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Non-arteritic anterior ischemic optic neuropathy associated with cataract extraction: a case report and review of the literature

Poster Details

First Author: K.Emeriewen UK

Co Author(s):    Y. Athanasiadis   S. Rassam           

Abstract Details



Purpose:

To demonstrate the case of a 74-year-old Caucasian female who suffered sudden visual loss after routine phacoemulsification cataract surgery. The patient was eventually diagnosed with non-arteritic anterior ischaemic optic neuropathy. This is a very rare complication after cataract surgery even in high risk patients with associated systemic co-morbidities.

Setting:

Presented to an Eye Unit in uk at a teaching session.

Methods:

Ocular investigations; as visual acuity, relative afferent pupillary defect, dilated fundal exam, visual field test, macular optical coherence tomography. Sytemic investigations included review of past medical history and appropriate investigations including Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP) with the exclusion of temporal arteritis.

Results:

No ocular risks for NAION such as small optic disc were identified, and the patient was diagnosed with NAION.

Conclusions:

This is the first case report of an isolated delayed CE-associated NAION without small optic discs and highlights the importance of careful selection and preoperative assessment of patients at high risk of developing this complication. Aspirin could be used as a prophylactic measure in such cases at a slighter higher dose (100-325 mg/day) than usually administered on a regular basis (75 mg).5 This could prove useful especially in cases where the fellow eye needs to undergo surgery as well. The surgeon is obligated to discuss the potential of such a devastating outcome with the patient preoperatively as the effect to the quality life would be detrimental, and an informed decision regarding surgery must be undertaken. FINANCIAL INTEREST: NONE

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