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CVA w/optic n. involvement

Discussion in 'Ophthalmology: Eye Physicians & Surgeons' started by bigdan, 05.07.04.

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  1. bigdan

    bigdan SDN Donor

    Ann Arbor
    Fellow [Any Field]
    SDN 10+ Year Member

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    Any info that you guys can give on the following, as posed to me by a fellow OT whose friend just suffered a CVA?
    - CVA, which impaired R optic nerve, which resulted in a scotoma in the R lower quadrant. Any thoughts on prognosis, treatment, etc. Are there any precautions that this person should be taking? Anything she can do to help speed the process of recovery?


  2. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur Moderator Emeritus Lifetime Donor

    San Diego, CA
    Attending Physician
    Physician SDN 10+ Year Member

    I'm sorry to hear about your friend. Usually a "stroke" of either the optic nerve or brain may recover a little, but it is unlikely that there will be much recovery as time passes.

    I'm confused about the symptoms. Is the scotoma only in the right eye or in both eyes (i.e. homonymous right lower quadrantanopia)? This is important in localization of the lesion.

    If only the right eye is affected, then it could be due to several things: branch retinal vein occlusion, branch retinal artery occlusion, AION, PION, optic neuritis, or arteritic AION. The treatment and prognosis depends on her age, underlying risk factors, and the exact diagnosis of her vision loss. Age is important in the setting of AION because GCA needs to be ruled out.

    If the field loss is a bilateral right lower quadrantanopia, then this is a CVA of the left parietal lobe or left occipital lobe above the calcarine fissure. Underlying risk factors must be elicited, such as: risk for emboli, hypertension, diabetes, hyperlipidemia, etc... Taking an aspirin a day may reduce the risk of CVA.

    Recovery will also be dependent on the correct diagnosis. It's difficult to provide prognosis and treatment assessment without an examination.

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