Thanks to Dr. Diana Sarkisyan for an outstanding case and presentation of likely NMO presenting as acute persistent vision loss.

Learning Points:

– Etiology of acute persistent vision loss can be divided into three broad categories: problems involving the media (keratitis, uveitis, vitreous hemorrhage), retina (CRAO, CVAO, retinal detachment) or optic nerve (ischemia, optic neuritis, or NMO).

-Neuromyelitis optica is an inflammatory disorder of the optic nerves and spinal cord which is distinct from optic neuritis. Diagnosis is made by MRI of brain and spine and seropositivity for NMO-IgG. Treatment includes high dose IV steroids and plasmapheresis for refractory cases.

– Click here for an article describing conditions requiring an emergent ophthalmologic consultation.