The optic nerve is located behind the eye, and sends visual images to the brain. Poor circulation to the blood vessels that supply the front (anterior) part of the optic nerve can cause an optic nerve stroke. If the nerve tissue cannot get the nutrients and oxygen it needs, part of the nerve tissue will be lost. This causes loss of vision. A stroke of the optic nerve is not related to a stroke in the brain, and does not cause weakness or paralysis.
There are two main kinds of optic nerve stroke:
An optic nerve stroke is most common in people over the age of 55.
You are at higher risk for the form caused by low pressure in the blood vessels if you have:
Optic neuropathy usually causes vision loss in one eye, which may worsen over several days. Signs of an optic nerve stroke caused by swollen or narrowed blood vessels include:
A common symptom of the form caused by low pressure in the blood vessels is vision loss when you wake up in the morning. This may be due to a drop in blood pressure when you sleep.
Your healthcare provider will ask about your symptoms, examine your eyes, and do tests. Tests you may have are:
You may be referred to a neuro-ophthalmologist (a healthcare provider who specializes in the eye and its relationship to the brain) or a neurologist.
The treatment of an optic nerve stroke depends on the cause. If there is high pressure in the eye, medicine to lower the pressure may improve blood flow to the optic nerve. If the cause is giant cell arteritis, it is treated with steroid medicines, such as prednisone.
Taking low dose aspirin may reduce the risk of an optic nerve stroke in the other eye.
After an optic nerve stroke, you may have permanent loss of some vision in one eye. Some people’s vision improves over several weeks or months after the stroke. Some people have problems with glare, and with seeing contrast (such as telling colors apart).
There are no medicines or surgeries to reverse vision loss from an optic nerve stroke.