TY - JOUR T1 - Two rare causes of posterior ischaemic optic neuropathy: eosinophilic fasciitis and Wegener's granulomatosis JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 1066 LP - 1068 DO - 10.1136/bjo.86.9.1066-a VL - 86 IS - 9 AU - B Paul AU - A M McElvanney AU - S Agarwal AU - F E Bruckner AU - W Ayliffe Y1 - 2002/09/01 UR - http://bjo.bmj.com/content/86/9/1066.2.abstract N2 - Anterior ischaemic optic neuropathy (AION) and the need for its early diagnosis and treatment in temporal arteritis are well known especially because of the risk of bilateral blindness. Posterior ischaemic optic neuropathy (PION) is a rarer condition but has been described in systemic lupus erythematosus, polyarteritis nodosa, hypertension, diabetes, anterior carotid artery occlusion, blood loss, intraoperative hypotension, as well as temporal arteritis. We describe two cases of retrobulbar ischaemic optic neuropathy, one due to eosinophilic fasciitis and the other to Wegener's granulomatosis and discuss their presentation and management. An 87 year old woman, who was previously diagnosed with eosinophilic fasciitis, presented with acute visual loss of her right eye. Ten years earlier she had had a history of skin tightness and thickening affecting her arms, legs, and trunk but sparing her face. She had pain and swelling of her hands, early morning stiffness, but no Raynaud's phenomenon. Blood tests at the time showed an erythrocyte sedimentation rate (ESR) of 21 mm in the first hour, haemoglobin 12.7 g/dl, white cell count 7.6 × 109/l, of which 19% were eosinophils (1–6%). Eosinophilic fasciitis was diagnosed on the basis of her clinical picture and blood eosinophilia. She was also antinuclear antibody positive; anti-double stranded DNA antibodies, anti-neutrophil cytoplasmic antibodies (ANCA), and cardiolipin antibodies were negative and protein S and C normal and she had been started on prednisolone and aspirin. She had also had several transient ischaemic attacks involving the right side of her body with paraesthesia of her face, hand, and right foot, which lasted 5 minutes at a time. She had a history … ER -