Pre PACES Podcast #10 Optic Neuropathy
Jun 6, 2021
Dr. Luke Bennetto, a consultant neuro-ophthalmologist, dives into the complexities of optic neuropathy. He breaks down the critical differences between optic neuropathy and optic atrophy, shares key symptoms to watch for, and explains how various causes can present differently in patients. Luke also highlights the significance of timely diagnosis, the impact of migraines, and what to look for during examinations. Plus, don't miss his fun quiz on England's rugby history, showcasing his lighter side amidst serious medical discussions!
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Clarify Laterality And Timing
- Ask early whether vision loss is monocular or binocular and clarify whether patients mean blurred vision, field loss, or double vision.
- Use timing of onset (seconds to years) to prioritise vascular, inflammatory, compressive, or degenerative causes.
Symptom Variability Narrows Causes
- Intermittent symptoms change the differential: transient obscurations suggest giant cell arteritis or raised intracranial pressure.
- Uthoff's phenomenon (heat/exercise) points toward demyelinating optic neuritis such as MS.
Use Pain And Age To Guide Initial Management
- Use pain (worse on eye movement) and age to separate inflammatory optic neuritis from ischaemic causes.
- Treat typical optic neuritis conservatively and follow at ~5 weeks unless severe or atypical.