28yrs/m , c/o d/v in both eyes for last 10 yrs. Current vn is 6/60 , improving to 6/36(p) in each eye with pin hole. There is no h/o injury to eye or skull. The d/v started gradually, 10 yrs back . Pt has consulted many ophthalmologist including very senior retinal specialist , but no improvement. Fundus shows absolutely normal findings . Both pupils r reacting to light , but lt pupil is slightly bigger than rt pupil. There is no squint. Kindly discuss & give your opinion.

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1 Retrobulbar neuritis steroids are line of treatment Anterior ischemic optic neuropathy high dose of steroids and neurotropic vitamins B1,6,12 Pupil dilatation lt eyeduee RAPD Relative afferent pupillary defect

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28 YEARS MALE PATIENT WITH VA 6/60 WITH ,PH6/36P NORMAL FUNDUS AND ANTVSEGMENT MEANS EVEN WITH GLASSES VA WILL BE 6/36P ONE OF THE PUPILS IS BIGGER DIFFICULT TO EXPLAINE POOR VISION IN PRESENCE OF NORMAL ANT SEGMENT AND REINA NO HO TRAUMA.OR ANY SYSTEMIC DESEASE SINCE THE POOR VISIIN IS SINCE LAST 10 YEARS NWE HAVE TO LOOK.FIR ANY RARE SYSTEMIC DESEASE WHICH COULD BE CAUSE OF SILENT VIDUAL LOSS IN PRESENCE OF NORMAL' ANT DEG AND RETINA

One of the the retinal specialists diagnosed the condition to be " atrophy fovea ".
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It may be case of refractive errors with amblyopia..

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