Anterior Ischemic Optic Neuropathy (AION)

[Mike_SV]

When you initially developed AION, which of the following best describes your condition?

[JohnHaganMD]

First of all cataract surgery is done on mostly older people who are at risk of NAION and the case of cause or co-incidence comes up. ION often develops in the setting of low blood pressure. That is why its not recommended to take blood pressure medicines at bedtime.  No one bleeds to death during cataract surgery but  ION can occur after heart or vascular surgery when there was a period of low blood pressure.

One mechanism is that cataract surgery is "injection" surgery. Local anesthesia is often injected behind the eye. In some instances the injection can lead to local high tissue pressure such that blood does not get to the optic nerve and its "infarcted"  this is one of the reasons a spreading enzyme is added to the injection anesthesia.  The optic nerve can also be struck and damage by the needle itself.

The incidence is low especially since many cases are not topical anesthesia i.e. no injection; the procedure much faster than in previous years and visco-elastics prevent hypotension within the eye.

JCHMD

[Mike_SV]

Getting back on subject, I'm trying to figure out if it is common when someone has a darkness in one eye, do they also have glare and contrast problems in the other eye?

In my case, the vision in my bad eye is dark from bottom to top with the top allowing in more light than the bottom. I initially told my ophthalmologist that I had glare and  contrast problems in my good eye but after my last visit, I got the impression that she assumed I didn't and may have assumed that since my vision is 20/25 in that eye.

[Mike_SV]

In the current issue (Lam B, et al2, (see page 585)), a retrospective study of 325 cases of unilateral NAION diagnosed between 1986 and 2001 is reported. A total of 17 patients underwent uncomplicated cataract surgery on the contralateral eye in the study period, 9 (53%) then developed NAION in the operated eye, two‐thirds in the first 6 months postoperatively. Of the 308 patients who did not undergo surgery, 59 (19%) developed contralateral NAION. Can cataract surgery trigger NAION in susceptible individuals, and if so how?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1954764/

[JohnHaganMD]

There are other, better sources but this is from Wikipedia:  . In approximately 6 months following the infarct visual acuity improves by 3 or more lines of vision on the Snellen Chart (the chart with smaller letters on each lower line) in 42.7% of patients. In addition, vision had worsened by 3 lines or more in 12.4% of patients. Second eye involvement occurs in approximately 15% to 20% of patients with NAION within 5 years.[3] Fortunately, it may not be terribly devastating as the visual acuity may remain only moderately impaired. Furthermore, most cases of NAION involve the loss of a hemifield (either the upper or lower half of the visual field, but not both). A few cases of NAION involve almost total loss of vision.[citation needed]


END Quote:  Your view of this disease is generally incorrect and errorneous. It does not "spread" to the other eye like cancer.  Not infrequently the second eye is involved because it is subjected to the same risk factors as the first eye.  People that have had NAION can have cataract surgery and many have without problem in my practice.  NAION can occur during the operative or perioperative period of any eye disease including cataract surgery but is relatively rare.  Your statement about the nerves dying is also wrong. Many patients get much or all of their vision back 3-6 months after the episode.

Why don't you read the appropriate sections on NAION on emedicine.

JCHMD

[Mike_SV]

Also one other point. Within 2 months of developing NAION, optical nerve fibers in the eye that goes dark die and nerves in the brain can't regenerate so there is no possibility for that eye to get better other than the possibility of seeing more light through the undamaged fibers.

[Mike_SV]

Mine got significantly better immediately after I did something. That may be possibly be a confidence but I have proof that what I did significantly changed my metabolism.

I'm surprised to hear that NAION gets better over time since every thing I've read and have been told, 20%-25% of people with NAION will be affected in the other eye within 2-3 years and the longer the period, the greater chance that it will spread to the other eye.

In fact, someone with NAION should never have cataract surgery in the good eye since that eye has a 50% chance of developing NAION if the surgery is performed.

[JohnHaganMD]

Anterior Ischemic Optic Neuropathy (AION) of the non-arteritic type usually gets better on its own without treatment; in fact that is the rule rather than the exception.  There is in fact no sure fire treatment foo AION so its much more likely it got better on its own rather than anything you did.

AION is more common in people with high blood  pressure and cardiovascular disease; users of nicotine and diabetics especially poorly controlled.

My mother had AION and made a full recovery with no RX.

JCHMD

[JohnHaganMD]

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[Mike_SV]

The reason that I'm requesting this information is that my vision was worsening in my good eye and I did something that appears to have made my vision significantly better (significantly less glare and more contrast plus significantly reduced side effects such as vision changes that were occurring during the day and eye irritations as well as quicker pupil reaction.

Therefore before I post what I did to significantly improve my condition, I want to gather as much information as possible to try to determine if what I did may possibly be beneficial to others with AION and the reasons why I believe that what I did caused the changes.