pressure too rapidly. Additionally, if you smoke you will need to stop. Roughly 40 percent of non-arteric AION patients experience an eventual spontaneous return of vision.
Understanding and Treating Arteric Optic Neuropathy
Arteric AION is caused by a disease known as giant cell arteritis (GCA). GCA afflicts women three times more frequently than men, and is triggered by a chronic inflammation that most typically strikes the arteries that run through the temples. This condition is potentially fatal, and if you experience its symptoms—fever, scalp tenderness and pain in the temples and neck—see your doctor immediately. In some cases no symptoms are present, and your best bet of receiving help is to notice the transient vision loss of developing arteric AION.
Treatment for arteric AION involves the systemic use of high dose corticosteroids such as prednisone to control the effects of GCA. While this may not be sufficient to save the vision in an afflicted eye, it will hopefully protect you from a fatal outcome.
Potential Outcomes
It is possible for your vision to improve, at least partially, after a bout of AION. However, results vary widely and cannot be predicted in advance of treatment.