21/07/2025
Mr M is a 68-year-old gentleman with hypertension and diabetes who presented with blurred vision in his left eye. Patient medical history : heavy craneal trauma with hospitalized for 3 days in parietal’s left lobe and 2 weeks ago Mr M had woken up with OS loss inferior visual field . There were no other symptoms of note. Specifically, there was no fever, weight loss, periorbital pain, headache, scalp sensitivity or jaw claudication. CVF: Examination revealed a left-sided inferior altitudinal VFD with 6/6 corrected visual acuity, a relative afferent pupillary defect and normal eye movements. There was no palpable temporal artery or scalp sensitivity. Fundoscopy revealed hyperaemic papilloedema in the left eye. FBC, ESR and CRP were all within the normal range. A brain MRI revealed some small white matter hyperintensities on T2WI but was otherwise normal. Tonometry revealed normal eye pressure (OD:18mmHg/ OS: 19mm Hg@NCT). Given the broadly normal investigations and patient risk factors, a diagnosis of non-arteritic ION was made.
