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:
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 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
HVF and OCT RNFL
CBC, CMP, 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