Nonarteritic Anterior Ischemic Optic Neuropathy: Exceptions to the Rules

Two unusual aspects of nonarteritic anterior ischemic optic neuropathy (NAION) include: 1) incipient NAION, and 2) prolonged resolution of optic disc edema. We present a patient who had an unusual course where it took 15 months (65 weeks) for her to note a change in vision with associated visual field loss. Of additional concern was the fact that for our patient's right optic disc edema was present for 19 months (82.5 weeks). This, too, is highly unusual for NAION as optic disc edema typically resolves within 5 to 18 weeks.