Stroke of the Optic Nerve
I was diagnosed with NAION in Feb. 2004 at 51 years of age. I appreciated web postings from others when first diagnosed, hence the creation of this page.
One morning I noticed the lower inside quadrant of the visual field in my right eye was black. There was no pain. I thought I might have gotten an infection or a particle in my eye. I received a misdiagnosis of macular edema, a minor problem, at the local eye doctor's office within a few days.
Two or three days after visiting the ophthalmologist, I noticed the loss of visual field had expanded to the entire lower half of my right eye. I scheduled an emergency appointment. A visual field test was administered and I was diagnosed with NAION (Nonarteritic Anterior Ischemic Optic Neuropathy). The doctor sent me immediately for a blood test (erythrocyte sedimentation rate ESR) to check for the more dangerous AION. The test was negative.
At the time of the episode, I had been on a protein diet (needed to lose 10 lbs). I was taking .075 mg. Synthroid daily (for hypothyroidism). I was also taking 10 mg of Lipitor daily (because HDL cholesterol has always tested very low). (7/06 I have never used Viagra or any ED drugs)
After doing some reading on the internet, I self-prescribed aspirin immediately and called an opthalmologist friend in Florida (Dr. Don Budenz) who urged me to see Dr. Robert Sergott, a Neuro-Opthalmologist at Wills Eye Hospital, associated with Jefferson Hospital in Philadelphia.
The NAION diagnosis was confirmed by Dr. Sergott. He noted a congenitally small optic nerve. He speculated cardiovascular disease as the likely culprit and ruled out MS.
Dr. Sergott referred me to a Lipid Management specialist -- Dr. John Morgan -- in order to treat cardiovascular risk factors as a preventative measure. This, it is hoped, will decrease the chances of the same thing happening in my other eye. Of course it would also reduce risk of heart attack or stroke. Dr Morgan is treating quite a few NAION patients referred from Wills.
Here is information regarding NAION and Lipid abnormalities, which I'm sure is influencing my current treatment:
Update January 2007: I now see my local internist who continues to monitor (cholesterol) levels.
Dr. Sergott also suggested a sleep study, which I had. The sleep study revealed simple snoring, but no significant apnea (a risk factor).
My Vision Now
Dr. Sergott indicated that after about 8 months I would begin to get more accustomed to the vision loss. That prediction has been accurate. While there has been no noticeable improvement in vision, my brain seems to be making the adjustment so I don't notice the black spot all the time.
I find it easier (not easy) to be in a crowd of people or in a brightly lit store now. And at least once or twice a week, I bump into someone, kick something, and knock stuff over on my blind side.
My visual field chart is nearly a perfect semi-circle of black in the lower half, The black extends just a bit into the bulls-eye central vision area above the horizontal bisector. This makes seeing an entire written word with my bad eye, almost impossible.
I am essentially unable to read with just the bad eye. (With my good eye closed, I can make out one or two words out at a time with the bad eye by moving my head from side to side and catching the missing letters as they go by).
The vision that remains in the upper field is somewhat blurry and is not correctable, but I'm thankful for what remains!
After working in front of the computer all day both eyes normally become fatigued. If I step outside after working on the computer, I have problems focusing especially if it is a bright day.
At night I sometimes "see" flashes of "light" in the bad eye when my eyes are closed. This occurs routinely as I'm going to sleep if there is a sudden noise of some sort. Any abrupt sound triggers a flash in my bad eye. Very strange (update 7/14/05 -- this rarely happens anymore now 1 1/2 years after the "event").
I can still read, work and drive, for which I am exceedingly thankful.
I have learned that some think they see a correlation between NAION and hypothyroidism. Also, some surmise that the neuropathy may be related to a drop in blood pressure during sleep. http://webeye.ophth.uiowa.edu/dept/AION/Index.htm
Karl Wuensch's excellent summary of Hayreh, S. S.
Ischemic optic neuropathy, Progress in Retinal and Eye Research,
28, 34 - 62.
An excellent and very informative page by Dr. Karl L. Wuensch, with many, many helpful links is here.
The text of an excellent NAION Q&A pamphlet may be found here.NAION Group at Yahoo (a support group for those with Nonarteritic Anterior Ischemic Optic Neuropathy)I can be contacted by email here.
Bill Patton, WY3AWest Chester, PA