Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with sudden, painless, unilateral vision loss upon awakening. Reports associated altitudinal visual field defect. Denies transient monocular vision loss, jaw claudication, scalp tenderness, or systemic symptoms suggestive of giant cell arteritis.
Clinical Examination Findings
Best corrected visual acuity (BCVA) reduced. Relative afferent pupillary defect (RAPD) present in the affected eye. Slit-lamp exam reveals a pale, swollen optic disc with peripapillary splinter hemorrhages. Cup-to-disc ratio in the fellow eye is characteristically small ("disc at risk").
Treatment Protocol
Immediate cessation of medications associated with NAION (e.g., PDE5 inhibitors). Optimization of systemic vascular risk factors, including blood pressure control, management of diabetes mellitus, and hyperlipidemia. Referral for cardiovascular risk assessment. No proven surgical or pharmacological intervention for acute vision recovery.