Anterior ischemic optic neuropathy is caused by inadequate blood supply to the optic nerve, leading to vision loss. It is more common in people over 50 and may be linked to smoking, high blood pressure, and diabetes. There is no effective treatment, but steroids can help prevent vision loss in patients with arteritis.
Anterior ischemic optic neuropathy is the most common cause of vision loss in people over the age of 50. Ischemia is a term that means inadequate blood supply and optic neuropathy means an abnormality in the optic nerve that supplies the eye. Anterior means in front, so anterior ischemic optic neuropathy refers to damage to the front of the optic nerve, caused by an insufficient blood supply. The disease normally initially affects only one eye, giving rise to symptoms of blurry and dull vision. While the condition isn’t fully understood and there’s no effective treatment, it usually doesn’t get worse over time.
The causes of anterior ischemic optic neuropathy are still being researched, but it is known that tiny blood vessels, called posterior ciliary arteries, cannot supply enough blood to the optic nerve. This nerve carries information between the eye and the brain. It is possible that smokers and people with high blood pressure or diabetes may have a higher risk of developing this type of ischemic neuropathy. Some people with anterior ischemic optic neuropathy have a condition that leads to inflammation of the arteries, known as arteritis.
Symptoms of anterior ischemic optic neuropathy include vision loss, usually occurring slightly above or below the central visual field. There is usually no pain, unless the person has arteritis, in which case headache, fever, weight loss, body aches, scalp and jaw pain, along with other symptoms. Vision loss is usually more severe in people with the arteritic form of anterior ischemic optic neuropathy, and it is more common for the other eye to be involved.
Where the optic nerve head joins the retina, tissue at the back of the eye that responds to light forms a blind spot known as the optic disc. In someone with anterior ischemic optic neuropathy, the optic disc appears swollen and bleeding may be visible on its surface. Neuropathy is known to occur more frequently in people who have small optic discs, although the reason for this is not understood.
There is no effective treatment for anterior ischemic optic neuropathy and once vision is lost it cannot be restored. For patients with arteritis, treatment with steroids can help prevent vision loss from affecting the other eye and can reduce the effects of arteritis elsewhere in the body. Many doctors recommend taking aspirin every day to prevent ischemic optic neuropathy from progressing to the other eye, but there is currently no evidence to show that this is effective.
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