How to Diagnose Optic Neuropathy
Instructions
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Obtain the patient history. Compressive optic neuropathy is marked by a slow, progressive loss of vision accompanied by a puillary defect and frequently a central scotoma. The vision problems may be vague and noticed only during a routine eye examination or when one eye becomes blind.
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Gather any specific presenting complaints. Patients with compressive optic neuropathy may notice that objects have less color or brightness and a constriction of the visual field may be present. Observers may notice that the affected eye appears more protuberant.
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Perform an eye exam. Refraction testing will usually show that visual acuity is reduced and there may be a shift towards hyperopia. Detect loss of peripheral vision with a pinhole test, and the Ishihara test plate can test the color vision.
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4
Examine the pupils for defects. The patient will focus on a distant object in a dimly lit room. Shine a bright focused light in alternating eyes for about 3 seconds. The affected eye may dilate or show other abnormal responses.
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Run laboratory tests, if needed, to diagnose the cause of compressive optic neuropathy. Blood tests for thyroid functioning should be run if thyroid opthalmopathy is suspected and an elevated angiotensin-converting enzyme may indicate sarcoidosis.
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