Ophtho On Call Case 1: Case Continued…

Ophtho On Call Case 1 Index

Answer: There is significant optic disc edema of the left eye. There is also disc hemorrhage with obscuration of all the major vessels as they leave the disc and almost complete loss of disc structures. 

Optic nerve head edema is graded on a Frisen scale, as follows: 

  • Stage 0 Normal optic disc/no swelling
  • Stage 1: Minimal swelling
  • Stage 2:  
  • Stage 3: Low degree swelling
  • Stage 4: Marked swelling
  • Stage 5: Severe swelling

The findings in this image are consistent stage 5 given 360 degrees of severe optic disc edema. 

What’s at the top of your differential now? Pick 1 before moving on.
Non-arteritic ischemic optic neuropathy 
Arteritic ischemic optic neuropathy
 
Optic neuritis 
Optic disc drusen 
 
Exudative “Wet” Macular Degeneration 
 
Central Retinal Artery Occlusion
 
Central Retinal Vein Occlusion
 
Compressive Optic Neuropathy
 

What other tests will you order to narrow your differential? Click all that apply
MRI of orbits and brain with and without contrast
B-scan
 
Lumbar puncture
CBC, ESR/CRP
 
 

Click here to move on!

Ophtho On Call Case 1 Index
Ophtho On Call Case 1: Introduction
Ophtho On Call Case 1: Additional History & Physical Exam