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Question: Can you identify this condition?

Zac Feilchenfeld and Edward Margolin
Canadian Family Physician November 2011, 57 (11) 1293;
Zac Feilchenfeld
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Edward Margolin
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Figure

A 78-year-old woman presents with a 1-day history of blurred vision in the right eye. She experienced the change suddenly and without any warning. She has also noticed a loss of appetite, a 5-kg weight loss, and headaches and pain in the neck and shoulder regions over the past 2 months. Upon questioning, she admits to pain in the jaw while chewing and scalp sensitivity (ie, tenderness to touch).

On examination, visual acuity is 20/25 in the left eye and she sees only hand motion in the right eye; there is a right relative afferent papillary defect. Results of fundoscopy reveal optic disk edema that has a chalky white colour. The left optic nerve appears normal. Both erythrocyte sedimentation rate and C-reactive protein levels are markedly elevated.

The most likely diagnosis is

  1. Nonarteritic anterior ischemic optic neuropathy

  2. Papilledema

  3. Optic neuritis

  4. Temporal arteritis

Answer on page 1296

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Canadian Family Physician: 57 (11)
Canadian Family Physician
Vol. 57, Issue 11
1 Nov 2011
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Question: Can you identify this condition?
Zac Feilchenfeld, Edward Margolin
Canadian Family Physician Nov 2011, 57 (11) 1293;

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