Optic neuropathy is the most common cause of sudden decreased vision in patients older than 50 years old.
The optic nerve transmits information from your eye to your brain and allows you to perceive images. The optic nerve receives its blood supply from an intricate vascular arrangement. If there is a lack of blood supply to these very delicate arteries, the optic nerve may be affected, resulting in optic neuropathy.
Symptomatically, patients may notice a sudden decrease in their vision, or more specifically a decrease in a portion of their vision (usually the top or bottom half). Sophisticated testing in our clinic can objectively show this.
The cause for such damage to the optic nerve is currently not well understood. However it has been suggested that any insult to small vessels can contribute to this damage, including, but not exclusive to, high blood pressure, smoking, diabetes, or even low blood pressure.
There is a small sub-group of people with optic neuropathies that have an underlying systemic inflammatory condition. These patients tend to present with a more significant loss of vision associated with other systemic symptoms including severe eye pain and headaches, pain while chewing, tenderness around the scalp, joint pain, fever, and night sweats. If these symptoms are noticed, it is important to alert your Neuro-Ophthalmologist as more aggressive treatment with steroids may be necessary.
Most patients who develop optic neuropathy will have stable vision after they experience symptoms and up to 40% will have improvement. Fortunately, there is a low chance of involvement of the other eye, and a second episode of damage to the same optic nerve is very rare.
Treatment for optic neuropathies typically involves minimizing any other risk factors that may cause damage to blood vessels, such as those suggested above. A dose of baby aspirin has also been suggested.