Optic disc oedema: a diagnostic dilemma.

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.