Emergency - Please help!!!!

I need help for my brother.  He is 52 and has a history of heart problems - will need a bypass in the future. On several meds, cholest, blood thinners, etc. but last Wed he woke up and said his vision in his right eye was grey - could only see a little light thru it and his shadow of his hand.  Had cat scan, mri, echo etc - nothing showed. Optha. said that he thought he might have had a stroke that only affected the eye. Has some sort of test today where the opthm. injects a dye in his arm and puts him in some machine that see's where the dye goes etc.  However, the opth said that he could see the optic nerve? - and that it looked swollen.  My brother has been been bothered with sinus/allergy systems for a month or so prior to this happening. Is it possible that it could not be a stroke and some sort of sinus prob or infection?  Just wondering......

[Michael J Kutryb, MD]

Could be ischemic optic neuropathy or a central retinal artery occlusion or ophthalmic artery occlusion.  Unfortunately the loss of vision could be permanant.  Doctor needs to rule out temporal arteritis or other vasculitis and also rule out an embolic blockage to the central retinal artery or ophthalmic artery.  If Temporal arteritis is not present - then treatment would be aimed at reducing risk of further ischemic blockages or emboli in order to protect other eye.  The cardiac risk factors are the same risk factors that can lead to vascular disease of the retina and optic nerve.

MJK MD