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Reminder of important clinical lesson
Optic disc oedema: a diagnostic dilemma
  1. Prakash Chand Agarwal1,
  2. Saroj Gupta1,
  3. Arunendu Thakur1,
  4. Rakesh Biswas2
  1. 1Ophthalmology Department, People’s College of Medical Sciences, Bhopal, Madhya Pradesh, India
  2. 2Department of Medicine, People’s College of Medical Sciences, Bhopal, Madhya Pradesh, India
  1. Correspondence to Professor Rakesh Biswas, rakesh7biswas{at}


The authors describe a patient who presented with bilateral disc oedema and left eye visual loss. The patient was evaluated for intracranial space occupying lesion, however, a CT and cerebrospinal tap was normal. No definitive diagnosis could be established and patient developed left eye optic atrophy which was thought to be post papilloedema atrophy. Six months later, the patient had similar visual loss in right eye and he was diagnosed as anterior ischemic optic atrophy (AION) by the ophthalmologist. The inferior altitudinal visual field loss, delayed visual evoked response and clinical picture supported the diagnosis. The patient was diagnosed with hypertension and type 2 diabetes and managed accordingly. All the symptoms, clinical findings, investigations supported the diagnosis of AION which occurred in left eye followed by right eye 6 months later. Appropriate treatment was started and patient regained vision in right eye.

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  • Competing interests None.

  • Patient consent Obtained.

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