Arteritic and idiopathic ischemic optic neuropathy

Ischemic optic neuropathy is a frequent cause of sudden visual loss in the older patient. There are two major causes of ischemic optic neuropathy; one, arteritic, due to an inflammatory process, and the other, idiopathic, possibly linked to hypertension. This paper presents four illustrative cases of ischemic optic neuropathy, one with an associated serous retinal detachment. The clinical appearance of the disorder, differential diagnosis of the two major types of ischemic optic neuropathy, and the pathogenesis and prognosis for vision are discussed. Currently accepted modes of treatment are also included.