NAION

[wade_tu]

I have been diagnosed with NAION in my right eye.  We have done an MRI (normal) and Stress Test (normal).  I am about 3 to 4 weeks into it and my visin is getting dimmer hoever the "blind spot" ( about 35% of vision field) hasn't changed significantly.  I am really needing a little hope at this point! My wife is insisting that I wear an eye patch so that I don't completely obess with it.  I really am not even functioning at this point. Any positive information?

[John C Hagan III, MD, FACS, FAAO]

Thanks, the small cup is called cathchingly "a disk at risk".

Statistically the tests will all come back normal and I think it far more likley a result of your smoking many years than the Chantix you took for a short period of time. Hopefully you'll be off the weed forever.

Glaucoma or elevated IOP is a risk for vascular occlusions but not for AION but tobacco use is.  (ref Ocular Differential Diagnosis, FH Roy, Williams & Wilkins


JCH III MD

[John C Hagan III, MD, FACS, FAAO]

Most people do experience some improvement. My mother had this (risk factors high blood pressure and heart disease) and got back 90% plus of her vision and did not get it in the other eye. I am NOT aware of any new treatment since it's the small vessels of the optic nerve that are blocked. The vision getting worse at this stage is unusual. Perhaps you and yourMDs review the work up to see that no stone is left unturned. If a neuro-ophthalmologist is available in you area might get a second opinion. Good luck.

JCH III MD

[wade_tu]

Guess it's a good thing I stopped smoking when I did!  No worries about starting smoking again...it isn't nearly as bad quitting as one would imagine.  Given my solomn vow to stay off the weed, if that was the cause of the NAION, what are my chances of "catching" it in the other eye now?  BP and colesterol well under control.  I could ,as is with most folks my age, stand ot shed a few pounds but am surely still very active.

Thanks for your time

[wade_tu]

I took your advise and found a very competent neuro opthomologist who is taking a reasonable interest in my situation.He has done another complete work up including ordering more than 20 blood tests mostly looking for clotting conditions and the very obvious such as STD's and so forth and one sent to Atlanta"s Emory for genetic testing.  I have not yet gotten back the results yet but am grateful that I have finally found someone who is taking interest!  He is befuddled since I don't have the customary small cups one would normally have with this condition.  I used the smoking cessation med Chantix at about the same time this happened and vascular eye problems is on of its rare side effects.  I have made a report with the FDA and told my GP and Neuro guy.  The eye seems stablized now with maybe even slight improvement to central acuity...I am still hopeful!  He has me using eye drops to relieve eye pressure which may actually be helping.  I thank you again for your information and encouragement...it made me keep fighting!  Hopefully, we will eventually find out what happened and ensure the health of my other eye.

[John C Hagan III, MD, FACS, FAAO]

Well yes a certain percentage of we physicians could do with a couple of months at Charm School. Good luck.

JCH III MD

[wade_tu]

thanks...I really appreciate your words of support.  The neuro-ophthalmologist I saw was, forgive the crassness, a complete jerk!  He spent 30 seconds looking at the back of the eye and then lectured me because I used to smoke, that I actually kind of deserved it, and told me to come back in 6 weeks and we'll see if it got any worse.  The regular ophthalmologist I saw ordered the MRI and was very compasionate and understanding.  Again, thank you for words of hope...I REALLY needed them.

[wade_tu]

Thamks for responding back.  We are doing all the thing you suggested and I had actually quit smoking about three months before the diagnosis.  Should my vision still be detereorating at this point?  Any chance that the vision will improve over time?  I have see two ophthalmologists and one neuro guy, none of which gave me a a clear understanding of what to expect.  Are you aware of any treatment research or "cutting edge" treatments?  This has taken a  tremendous emotional toll on me.

[wade_tu]

Thamks for responding back.  We are doing all the thing you suggested and I had actually quit smoking about three months before the diagnosis.  Should my vision still be detereorating at this point?  Any chance that the vision will improve over time?  I have see two ophthalmologists and one neuro guy, none of which gave me a a clear understanding of what to expect.  Are you aware of any treatment research or "cutting edge" treatments?  This has taken a  tremendous emotional toll on me.

[John C Hagan III, MD, FACS, FAAO]

You should not wear an eye patch except to drive. For readers NAION means non-arteritic ischemic optic neuritis.  There is no accepted treatment for NAION and it has a tendency to occur in the fellow eye. You need a complete physician and vigorous treatment of any condition that predisposes to the disease:  diabetes, high blood pressure, high cholesterol, smoking needs to stop if you smoke, you need to watch you weight and not be obese or very heavy, you need to exercise, eat a good diet, etc.  Anything that causes heart attacks increases the risk of NAION> Talk to you MD about taking low dose aspirin.

JCH III MD