Visual recovery from optic atrophy following acute optic neuropathy in the fellow eye
The patient was a 65 years old man with hypertension who had been monitored for dry age-related macular degeneration for the last two years in ophthalmology department of University Hospital, Kırıkkale, Turkey, 2009. He also had optic atrophy due to anterior optic neuropathy in the left eye diagnosed two years previously. Visual acuities were 3/10 on the right and count fingers at 3 m on the left at his last visit. The patient presented with sudden onset of painless visual loss in the right eye. He did not complain of headache, scalp tenderness, jaw claudication, or any neurologic symptoms.\nBest corrected visual acuities were hand movements and count fingers at 3 m right and left, respectively. Intraocular pressure measurements were normal. He was bilaterally pseudophakic. He had macular pigmentary disturbance predominantly in the right eye. On neuro-ophthalmic examination, the right eye had afferent pupillary defect with complete loss of color vision. The optic disc was swollen and hyperemic in the right eye and pale in the left [Figures ]. He had inferior altitudinal visual field defect on Goldmann visual field testing. Computed tomographies of orbit and brain revealed only age-related changes. Pattern visual evoked response demonstrated a conduction defect in the right eye. Hematological and biochemical investigations revealed no pathological findings.\nThe patient was decided to be followed with the diagnosis of anterior optic neuropathy in the light of these findings without any medications. At the one week's visit, the blind eye had visual acuity of 2/10. The right eye was the same. On examination, there was not any significant change when compared with the previous findings. Two weeks later, the left eye came to the same level as the right eye was before the visual loss (3/10). Optic disc oedema was minimal. Visual acuity at six months was 3/10.