Non-arteritic anterior ischaemic optic neuropathy secondary to menorrhagia in a young healthy woman

Non-arteritic anterior ischaemic optic neuropathy (NAION) may develop due to severe anaemia and hypotension which is seen in acute blood loss. The devastating visual loss is often irreversible. We report a case of NAION in a 20-year-old healthy woman, who presented on the third day of a heavy menstr...

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Bibliographic Details
Published in:BMJ case reports 2018-06, Vol.2018, p.bcr-2018-225113
Main Authors: Koh, Koon-Ling, Sonny Teo, Khairy Shamel, Chong, Mei-Fong, Wan Hitam, Wan-Hazabbah
Format: Article
Language:English
Subjects:
Anemia
Atherosclerosis
Blood transfusions
Case reports
Defects
Edema
Gynecology
Hypertension
Menstruation
Optic nerve
Patients
Sleep
Surgery
Unusual Association of Diseases/Symptoms
Womens health
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Summary:Non-arteritic anterior ischaemic optic neuropathy (NAION) may develop due to severe anaemia and hypotension which is seen in acute blood loss. The devastating visual loss is often irreversible. We report a case of NAION in a 20-year-old healthy woman, who presented on the third day of a heavy menstrual cycle with hypovolaemic shock. On day 2 of admission, she had sudden right eye blurring of vision at the superior field on awakening from sleep. Funduscopy revealed a pale and swollen right optic disc. There was a dense right superior altitudinal visual field defect. Her haemoglobin level was low (3.6 g/dL), but she refused blood transfusion due to her religious belief (Jehovah’s Witness) and opted for conservative management. She later developed right optic atrophy with persistent visual field defect despite an improved haemoglobin level of 10.5 g/dL.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-225113