24 yrs/m , c/o loss of vn in rt eye for 4 days. No rx is done so far . There is no injury . Vn is no pl , & no pr. 2 pictures r of rt eye & 2 pictures r of lt eye . No e/drops r instilled in rt eye till presentation. suggest possibilities rx . thanks.

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Looks like RAPD is present.. most probably not congestive glaucoma because no corneal edema, no ciliary injection.. do a detailed fundus examination along with color vision. D/D Optic neuritis Ischemic CRVO CRAO
What is the fundus finding? Do a Brain and Orbital MRI TO Rule out extraorbital optic nerve involvement. Can also do a VEP
Look for RAPD and IOP , findings are indicating of either acute congestive glaucoma or Optic neuritis....
No pain at all.
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Vision is NO PL..so that really narrows down the DD... It could be retinal detachment..which initially didn't involve the fovea but now has extended. Vision loss has occured in only one eye..so if retina isn't the cause,we should rule out anterior visual pathway lesions..before the chiasma..so MRI brain with orbital cuts should be done. if everything is normal...then VEP should be considered to just see if the patient is malingering or not
Pupil will not be found dilated in malingering . In retinal detachment , pl & pr would be present.
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may be CRAO..thromboembolic .. check for bp sugar..cardiac murmur may be glaucomatous optic atrophy as iris pattern looks mild atrophied... may be toxic neuropathy... may be ON..
Glaucoma is very unlikely at this age.
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This pt had consensual reaction present ,but direct pupillary reaction to light was absent . The fundus revealed optic atrophy. So , this was a case of optic atrophy.
Will you be able to post the fundus photograph of the patient. B/E
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Mid dilated pupil There may be RAPD ALSO SUDDEN LOSS OF VISION YOUNG MALE PATIENT mostly in favour of. CRAO due high homocysteine levels Eales disease
Looks like something to do with nerve . Glaucoma chances less as there is no congestion. Look for find us and a VER
1 Suppurios alcohol 2 CRAO 3 Opti neuritis diagnose by excusion
Spurious alcohol will involve both eyes.
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Fundus findings sir? And the pupil is pharmacologically dilated?
No. I have mentioned It in the findings I have given.
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