Optic Neuropathy in Progressive Systemic Sclerosis (Scleroderma)

A 46 yr old white male complained of decreasing vision in his left eye of 6 days duration when he presented for neuro-ophthalmologic evaluation. The patient stated that he developed "a small gray cloud just below the horizontal" in the visual field of left eye and claimed that the deficit had been expanding for 6 days. He denied having any pain in either eye at rest or with eye movement. He also did not have headache, nausea, vertigodizziness, diplopia, weakness or numbness, loss of sphincter control or prior history oftransient visual loss. He was not photophobic.