Optic Neuropathies

This 34-year-old otherwise-healthy woman was referred for a neuro-ophthalmologic consultation for unexplained loss of vision OD following head trauma. Two months earlier, she was involved in a motor vehicle accident that resulted in a closed head injury complicated by a spontaneously resolving small subdural hematoma. While in the hospital, she complained of blurred vision, and an ophthalmologic evaluation revealed visual acuity of 20/20 in both eyes and a small preretinal hemorrhage above the fovea in her left eye. She was treated conservatively and did well without any neurological sequelae. While vacationing the Hawaii, she experienced painless loss of central vision in her right eye. At the time of referral, 2 weeks later, her visual acuity was 20/40 in the right eye and 20/20 in the left eye, and her macula showed lesions consistent with acute macular neuroretinopathy. These lesions eventually faded after several months and her acuity recovered to 20/20 in both eyes. Pair with 97_25, 97_27, and 97_28.